Palato-gingival groove: An innocuous culprit for endo-perio lesion

This case report represents the clinical management of tooth with palato-gingival groove in a right maxillary lateral incisor with endo-perio lesion leading to dento-alveolar abscess and sinus tract. The right maxillary lateral incisor was examined clinico-radiographically. On clinical examination, the offending tooth revealed localized swelling and an intraoral draining sinus pointing on the labial gingiva without any evidence of caries, discoloration and trauma. The palatal surface of lateral incisor showed a groove with mild calculus embedded in it. The radiographic examination revealed periapical radiolucency. This case provides an evidence of morphological defect of tooth. Complete clinical and radiological examination and adequate knowledge of such morphological/ developmental defects of teeth are necessary for recognition and identification especially because of their diagnostic complexity and further consequences.

Conduction of reparative dentin: A pulp protecting approach by indirect pulp capping in deep carious lesion with biodentine

This case report represents, the treatment of deep carious lesion in a male was done by using indirect pulp capping with biodentine. The clinical and radiological outcomes were evaluated. The patient was presented with mild to moderate sensitivity on thermal (cold) stimulation and discomfort associated with eating in the left mandibular first molar. The clinicoradiographical examination revealed a distoocclusal carious lesion, very close to the pulp, absence of radiolucencies in the periapical region and no periodontal space widening. Pulp sensitivity was confirmed by thermal pulp vitality test. Indirect pulp capping treatment was performed with biodentine. Following 6 months of the treatment, the clinical symptoms were resolved and a calcific bridge was found at the dentin over the pulp and biodentine interface that was indicative the evidence of reparative dentin formation

Evaluation of clinical and radiological outcomes of mineral trioxide aggregate and calcium hydroxide as indirect pulp capping agents in the treatment of deep carious lesion of permanent teeth

The maintenance of pulp vitality and conduction of reparative dentin can be possible by indirect pulp capping with mineral trioxide aggregate (MTA) and calcium hydroxide as pulp capping agents. The objective of the study is to assess the clinical and radiological outcomes of MTA and calcium hydroxide as indirect pulp capping agents in deep carious lesions of permanent teeth. The present study included 50 permanent teeth having deep carious lesions with reversible pulp status were selected and then randomly divided into two groups of 25 teeth in a group. Standard indirect pulp capping procedures were followed. Patients were recalled at 3, 6 and 12 months interval to assess postoperative pain, the vitality of the pulp and formation of reparative dentin. In all observation periods, MTA showed more capable of reducing pain and maintain pulp vitality which was statistically significant than that of calcium hydroxide. At 12 months observation period, 24 teeth (96%) of MTA and 19 teeth (76%) of calcium hydroxide showed reparative dentin formation. It can be concluded that MTA is more effective than that of calcium hydroxide.

Evaluation of clinical and radiological outcomes of mineral trioxide aggregate and calcium hydroxide as indirect pulp capping agents in the treatment of deep carious lesion of permanent teeth

The maintenance of pulp vitality and conduction of reparative dentin can be possible by indirect pulp capping with mineral trioxide aggregate (MTA) and calcium hydroxide as pulp capping agents. The objective of the study is to assess the clinical and radiological outcomes of MTA and calcium hydroxide as indirect pulp capping agents in deep carious lesions of permanent teeth. The present study included 50 permanent teeth having deep carious lesions with reversible pulp status were selected and then randomly divided into two groups of 25 teeth in a group. Standard indirect pulp capping procedures were followed. Patients were recalled at 3, 6 and 12 months interval to assess postoperative pain, the vitality of the pulp and formation of reparative dentin. In all observation periods, MTA showed more capable of reducing pain and maintain pulp vitality which was statistically significant than that of calcium hydroxide. At 12 months observation period, 24 teeth (96%) of MTA and 19 teeth (76%) of calcium hydroxide showed reparative dentin formation. It can be concluded that MTA is more effective than that of calcium hydroxide.

Reattachment of fractured anterior tooth fragment: An approach in endo esthetic view

Esthetic rehabilitation of crown fractured anterior teeth is one of the greatest challenges to the dental specialists in concern of long-term biological function. Traditional views demonstrate limitations with much controversy in MICD (Minimally invasive cosmetic dentistry) concept. To meet the challenge a new biological approach in endo esthetic view is considered. This case report represents the management of a fractured right maxillary central incisor tooth of 27 year-old-male patient where his own fractured tooth fragment restored by reattachment technique. The clinical examination revealed complicated crown fracture extended horizontally from mesial to distal and angulated incisally from palatal to labial with pulp exposure. The fracture was not evident labially. In this case, the procedure was used to repair the fracture tooth fragment included root canal treatment and glass fiber post for reinforcement. The tooth fragment was luted with light activated flowable composite resin.  Onward assessment showed a stable reattachment, good esthetic and function with healthy periodontium.

Palato-gingival groove: An innocuous culprit for endo-perio lesion

This case report represents the clinical management of tooth with palato-gingival groove in a right maxillary lateral incisor with endo-perio lesion leading to dento-alveolar abscess and sinus tract. The right maxillary lateral incisor was examined clinico-radiographically. On clinical examination, the offending tooth revealed localized swelling and an intraoral draining sinus pointing on the labial gingiva without any evidence of caries, discoloration and trauma. The palatal surface of lateral incisor showed a groove with mild calculus embedded in it. The radiographic examination revealed periapical radiolucency. This case provides an evidence of morphological defect of tooth. Complete clinical and radiological examination and adequate knowledge of such morphological/ developmental defects of teeth are necessary for recognition and identification especially because of their diagnostic complexity and further consequences.

Evaluation of clinical and radiological outcomes of mineral trioxide aggregate and calcium hydroxide as indirect pulp capping agents in the treatment of deep carious lesion of permanent teeth

The maintenance of pulp vitality and conduction of reparative dentin can be possible by indirect pulp capping with mineral trioxide aggregate (MTA) and calcium hydroxide as pulp capping agents. The objective of the study is to assess the clinical and radiological outcomes of MTA and calcium hydroxide as indirect pulp capping agents in deep carious lesions of permanent teeth. The present study included 50 permanent teeth having deep carious lesions with reversible pulp status were selected and then randomly divided into two groups of 25 teeth in a group. Standard indirect pulp capping procedures were followed. Patients were recalled at 3, 6 and 12 months interval to assess postoperative pain, the vitality of the pulp and formation of reparative dentin. In all observation periods, MTA showed more capable of reducing pain and maintain pulp vitality which was statistically significant than that of calcium hydroxide. At 12 months observation period, 24 teeth (96%) of MTA and 19 teeth (76%) of calcium hydroxide showed reparative dentin formation. It can be concluded that MTA is more effective than that of calcium hydroxide.

Reattachment of fractured anterior tooth fragment: An approach in endo esthetic view

Esthetic rehabilitation of crown fractured anterior teeth is one of the greatest challenges to the dental specialists in concern of long-term biological function. Traditional views demonstrate limitations with much controversy in MICD (Minimally invasive cosmetic dentistry) concept. To meet the challenge a new biological approach in endo esthetic view is considered. This case report represents the management of a fractured right maxillary central incisor tooth of 27 year-old-male patient where his own fractured tooth fragment restored by reattachment technique. The clinical examination revealed complicated crown fracture extended horizontally from mesial to distal and angulated incisally from palatal to labial with pulp exposure. The fracture was not evident labially. In this case, the procedure was used to repair the fracture tooth fragment included root canal treatment and glass fiber post for reinforcement. The tooth fragment was luted with light activated flowable composite resin.  Onward assessment showed a stable reattachment, good esthetic and function with healthy periodontium