Preorthodontic dilacerated incisive crown modification in a pediatric patient: a case report.

Dental dilacerations are abrupt deviations of the longitudinal axis of the crown or root portion of the tooth, caused by traumatic axial displacement of previously formed hard tissue in relation to the developing soft tissue. CASE PRESENTATION: A 13-year-old boy in good general health was referred for root canal treatment of the maxillary left central incisor, for which abnormal crown morphology impeded orthodontic treatment. He presented bilateral crown dilaceration at both maxillary central incisors. Treatment involved a CAD/CAM milled veneer of the maxillary left central incisor and semidirect warm composite veneer of the maxillary right central incisor. Follow-up and monitoring of the restoration was performed through .stl file analysis. DISCUSSION: Crown dilaceration severity assessment is crucial for deciding the best treatment plan for each case. In this patient, additive restorative protocols, CBCT, and 3D digital model analysis were the most useful aids by providing key multidisciplinary information. CONCLUSION: A multidisciplinary treatment workflow with a minimally invasive approach aided by digital tools such as CBCT and CAD/CAM technologies is useful to achieve successful and predictable outcomes in crown dilaceration cases.

Retrospective study of the long-term survival of 980 implants placed in a periodontal practice.

PURPOSE: To assess the long-term behavior of 980 implants placed in a private practice and evaluate the influence of periodontitis history and smoking habit on implant survival rates. MATERIALS AND METHODS: A retrospective review of clinical records of consecutively treated patients with Astra Tech implants was conducted. This review included all patients treated between February 1994 and January 2005. Clinical histories were reviewed, and data were gathered on clinical and radiographic examinations. A record was kept on smoking habits, periodontitis history, length and diameter of implant(s), and whether the sinus was elevated. Cumulative survival proportions analysis was performed, and Cox regression multivariate analysis modified for correlated dependent observations was also used, with the implant as the unit of analysis. RESULTS: A total of 323 patients (185 [57.3%] female; mean age, 55.4 +/- 15.2 years) received 980 implants. Of the implants evaluated in this study, 71.1% were placed in patients who were undergoing periodontal maintenance care and 38.8% were placed in smokers. The cumulative survival rate was 96.2% at 5 years; 4.3% of implants failed; 57.1% of failures occurred before implant loading. Tobacco use and periodontitis did not affect the risk of failure, and their interaction did not show significance (P = .386). Implants from individuals with many implants and those placed in patients with sinus elevation showed a higher risk of failure (P < .05). Regression analysis showed no significant interaction between periodontitis history, tobacco use, and implant failure. CONCLUSIONS: Implant placement is an effective and reliable long-term treatment, even in periodontal patients under maintenance care and with a smoking habit. Combined analysis of tobacco use and history of periodontitis showed no significant interaction with implant failure in this sample.