Amniotic Band Syndrome: A Multidisciplinary Care Approach to the Treatment of a Rare Case.

Amniotic band syndrome (ABS) is a rare developmental disorder associated with defects such as syndactyly, facial and/or palatal clefts, and dental anomalies like malformed or impacted teeth. In this report, a patient with ABS was successfully treated with orthodontic, endodontic, and periodontal therapies. Cone beam computed tomography revealed a unique eruptive path of the impacted central incisor through the incisive canal and cleft area. The tooth was occlusally and functionally stable after 1 year of treatment. Multidisciplinary care was critical to the success of this case. Available literature on ABS is also briefly reviewed.

Regenerative Endodontic Treatment with Orthodontic Treatment in a Tooth with Dens Evaginatus: A Case Report with a 4-year Follow-up.

Dens evaginatus is a developmental tooth anomaly in which an extra cusp or tubercle protrudes on the occlusal surface of the tooth along with some pulpal tissue. Because of the fragile nature of the protrusion, these teeth are often at risk of pulpal exposure. When this occurs in an immature tooth, regenerative endodontic treatment may be a good treatment approach to promote root formation. There is limited literature that documents the occurrence of orthodontic treatment in teeth that have undergone regenerative endodontic therapy using triple antibiotic paste. Here we present a case of an immature premolar tooth with dens evaginatus that was diagnosed with pulp necrosis and chronic apical abscess. The tooth was treated with regenerative endodontic treatment; after which, the patient received orthodontic treatment with fixed appliances for 2 years. The tooth responded favorably to the regenerative endodontic treatment and orthodontic tooth movement. Clinically and radiographically, all the follow-up examinations revealed an asymptomatic tooth with evidence of periapical healing with stunted root development. The tooth remained asymptomatic even after 4 years. The regenerative endodontic procedure (REP) was successful in treating an immature permanent premolar with pulp necrosis and apical periodontitis with dens evaginatus. In this case, the tooth treated with an REP responded to orthodontic treatment similar to the nonendodontically treated teeth. Further studies are recommended to clarify the precise effects of orthodontic treatment on teeth treated with an REP.

A comparison of two gutta-percha obturation techniques to replicate canal irregularities in a split-tooth model.

OBJECTIVE: The purpose of this study was to compare a modified injectable gutta-percha (MIGP) obturation technique with continuous wave technique (CWT) for the ability to fill the root canal system (RCS) and replicate artificially created intracanal defects at the apical third, using a split-tooth model. STUDY DESIGN: A maxillary canine was use to build a split-tooth model. The root canal was cleaned and shaped using crown-down technique with rotary files to size #40 at the apex. Intracanal defects were created in the dentin of the root canal walls with a half-round bur at the apical third. The canal was obturated 48 times with gutta-percha and sealer. Twenty-four obturations were performed for each technique, MIGP and CWT. After each obturation, the model was separated in 2 halves; buccal and lingual. Each obturation was examined and photographed under operating microscope at ×5 magnification. The images were blindly evaluated by 2 endodontists for the length of gutta-percha fill, ability to fill the RCS, presence of voids, and replication of the canal defects. RESULTS: Results were analyzed with the Mann-Whitney U test and showed statistical difference between the 2 groups in the quality of the obturation (P < .05). CONCLUSIONS: The MIGP technique appeared to replicate the canal defects at the apical third better than CWT, with fewer voids in between the canal walls and the gutta-percha mass.

A comparative evaluation of the sealing ability of 2 root-end filling materials: an in vitro leakage study using Enterococcus faecalis.

OBJECTIVE: The purpose of this study was to evaluate the sealing ability of EndoSequence Bioceramic Root-end Repair (BCRR) material when compared with white mineral trioxide aggregate (WMTA). STUDY DESIGN: Forty single-rooted teeth were instrumented, obturated with gutta-percha, root-end resected, and retrofilled with 2 different materials: white ProRoot MTA (WMTA) (n = 15) and BCRR (n = 15). Unfilled specimens (n = 10) received no retrofill and were used as controls. All groups received E. faecalis in a created reservoir coronal to the root filling and the presence of microleakage was evaluated by counting the colony-forming units from each specimen. The results were analyzed with 1-way analysis of variance. RESULTS: There was no significant difference in leakage between the 2 experimental groups, but there was a significant difference with the control (P ≤ .05). CONCLUSIONS: This study suggests that BCRR is equivalent in sealing ability to WMTA when used as root-end filling material in vitro.