Main Article Content
Abstract
Trauma induced periapical lesions often require complex treatment, as conventional root canal therapy poses a high risk of failure due to apical transportation of infection. However, complete crown fractures with a fracture line close to the gingiva or extending subgingivally may require orthodontic extrusion to re-establish the biologic width thereby achieving aesthetic and functional restoration of the tooth. The purpose of this case report is to suggest an alternative treatment approach to achieve healing of periapical lesions and causing extrusion of the teeth by moving the fracture line above the supragingival level for final aesthetic and functional restoration. This case report discusses the management of an anterior tooth with long-standing subgingival fracture and large cyst-like periapical lesion using apicoectomy and orthodontic extrusion with a removable appliance.
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References
- Graunaite I, Lodiene G, Maciulskiene V. Pathogenesis of apical periodontitis: a literature review. Journal of Oral & Maxillofacial Research 2012;2(4):e1.
- Morrison A. Periapical (dental) granuloma. https://www.pathologyoutlines.com/topic/mandiblemaxilladentalgranuloma.html. Accessed May 10th, 2021.
- Shashant A, Agrawal E, Mushtaq I, et al. Apicoectomy: an elucidation to a hitch. J Dent Specialities 2019;7(1):28-32.
- Von Arx T. Apical surgery: a review of current techniques and outcome. Saudi Dent J 2011;23(1):9-15.
- Elkhadem A, Mickan S, Richards D. Adverse events of surgical extrusion in treatment for crown–root and cervical root fractures: a systematic review of case series/reports. Dental Traumatology 2014;30(1):1-4.
- Andreasen JO. Relationship between cell damage in the periodontal ligament after replantation and subsequent development of root resorption. A time-related study in monkeys. Acta Odontol Scand 1981;39(1):15-25.
- Heithersay GS. Combined endodontic-orthodontic treatment of transverse root fractures in the region of the alveolar crest. Oral Surg Oral Med Oral Pathol 1973;36(3):404-15.
- Proffit WR. Contemporary Orthodontics. 3rd edn. St. Louis, Mosby 2000.
- Walton RE, Torabinejad M. Management of traumatized teeth. In: Principles and Practice of Endodontics. 3rd edn. Philadelphia, Pa, USA: Saunders 2002: p. 445-65.
- Garlapati R, Venigalla BS, Patil JD, et al. Surgical management of mandibular central incisors with dumbbell shaped periapical lesion: a case report. Case Rep Dent 2014;2014:769381.
- Natkin E, Oswald RJ, Carnes LI. The relationship of lesion size to diagnosis, incidence, and treatment of periapical cysts and granulomas. Oral Surgery Oral Medicine and Oral Pathology 1984;57(1):82-94.
- Pawar AM, Kokate SR, Shah RA. Management of a large periapical lesion using Biodentine TM as retrograde restoration with eighteen months evident follow - up. J Conserv Dent 2013;16(6):573-5.
- Mortensen H, Winther JE, Birn H. Periapical granulomas and cysts. An investigation of 1,600 cases. Scand J Dent Res 1970;78(3):241-50.
- Rani N, Gupta RK, Karode A. Surgical endodontic management after conventional root canal treatment failure: a case report. International Journal of Oral Health Dentistry 2018;4(1):52-4.
References
Graunaite I, Lodiene G, Maciulskiene V. Pathogenesis of apical periodontitis: a literature review. Journal of Oral & Maxillofacial Research 2012;2(4):e1.
Morrison A. Periapical (dental) granuloma. https://www.pathologyoutlines.com/topic/mandiblemaxilladentalgranuloma.html. Accessed May 10th, 2021.
Shashant A, Agrawal E, Mushtaq I, et al. Apicoectomy: an elucidation to a hitch. J Dent Specialities 2019;7(1):28-32.
Von Arx T. Apical surgery: a review of current techniques and outcome. Saudi Dent J 2011;23(1):9-15.
Elkhadem A, Mickan S, Richards D. Adverse events of surgical extrusion in treatment for crown–root and cervical root fractures: a systematic review of case series/reports. Dental Traumatology 2014;30(1):1-4.
Andreasen JO. Relationship between cell damage in the periodontal ligament after replantation and subsequent development of root resorption. A time-related study in monkeys. Acta Odontol Scand 1981;39(1):15-25.
Heithersay GS. Combined endodontic-orthodontic treatment of transverse root fractures in the region of the alveolar crest. Oral Surg Oral Med Oral Pathol 1973;36(3):404-15.
Proffit WR. Contemporary Orthodontics. 3rd edn. St. Louis, Mosby 2000.
Walton RE, Torabinejad M. Management of traumatized teeth. In: Principles and Practice of Endodontics. 3rd edn. Philadelphia, Pa, USA: Saunders 2002: p. 445-65.
Garlapati R, Venigalla BS, Patil JD, et al. Surgical management of mandibular central incisors with dumbbell shaped periapical lesion: a case report. Case Rep Dent 2014;2014:769381.
Natkin E, Oswald RJ, Carnes LI. The relationship of lesion size to diagnosis, incidence, and treatment of periapical cysts and granulomas. Oral Surgery Oral Medicine and Oral Pathology 1984;57(1):82-94.
Pawar AM, Kokate SR, Shah RA. Management of a large periapical lesion using Biodentine TM as retrograde restoration with eighteen months evident follow - up. J Conserv Dent 2013;16(6):573-5.
Mortensen H, Winther JE, Birn H. Periapical granulomas and cysts. An investigation of 1,600 cases. Scand J Dent Res 1970;78(3):241-50.
Rani N, Gupta RK, Karode A. Surgical endodontic management after conventional root canal treatment failure: a case report. International Journal of Oral Health Dentistry 2018;4(1):52-4.