Asian Journal of Dental and Health Sciences

CT-Assisted Management with Biodentine Obturation and Aesthetic Rehabilitation of a Geminated Maxillary Central Incisor with Mid-Root Fracture: A Rare Case Report

Sun, 15 Sep 2024 00:00:00 -0400

Gemination, a rare aberration in tooth development, results from the incomplete division of one tooth germ into two. In this case report, a true geminated permanent maxillary central incisor tooth with a horizontal mid-root fracture is successfully treated by non-surgical endodontic treatment. To elucidate the intricate root canal anatomy of this rare geminated incisor, we employed computed tomography imaging technology, enhancing our understanding of this complex case. Utilizing biodentine for obturation proved pivotal, as its capacity to accelerate reparative dentin formation facilitated prompt healing, particularly beneficial in fracture cases. This was followed by aesthetic rehabilitation to achieve a pleasing mesio-distal dimension for both the central incisors using a zirconia-reinforced porcelain crowns.

Keywords: Computed Tomography (CT), Gemination, Horizontal root fracture, Biodentine Obturation

Rehabilitation of a Cracked Tooth: A Case Report

Kshema Mathew, H Murali Rao, B S Keshava Prasad — Sun, 15 Sep 2024 00:00:00 -0400

A cracked tooth is a tooth in which there exists a partial or complete fracture of a stress plane. The prevalence of cracked teeth is relatively more in patients over 40 years of age. The incidence of cracks or incomplete tooth fracture with vital pulps is 9.7%. The average biting loads in humans range from 45.7kg/mm² (males) to 36.4kg/mm² (females) and the force ratio between molars, premolars, and incisors is 4:2:1 respectively.

A tooth stress plane results from occlusal forces that are commonly imposed on that tooth. This may cause an instance of higher energy to occur within the stress plane during masticatory cycle. The functional prognosis and periodontal treatment requirements of a cracked or incompletely fractured tooth depend on the location and amount of tooth structure intersected along with involvement in the stress plane.

This case report highlights the diagnosis and management of a cracked maxillary first molar and identifies the prognostic indicators, which are largely dependent on the extent of the fracture within the tooth structure.

Keywords: Crack tooth; Orthodontic banding; Ribbond; Bite test; Transillumination

Exploring the Efficacy of Natural Biomaterials in Endodontics

ELIZABETH THOMAS, H Murali Rao, B S Keshava Prasad, C Suman — Sun, 15 Sep 2024 00:00:00 -0400

Endodontic therapy aims for thorough disinfection and three-dimensional filling of the root canal system, a goal often challenged by the complexity of root canal morphology. Traditional chemical irrigants and intracanal medicaments, such as sodium hypochlorite (NaOCl) and calcium hydroxide (CaOH2), are effective but can be cytotoxic and cause detrimental effects on periapical tissues and radicular dentin. Increasing antibiotic resistance and the adverse effects of synthetic agents have spurred interest in natural phytochemicals as alternatives. These phytochemicals exhibit promising antimicrobial, anti-inflammatory, and chelating properties, making them viable candidates for root canal irrigation, intracanal medicaments, and smear layer removal. The agents reviewed include Terminalia chebula [Triphala], Camellia sinensis [Green Tea] , Curcuma longa [Turmeric], Glycyrrhiza glabra [Liquorice], Propolis, Melaleuca alternifolia [Tea Tree Oil], Azadirachta indica [Neem] etc. These biomaterials have been studied in various combinations and against a variety of common intraoral bacteria like Enterococcus Faecalis. However, most of the conducted researches are in-vitro studies such as agar diffusion test. Despite their potential, there is a need for further comprehensive clinical and experimental studies to fully evaluate their biocompatibility, safety, and effectiveness compared to conventional treatments. This review aims to underscores the necessity of rigorous research and standardization protocols to confidently employ herbal extracts in endodontic practice.

Keywords: Endodntic irrigants, Herbal irrigants, Intracanal medicaments, antibacterial, Glycyrrhiza glabra, Azadirachta indica, Aloe vera