MyMedR

Fulltext Management of symptomatic intra-alveolar mid-root fracture with displaced and infected apical fragment

Varghese LL, Bhattacharya A, Sahu GK, Consul S

BMJ Case Rep, 2021 Feb 18;14(2).

PMID: 33602766 DOI: 10.1136/bcr-2020-239382

Matched MeSH terms: Tooth Fractures*

Othman NH, Rajali A, Zulkifeli NRN, Shaharuddin IM, Hussein KH, Hassan MIA

Spec Care Dentist, 2024;44(1):221-230.

BACKGROUND: Athletes with disabilities may be at an even greater risk of orofacial trauma than their counterparts, and the risk may vary depending on the type of sports. This study aimed to assess the incidence of sports-related dental injuries and oral health status among Malaysian para-athletes.

METHODS: A questionnaire survey was conducted to assess self-reported dental injuries and knowledge of their management. An intraoral examination was performed using the decayed, missing, and filled teeth (DMFT) index following the World Health Organization guidelines.

RESULTS: A total of 61 para-athletes (men = 90.16%, n = 55; women = 9.84%, n = 6) from different sports categories with different disabilities randomly participated in this study. The incidence of self-reported dental injuries was 18.0% (n = 11), with the most common injury being crown tooth fracture (72.7%) and lip laceration (63.6%). However, the majority of the athletes (70.5%, n = 43) did nothing after experiencing dental trauma, and 82.0% (n = 50) were unaware of the immediate management of dental trauma. Based on the intraoral examination, only 9.8% (n = 6) of the athletes had perfectly sound teeth. The mean total DMFT index was 3.49 ± 2.371, while the mean DMFT index for decayed, missing, and filled teeth was 1.28 ± 1.293, 0.74 ± 0.705, and 1.48 ± 1.120, respectively. The mean DMFT index for decayed, missing, and filled teeth and total DMFT index significantly differed among the types of disabilities (P .05).

CONCLUSION: The most commonly reported injuries among para-athletes are crown tooth fractures and lip lacerations. The total DMFT index among para-athletes is moderate, emphasising the need for improvements.

Matched MeSH terms: Tooth Fractures*

Dens evaginatus on a wisdom tooth: a diagnostic dilemma. Case report

Ngeow WC, Chai WL

Aust Dent J, 1998 Oct;43(5):328-30.

PMID: 9848984

Pericoronitis is the most common odontogenic problem associated with the wisdom tooth in young men and women. Patients may present with problems associated with infection, swelling and pain. However, other associated pathology such as caries, periodontal disease and referred pain from the temporomandibular joint must be investigated when treating pain from the wisdom tooth. The authors wish to present a case in which the pain from a wisdom tooth was due to a fractured dens evaginatus. The importance of this dental anomaly should not be overlooked.

Matched MeSH terms: Tooth Fractures/diagnosis*

A study of traumatised permanent anterior teeth in a school population

Meon R

Singapore Dent J, 1986 Jul;11(1):19-21.

PMID: 3472352

Matched MeSH terms: Tooth Fractures/epidemiology*

The effect of fiber post location on fracture resistance of endodontically treated maxillary premolars

Sulaiman E, Alarami N, Wong YI, Lee WH, Al-Haddad A

Dent Med Probl, 2018 10 18;55(3):275-279.

PMID: 30328305 DOI: 10.17219/dmp/94656

BACKGROUND: There is no sufficient literature on the effect of post location on endodontically treated premolar teeth with 2 roots.

OBJECTIVES: The aim of the study was to evaluate the effect of fiber post location on fracture resistance and failure mode of endodontically treated premolars with 2 roots.

