Is endodontic treatment necessary during coronectomy procedure?

PURPOSE: Close proximity of the inferior alveolar nerve (IAN) to the third molar roots can result in nerve injuries during extraction of third molars. Consequently, it is necessary to determine the relationship of the nerve and roots to avoid damage to the IAN. Computed tomography scans are widely used to determine the correct relationship between the IAN and lower third molars. PATIENTS AND METHODS: The study consisted of 10 patients with 16 lower third molars in close relationship with the IAN who were divided into a study group and a control group. The patients in the study group were treated via coronectomies performed with endodontic treatments. The patients in the control group underwent coronectomies without endodontic treatment. The patients were followed up for at least 1 year. RESULTS: We had to extract 7 of the roots because of the infection in 8 patients belonging to the study group, which were treated endodontically. Moreover, there were 3 cases of IAN damage because of the extraction in the study group. However, in the control group, no infection was determined and IAN damage was absent. CONCLUSION: Coronectomy appears to be a reliable technique to protect the IAN from damage. This procedure has a low incidence of complications. Endodontic treatment does not affect the success of this method according to our results.

Decoronation of an ankylosed permanent incisor: alveolar ridge preservation and rehabilitation by an implant supported porcelain crown.

Replacement resorption and ankylosis are frequently diagnosed following severe dental trauma. The complications that may develop as a result of ankylosis of a permanent incisor in children and adolescent include: esthetic compromise, orthodontic complications because of: arch irregularity; lack of mesial drift; tilting of adjacent teeth, arch length loss and local arrest of alveolar ridge growth. To avoid such complications, an ankylosed tooth should be removed before the changes become so pronounced that they compromise future prosthetic treatment. The purpose of this article was to present a case of preservation of the alveolar ridge for implant rehabilitation by utilizing decoronation for the treatment of a young permanent central incisor. An implant was inserted, without any bone augmentation procedures, followed by prosthetic porcelain crown rehabilitation. We conclude that treatment of an ankylosed young permanent incisor by decoronation may maintain the alveolar bone ridge width, height and continuity, and facilitate future rehabilitation with minimal, if any, ridge augmentation procedures.

Efficacy of Autologous Platelet Concentrates in Regenerative Endodontic Treatment: A Systematic Review of Human Studies.

INTRODUCTION: The latest research concerns the use of platelet concentrates, which are introduced into the root canal. The aim of this study was to examine the effectiveness of platelet-rich fibrin and platelet-rich plasma in regenerative endodontics. METHODS: This literature review was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The literature search included all publications without a year limit. The last search was performed on January 31, 2018. An electronic search was performed using MEDLINE (PubMed), Cochrane, and Scopus. Articles were selected that addressed the following research question: Is the use of platelet concentrates effective in regenerative endodontics? The necessary information was extracted by 2 authors independently using a standardized form. RESULTS: The search resulted in 426 titles from all databases, and 26 studies met the inclusion criteria. Five were randomized trials, and the others were case reports. All described cases were asymptomatic. Only 3 cases from randomized trials were unsuccessful. Ten of the case reports found positive results for pulp vitality. In randomized trials, the teeth treated with platelet concentrates showed better results for pulp vitality. In almost all cases, they also described thickening and lengthening of the root wall and closure of the apical foramen, which are important for successful treatment of permanent teeth. CONCLUSIONS: This review showed that procedures using autologous platelet concentrates were successful in treating permanent teeth with root development. However, more long-term clinical studies are needed.

Advantages of the root submergence technique for pontic site development in esthetic implant therapy.

