Premium
Comprehensive management of a complex traumatic dental injury
Author(s) -
Cotti Elisabetta,
Esposito Stefano,
Jacobs Reinhilde,
Slagmolen Pieter,
Bakland Leif K.
Publication year - 2014
Publication title -
dental traumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.82
H-Index - 81
eISSN - 1600-9657
pISSN - 1600-4469
DOI - 10.1111/edt.12064
Subject(s) - medicine , crown (dentistry) , dentistry , root canal , radiodensity , cone beam computed tomography , lesion , apexification , orthodontics , dental trauma , maxillary central incisor , radiography , computed tomography , surgery
A 24‐year‐old female patient presented with complaint of palatal swelling and a sinus tract facial to tooth #22. She reported an injury to the tooth 15 years earlier and no recollection of treatment, although there was evidence of an endodontic access into the crown. Radiographically the root appeared to have stopped developing, and it was associated with a large periapical lesion. After 3 unsuccessful attempts at apexification using calcium hydroxide ( CH ), further examination including use of cone‐beam computed tomography ( CBCT ) was carried out. The latter allowed for better evaluating the situation and for better planning a more comprehensive treatment plan to include surgical removal of the apical lesion. The large radiolucent area extended from tooth #21 to #23. Using a dedicated software tool developed to be used in conjunction with CBCT , volumetric assessment of the lesion was carried out for healing follow up. The root end was filled from the apical direction with newly developed accelerated silicate cement 4–5 mm into the apical part of the canal. Subsequently, the rest of the canal was filled with the same type of cement. At the 1‐year postsurgical follow up, the tooth remained asymptomatic, and using the CBCT volumetric program, bony healing could be demonstrated.