MATERIAL AND METHODS: Fifty extracted maxillary first premolars with 2 roots were divided randomly into 5 groups. Group 1 was comprised of sound teeth, which received only metal crowns (control). Teeth from groups 2, 3, 4, and 5 were decoronated 2 mm above the cementoenamel junction (CEJ) and were endodontically treated. No post was placed in group 2 teeth. Teeth from groups 3, 4 and 5 were given a fiber post placed in the buccal canal, palatal canal, and both buccal and palatal canals, respectively. All teeth in groups 2, 3, 4, and 5 were built up with composite and full coverage metal crowns. A compressive static load was applied at an angle of 25° to the crowns with a crosshead speed of 0.5 mm/min, until fracture.

RESULTS: One-way analysis of variance (ANOVA) showed significant differences among the groups (p = 0.002). A post hoc test showed significantly lower fracture resistance of group 4 compared to group 5 (p = 0.011). Furthermore, group 2 had significantly less fracture resistance compared to group 1 (p = 0.021) and group 5 (p = 0.002). According to Fisher's exact test, different post locations are non-significantly associated with fracture mode (p = 0.256).

CONCLUSIONS: Fiber post location has a significant effect on fracture resistance of severely damaged, endodontically treated maxillary premolars with 2 roots. However, post placement in the palatal root is preferred, as it maintains the restorability of the tooth.

Matched MeSH terms: Tooth Fractures/prevention & control*

Current strategies for conservative endodontic access cavity preparation techniques-systematic review, meta-analysis, and decision-making protocol

Ballester B, Giraud T, Ahmed HMA, Nabhan MS, Bukiet F, Guivarc'h M

Clin Oral Investig, 2021 Nov;25(11):6027-6044.

PMID: 34623506 DOI: 10.1007/s00784-021-04080-7

OBJECTIVES: To assess related studies and discuss the clinical implications of endodontic access cavity (AC) designs.

MATERIALS AND METHODS: A systematic review of studies comparing the fracture resistance and/or endodontic outcomes between different AC designs was conducted in two electronic search databases (PubMed and Web of Science) following the PRISMA guidelines. Study selection, data extraction, and quality assessment were performed. Meta-analyses were undertaken for fracture resistance and root canal detection, with the level of significance set at 0.05 (P = 0.05).

RESULTS: A total of 33 articles were included in this systematic review. The global evaluation of the risk of bias in the included studies was assessed as moderate, and the level of evidence was rated as low. Four types of AC designs were categorized: traditional (TradAC), conservative (ConsAC), ultraconservative (UltraAC), and truss (TrussAC). Their impact on fracture resistance, cleaning/disinfection, procedural errors, root canal detection, treatment time, apical debris extrusion, and root canal filling was discussed. Meta-analysis showed that compared to TradAC, (i) there is a significant higher fracture resistance of teeth with ConsAC, TrussAC, or ConsAC/TrussAC when all marginal ridges are preserved (P 0.05), and (iii) there is a significantly higher risk of undetected canals with ConsAC if not assisted by dental operating microscope and ultrasonic troughing (P tooth structure are lost. To date, the evidence available does not support the application of TrussAC. UltraAC might be applied in limited occasions.

CLINICAL RELEVANCE: Maintaining the extent of AC design as small as practical without jeopardizing the root canal treatment quality remains a pragmatic recommendation. Different criteria can guide the practitioner for the optimal extent of AC outline form which varies from case to case.

Matched MeSH terms: Tooth Fractures*

Fulltext Unusual migratory foreign body in the neck

Sreetharan SS, Prepageran N, Satwant S

Singapore Med J, 2004 Oct;45(10):487-8.

PMID: 15455170

Reports of ingested foreign bodies penetrating the pharynx and migrating through the neck are rare, and mostly involved fish bones. We describe a 44-year-old man who was involved in a motor vehicle accident and accidentally swallowed his tooth. The swallowed tooth penetrated the pharynx and became lodged adjacent to his right thyroid gland. It was successfully removed via neck exploration and the patient recovered well.

Matched MeSH terms: Tooth Fractures/complications

Traumatized anterior teeth in children. A 24-month follow-up study

Rusmah M

Aust Dent J, 1990 Oct;35(5):430-3.