A single-tooth implant in the esthetic region has good potential for success, but it is still challenging to restore multiple-tooth defects with implant-supported prostheses that resemble the natural dentition. This article suggests a strategy to provide a more predictable protocol for esthetic implant treatment for multiple-tooth defects using the root submergence technique (RST). By maintaining the natural tooth root with the RST a much greater amount of surrounding tissue may be preserved than with the commonly used socket preservation technique, which almost always leads to crestal bone resorption and thus reduction of the height of the interdental papillae and width of the edentulous ridge. RST instead maintains the natural attachment apparatus of the tooth in the pontic site, which in turn allows for complete preservation of the alveolar bone frame and assists in the creation of an esthetic result in adjacent multiple-tooth-replacement cases. In situations with periodontal bone loss, orthodontic extrusion is required to create the underlying bone support for the papilla that is necessary to guarantee predictability.

Apexification in a nonvital tooth by control of infection.

Incomplete formation of roots in permanent dentition because of death of the pulps is fairly common. Various pastes are used in apexification procedures. It has been suggested that minimum mechanical intervention and removal of infection alone may be sufficient. A case is reported in which this was observed.

The case against the edentulous ridge--and an alternative.

Loss of alveolar bone height frequently occurs when all teeth have been extracted, and many consider this loss irreversible. Retaining teeth under complete and partial dentures is a way of preventing bone loss; this type of treatment should be considered more often to prevent the handicapping condition of edentulism.

The role of the overlay denture in the prevention of mandibular ridge atrophy.

The overlay denture concept may be used to postpone and in some cases avoid the atrophied mandibular ridge syndrome. The co-operation of the patient is a vital factor for success and the treatment regimen is divided into a series of self-contained stages to allow the patient to demonstrate his mastery of each before proceeding to the next. Function in the edentate can be enhanced by the use of this type of denture.

The retention of vital submucosal roots under immediate dentures: a surgical procedure.

An approach to soft tissue management and surgical crown/root sectioning for submucosal vital root retention has been presented. Attention to detail during soft tissue reflection, tooth sectioning, and the relaxing of attached mucogingival tissues is very important. Adequate healthy soft tissue is necessary for proper suturing over the retained roots. Postoperative complications are reduced by placement of well-fitted prostheses. Clinical evaluation of this technique has proved it to be highly successful.

Submucosal root retention. A two-year clinical observation.

Eight subjects had the crowns of 21 teeth surgically amputated, and the roots were covered by alveolar mucosa. At the time of surgery, 17 teeth were vital and four had received endodontic therapy. After an average 2-year-period, 12 teeth (57%) remained submerged without complications. Two roots have been extracted, three have been successfully converted to regular overdenture abutments, and the remaining four have appeared in the mouth and are still under observation. Caution is urged as to expectations of a long-term prosthetic benefit from this procedure.

Ideal arch force systems: a center-of-resistance perspective.

The analysis of force systems from an ideal arch has shown that the ratio of the moments produced by a straight wire connecting two malaligned brackets depends on the ratio of the angulations of the brackets to the interbracket axis. Although this result permits assessment of the relative forces and moments, prediction of future tooth movement requires knowledge of the position of center of resistance as well. In this study, the forces and moments produced by a straight portion of an arch wire were transferred from the brackets to the center of resistance. The purpose was to compare the force system at the brackets to the force system at the center of resistance and to assess whether bracket geometry can be applied to predict initial tooth movement. A computer model was used to simulate two teeth connected by a straight portion of wire. Forces and moments were calculated with the use of equations derived from elementary beam theory. The results show that the force system at the center of resistance may be of an entirely different "geometry" type than that at the bracket. Factors that influence the force system include the interbracket distance, the angulation of the teeth, the length of the tooth root, and the width of the bracket.

Vital root retention in humans: a final report.

A research protocal for submucosal vital root retention in humans has been developed based on laboratory animal studies. Procedures, patient management, and statistical results have been reported in a series of three articles. Changes in techniques have also been reported, along with explanation of a flowchart for tooth root retention and alveolar ridge preservation. Some ideas for future investigations are presented. Vital root retention in humans appears to be a valid means of retaining residual bony ridge tissues to a greater degree than when patients are rendered totally edentulous.