Immediate Surgical Repositioning Following Intrusive Luxation: A Case Report and Review of the Literature

This report presents a case of severe intrusive luxation of mature maxillary lateral incisor in a 10-year-old boy. The intruded tooth was immediately repositioned (surgical extrusion) and splinted within 2 h following injury. Tetracycline therapy was initiated at the time of repositioning and maintained for 10 days. Pulp removal and calcium hydroxide treatment of the root canal was carried out after repositioning. Splint was removed 1 month later. Definitive root canal treatment with gutta percha was accomplished at the second month recall. Clinical and radiographic examination 28 months after the surgical extrusion revealed satisfactory apical and periodontal healing

An evaluation of the effect of non-setting calcium hydroxide on human dentine: a pilot study.

AIM: To evaluate the effect of non-setting calcium hydroxide (NSCH) on the hardness and elastic modulus of dentine from extracted permanent premolar human teeth. METHODS: 30 freshly extracted single rooted human premolar teeth were decoronated and the roots then sectioned longitudinally into equal halves. In the experimental group a thin layer of NSCH was applied whilst the control group had no medicament. After 1, 3 and 6 months, nanoindentation was used to assess dentine hardness and the modulus of elasticity. Scanning Electron Microscopy (SEM) was used to visualize the depth of penetration of NSCH into the dentinal tubules. RESULTS: SEM images showed that there were no structural changes in the dentine slabs that had NSCH application after 1, 3 or even 6 months. However, penetration of NSCH into the dentine tubules was seen at both 3 and 6 months with a significant reduction in the hardness of dentine observed at 3 (p<0.02) and 6 months (p<0.01). The modulus of elasticity was significantly lower (p<0.01) at 6 months. CONCLUSION: It appears that there is a significant reduction in the hardness of dentine with increasing periods of calcium hydroxide application. Prolonged application of NSCH could have a detrimental effect on dentine, making the dentine more prone to fracture

Factors affecting the timing of pulp extirpation in a sample of 66 replanted avulsed teeth in children and adolescents

The management of 66 replanted avulsed permanent teeth in 46 patients over a 4-year period was studied. Treatment was compared with the recommendations in published guidelines for the management of avulsed permanent teeth. For total extra-alveolar times longer than 45 min, the pulps were extirpated in 96% of teeth. Extra-alveolar times longer than 45 min were associated with earlier pulp extirpation (median 16 days) compared with teeth with shorter extra-alveolar times (median 25 days). Endodontic treatment was postponed in teeth with open apices (median 27 days) compared with closed apices (median 15 days). Teeth in which pulps were removed within 10 days post-trauma had a lower prevalence of inflammatory root resorption compared with teeth in which pulps were removed later. Where inflammatory root resorption did occur, onset was significantly delayed when the pulp had been removed within the first 10 days. This study indicates that clinicians are following the guidelines in key areas of endodontic management of traumatized incisors resulting in more favourable outcomes