PMID: 2073190

The objectives of this Malaysian study were to investigate the relationship between severity of trauma and interval before treatment, and the effect of delayed treatment on prognosis. A total of 123 traumatized permanent incisors were observed over a 24-month period. Results of this study suggest that the interval between trauma and emergency treatment is directly related to the severity of injury and the level of dental awareness of the patients. However, prognosis of these teeth is greatly influenced by the interval between trauma and initial treatment. Pathological pulp changes in these teeth can occur as late as two years after injury and this justifies the necessity for a long observation period following treatment.

Matched MeSH terms: Tooth Fractures/pathology*; Tooth Fractures/therapy

Treatment of root fracture with accompanying resorption using cermet cement

Lui JL

Endod Dent Traumatol, 1992 Feb;8(1):36-8.

PMID: 1396360

A method of treating an apical root fracture with accompanying resorption at the junction of the fracture fragments using glass-cermet cement is described. Endodontically, the material had previously been used for repair of lateral resorptive root defects and retrograde root fillings. Complete bone regeneration was observed three years post-operatively following treatment of the root fracture in the conventional manner. The various advantages of glass-cermet cement as a root filling material used in the technique described are discussed.

Matched MeSH terms: Tooth Fractures/complications; Tooth Fractures/therapy*

Fulltext Management and prognosis of teeth with trauma induced crown fractures and large periapical cyst like lesions following apical surgery with and without retrograde filling

Ahmed HM, Al Rayes MH, Saini D

J Conserv Dent, 2012 Jan;15(1):77-9.

PMID: 22368341 DOI: 10.4103/0972-0707.92612

Crown fractures are common detrimental consequences of dental traumatic injuries. Early management of such cases is mandatory in order to prevent subsequent pathological changes that could further complicate the treatment. Pulp necrosis, chronic and cystic apical periodontitis can be the fate if these teeth are left untreated. Despite these serious complications, root canal treatment followed by apical surgery is considered a valid treatment option when such cases become complicated with large periapical lesions. However, whether a retrograde filling is essential to be placed or not is still a matter of debate. This case report discusses the orthograde endodontic management, the surgical approach and the clinical outcomes of longstanding crown fractured teeth with large cyst-like periapical lesions with and without retrograde filling.

Matched MeSH terms: Tooth Fractures

Fulltext Knowledge and attitude of teachers in selected Malaysian primary school towards dental injuries

Syazwani Hassan, Nur Nabila Zulkifly, Venkiteswaran, Annapurny, Rohaida Abdul Halim

Scientific Research Journal, 2018;15(2):51-66.

MyJurnal

To ascertain the level of knowledge among primary school teachers towards the management of traumatic dental injuries (TDIs) in school and to determine the preference among teachers regarding the education tools that can be used to increase awareness and knowledge among them. A total of 150 teachers from primary schools in three different districts were included in the study and they were given self-administered questionnaires to be filled. The validated questionnaire was distributed randomly in the selected schools. The questionnaire included two scenarios comprising of tooth fracture and avulsion. Questions regarding awareness and management of these scenarios were asked. All 150 participants answered the questionnaire; of these 74% were females 26% were males. 64% of the participants had received tertiary education. Although 70% of teachers had obtained first aid training, only 9.3% of them had received training regrading dental injuries. About 53% of participants knew the correct answer for the appropriate response to fractured tooth and only 35.3% managed to correctly answer the question related to appropriate response to an avulsed tooth. Only 38.7% knew about appropriate rinsing solution and a mere 4.7% were familiar with proper storage media. Even though the teachers have poor knowledge regarding management of dental injuries, it is reassuring to know that 93% of them are keen on further training and awareness. More educational programmes need to be introduced to empower the teachers with the relevant knowledge required to deal with dental emergencies.

Matched MeSH terms: Tooth Fractures

Fulltext Complicated crown root fracture treatment option: a case report

Sockalingam, S. Nagarajan M.P., Alida Mahyuddin

Archives of Orofacial Sciences, 2009;4(1):25-28.

