Novel management of internal root resorption with vertical root fracture using mineral trioxide aggregate - A case report.

Introduction: This case report presents the diagnosis and management of extensive internal root resorption (IRR) in a 17-year-old male patient, with a 9-year-old history of trauma. Method: The affected tooth 21 was associated with vertical root fracture (VRF) and incomplete apex closure with a substantial loss of tooth structure, including dentin and cementum. Encouraged by a healthy periodontal condition, the choice was made to use mineral trioxide aggregate (MTA) to reconstruct and reinforce the resorptive defect and the fractured segment. A composite veneer was placed to enhance the aesthetics. Result: A follow-up of the patient after 2 years revealed healing with a resolution of the lesion. Conclusion: This case report highlights the use of MTA as a lone-standing filling material for the treatment of IRR with VRF in a non-vital immature tooth.

An In Vitro Evaluation of Fracture Resistance of Endodontically Treated Maxillary Central Incisor Restored with Custom-Made Cast Post and Core with Uniform and Nonuniform Core Ferrule Heights.

AIM: The aim of this study was to evaluate in vitro fracture resistance of endodontically treated teeth restored with custom-made cast post and core having uniform and nonuniform core ferrule heights. MATERIALS AND METHODS: Thirty-five freshly extracted human maxillary central incisors were included in this study. All teeth were subjected to standard root canal treatment. The teeth were randomly divided into five groups-Group 1: uniform ferrule (2 mm buccal, lingual, and proximal), Group 2: uniform ferrule (3 mm buccal, lingual, and proximal), Group 3: nonuniform ferrule (2 mm buccal, 3 mm lingual), Group 4: nonuniform ferrule (2 mm buccal, 4 mm lingual), and Group 5: no ferrule. The teeth were sectioned horizontally 4 mm above cementoenamel junction and post space preparation was performed maintaining 4 mm of apical gutta-percha. Ferrule was prepared according to dimension designated for each group. Custom-made cast post and core were fabricated and luted using zinc phosphate cement. Testing was conducted using universal testing machine with application of static load (Newton), and failure load was recorded. Data were analyzed by one-way analysis of variance and Tukey test. The mode of fracture was noted by visual inspection for all specimens. RESULT: Significant differences (P < 0.001) were found among mean fracture forces of test groups. Group 1: 1181.66 ± 68.29, Group 2: 1455.58 ± 173.11, Group 3: 1019.00 ± 52.55, Group 4: 971.58 ± 66.52, and Group 5: 888.00 ± 60.56. The presence of nonuniform ferrule height resulted in a significant decrease (P < 0.0001) in mean fracture strength compared to uniform 2- and 3-mm core ferrule height. CONCLUSION: The central incisors restored with cast post and core and crowns with 3-mm uniform core ferrule were more fracture resistant compared to central incisors with nonuniform core ferrule height. Both the uniform and nonuniform core ferrule groups were more fracture resistant than the group that lacked ferrule.

Mandibular first molar having an unusual mesial root canal morphology with contradictory cone-beam computed tomography findings: a case report.

INTRODUCTION: The objective of this article is to highlight the importance of having a thorough knowledge about the root canal anatomy and the possibility of misleading findings in the cone-beam computed tomography (CBCT) images. METHODS: This case report presents the endodontic management of a right mandibular first molar with 2 roots and 2 canals. A CBCT imaging was performed to ascertain this rare root canal anatomy. RESULTS: The clinical and radiographic diagnosis of the existence of a single root canal within the mesial root of mandibular first molar did not correlate with the CBCT findings. CONCLUSIONS: The confirmative diagnosis should be based on cognitive deduction of the clinical picture and intelligent interpretation of radiologic information.