MyJurnal

Complicated crown-root fractures are rare and often need complex treatment planning. This paper describes a simplified treatment option for a complicated crown root fracture that minimally encroached into the biologic region in a growing child without the need for surgery or orthodontic treatment.

Matched MeSH terms: Tooth Fractures

Fulltext Sectional Fixed Orthodontic Extrusion Technique in Management of Teeth with Complicated Crown-Root Fractures: Report of Two Cases

M P Sockalingam SN, Kong Loh Seu K, Mohamed Noor H, Irfani Zakaria AS

Case Rep Dent, 2018;2018:8715647.

PMID: 29581902 DOI: 10.1155/2018/8715647

Complicated crown-root fractures account for a small percentage of traumatic dental injuries seen in children; however, management of these injuries can be very challenging to clinicians. Factors such as complexity of the injury, patient's age and dentition stage, patient's cooperation, and parental demands may have some bearing on the type of treatment undertaken and its outcomes. In some children, these injuries may have significant impact on their quality of life. The purpose of this article is to describe two cases of complicated crown-root fracture which were successfully managed through orthodontic extrusion using a sectional fixed orthodontic technique. The basis for the treatment technique and its favourable outcomes were highlighted with its advantages and drawbacks.

Matched MeSH terms: Tooth Fractures

Paediatric mandibular fractures: report of a case

Qadri GW, Mokhtar SM

Dent Traumatol, 2008 Dec;24(6):e67-70.

PMID: 19021642 DOI: 10.1111/j.1600-9657.2008.00700.x

The conservative approach in the treatment of maxillofacial trauma in children has been widely adopted. The type of fracture and its presence within the growing facial skeleton along with the presence of tooth buds may result in different management strategies to that employed in adults. An understanding of conservative treatment options is essential to make informed choices which will best manage these injuries, and an example is presented in this paper. This case report describes a 14-year-old boy who sustained trauma to the chin as a result of a fall, causing a mandibular symphyseal fracture. He was successfully treated by the means of applying direct interdental wiring combined with an acrylic splint.

Matched MeSH terms: Tooth Fractures/therapy

Oral health status of 16-year-old school children in Malaysia

Nik-Hussein NN, Abdul Muttalib K, Junid NZ, Wan MN, Abang A

Singapore Dent J, 2004 Dec;26(1):30-8.

PMID: 15736839

The aim of the present study was to determine the oral health status of 16-year-old Malaysian school children. The prevalence of caries was 75.5%. More than 60% of subjects had caries experience by teeth (DMFT) scores of 0-3. The largest component of the DMFT and caries experience by surface index was the filled component. Females had higher caries prevalence and caries scores than males. The mouth and tooth prevalences of enamel defects were 56% and 21.8%, respectively. The most common type of enamel defects observed were diffuse opacities, affecting 95.5% of affected subjects and 92.1% of affected teeth. One-third of subjects had healthy gingival conditions, 8.6% had bleeding gingivae, 55.1% had calculus and 3% had pockets. Less than 1% of subjects wore or required dentures. Cleft lip and/or palate was uncommon. This study shows that the prevalence of caries and DMFT scores have declined over the last 30 years.

Matched MeSH terms: Tooth Fractures/epidemiology

Enhanced post crown retention in resin composite-reinforced, compromised, root-filled teeth: a case report

Lui JL

Quintessence Int, 1999 Sep;30(9):601-6.

PMID: 10765865

The introduction of an intraradicular composite reinforcing technique, in conjunction with the reestablishment of matching post canal spaces, has allowed compromised, root-filled teeth to be restored with functional, esthetic post crowns. This clinical case report suggests that reconstituted post canals, in accurately adapting to passive, parallel-sided, matching, and well-fitting posts, can enhance the retention of post crowns. Other factors of clinical importance relating to the resin-reinforced technique are discussed, including fracture resistance, depth of polymerization, dentin adhesion, polymerization shrinkage, and coronal microleakage.

Matched MeSH terms: Tooth Fractures/therapy

A case report of reattachment of fractured root fragment and resin-composite reinforcement in a compromised endodontically treated root

Lui JL

Dent Traumatol, 2001 Oct;17(5):227-30.

PMID: 11678543

The composite reinforcement technique has been used clinically to salvage damaged root-filled teeth compromised by caries, trauma, developmental abnormalities, internal resorption and iatrogenic causes. This clinical case report describes the use of the technique to reattach a fractured fragment in a compromised endodontically treated root besides reinforcing it for continued function in the mouth. Factors of clinical importance related to this additional application; including reattachment of tooth fragments, post crown retention, coronal microleakage and fracture resistance and strength, are also briefly discussed.

Matched MeSH terms: Tooth Fractures/therapy*

Fracture resistance of endodontically-treated mandibular molars restored with different intra-radicular techniques

Alarami N, Sulaiman E, Al-Haddad A

Am J Dent, 2017 Aug;30(4):197-200.

PMID: 29178701

PURPOSE: To evaluate fracture resistance and failure mode of endodontically-treated mandibular molars restored with different intra-radicular techniques.

METHODS: 75 human mandibular molars were randomly divided into five equal groups. Teeth were standardized, endodontically-treated and restored according the assigned group as follows: amalgam core only, prefabricated titanium post in the distal canal and amalgam core, composite core only; fiber post in the distal canal and composite core. One group of untreated sound teeth was used as a control. Non-precious metal crowns were fabricated and cemented on the prepared specimens with Rely X U200 resin cement. All specimens were subjected to a compressive load at crosshead speed 0.5 mm/minute, 25° to the long axis of the tooth. Failure loads and modes were recorded.

RESULTS: Mean failure loads among the groups were significantly different (P= 0.035). Post-hoc multiple pair-wise comparisons revealed the amalgam core and composite core groups produced significantly lower fracture resistance than the control group (P= 0.041 and P= 0.025, respectively) and no significant differences among the different intra-radicular techniques (P> 0.05). The composite core with fiber post and amalgam core with titanium posts showed the highest percentage of favorable failures (67%) and non-favorable failures (87%) respectively.

CLINICAL SIGNIFICANCE: The composite core with fiber post is the most appropriate intraradicular restoration in cases of severely compromised molars.

Matched MeSH terms: Tooth Fractures/prevention & control*

Predisposing factors and prevalence of fractured anterior teeth among 12 and 16 years old school Malaysian children

Gopinath VK, Ling KT, Haziani KN, Ismail NM

J Clin Pediatr Dent, 2008;33(1):39-42.

PMID: 19093650

This study reports on the predisposing factors and prevalence of fractured anterior teeth among 12 and 16 years-old school children in Kubang Kerian, Kelantan, West Malaysia.

Matched MeSH terms: Tooth Fractures/epidemiology*

Anterior tooth trauma in eleven-year-old South African children

Hargreaves JA, Matejka JM, Cleaton-Jones PE, Williams S

ASDC J Dent Child, 1995 Sep-Oct;62(5):353-5.

PMID: 8550926

Little new evidence on the prevalence of injury to the anterior teeth of children has been reported in the past five years and, in South Africa, trauma to the teeth of children in different ethnic groups has not been compared respectively. The purpose of this investigation was to determine the prevalence of dental trauma using well-defined criteria and to sample a specific age-group. Five regions were chosen and 1035 children in the eleven-year age-group were examined. No statistical significance was found between the ethnic groups related to the amount of injury sustained. For all groups, boys received more injuries than girls. The most common injury was fracture of the enamel of the maxillary central incisor. With 15 percent of the children receiving some level of trauma by age eleven years, this is one of the main dental treatment needs for South African children.

Matched MeSH terms: Tooth Fractures/ethnology; Tooth Fractures/epidemiology

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