International Journal of Clinical Pediatric Dentistry

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2019 | May-June | Volume 12 | Issue 3

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Original Article

Chrishantha Joybell, Ramesh Krishnan

Evaluation of Postsurgical Dentofacial Deformities in Children Operated for Correction of Cleft Lip and Palate—A Cross-sectional Study

[Year:2019] [Month:May-June] [Volume:12] [Number:3] [Pages:13] [Pages No:165 - 177]

Keywords: Cleft lip, Cleft palate, Cleft lip and palate

   DOI: 10.5005/jp-journals-10005-1613  |  Open Access |  How to cite  | 


Aim: The aim of this study is to evaluate the various dentofacial deformities in children who were surgically managed for cleft lip and palate (CLP). Materials and methods: The study was carried out in 100 surgically managed cleft lip palate children between the ages of 4 years and 15 years. After eliciting a detailed history, a thorough intraoral and extraoral examination was done and details were recorded in a printed proforma with photographs. Design: Cross-sectional study. Statistical analysis used: All the data were analyzed using SPSS 11.5 software for evaluation using the Chi-square test. Results: A wide range of surgical, dental, and functional problems among the surgically managed CLP patients were seen. Conclusion: The timing of direct lip repair showed a significant influence on the severity of dentofacial deformities. Lip repair before the age of 1 increases the severity of the deformity.


Original Article

Tejashri Gupte, Urvi A Modi, Shreyas Gupte, Ameya Sawant

Determination of Onset of Action and Efficacy of Topical Lignocaine Anesthesia in Children: An In Vivo Study

[Year:2019] [Month:May-June] [Volume:12] [Number:3] [Pages:4] [Pages No:178 - 181]

Keywords: Lignocaine, Topical gel, Topical spray

   DOI: 10.5005/jp-journals-10005-1615  |  Open Access |  How to cite  | 


Anxiety is one of the major issues in the dental treatment in children and needle is the most anxiety provoking armamentarium. For this reason, pediatric dentists are on a constant search to find more comfortable means for administering anesthesia. Topical anesthesia has proven to be a boon in this attempt. Literature shows that quite often there is little pain relief from topical anesthesia and one reason for failure may be that there is no consensus regarding the most appropriate time duration for topical anesthesia to anesthetize intraoral tissue prior to injection. Therefore, the aim and objectives of the study are as follows: (1) To determine duration for onset of action of lignocaine gel and lignocaine spray used as a topical anesthesia during local anesthetic infiltration in palatal area in pediatric patients. (2) To compare the efficacy of lignocaine spray and lignocaine gel in the same patient with bilateral injection. The study group consists of children in the age group of 6–12 years of both genders. Only those children who require palatal bilateral infiltration for their treatment, included in the study. A total of 120 children divided equally into 3 sub-groups depending on the amount of time gap between topical anesthetic application and local infiltration. (1) Group I–30 seconds (2) group II–1 minute (3) group III–3 minutes. Pain responses compared based on subject self-report using visual analogue scale to record subjective symptoms and sem (sound eye motor) scales to record objective symptoms. Results subjected to statistical analysis.


Original Article

Preeti Jha, Mandeep S Virdi, Suman Nain

A Regenerative Approach for Root Canal Treatment of Mature Permanent Teeth: Comparative Evaluation with 18 Months Follow-up

[Year:2019] [Month:May-June] [Volume:12] [Number:3] [Pages:7] [Pages No:182 - 188]

Keywords: Apical periodontitis, Mature teeth, Necrotic pulp, Periapical abscess, Regenerative endodontics, SealBio

   DOI: 10.5005/jp-journals-10005-1616  |  Open Access |  How to cite  | 


Aim: SealBio is a novel technique which stimulates the periradicular cells to deposit a biological barrier at the root apex by inducing healing and regeneration. This clinical trial was undertaken to compare the outcome of teeth treated with the SealBio and the obturation technique. Materials and methods: Thirty patients met the inclusion criteria and consented to participate in the study. Patients were randomly assigned to the SealBio and the obturation group. The time taken for both the techniques and periapical healing was evaluated. The patients of both the groups were evaluated at 6, 12, and 18 months follow up. The periapical index (PAI) was the primary outcome measure to check the apical bone density and healing. The secondary outcome measure was the presence/absence of signs and symptoms. The final outcome measure was the sum of the primary and secondary outcome measures. Results and conclusion: The time taken to perform endodontic treatment with the SealBio technique was significantly lesser than that of obturation. Both groups showed equally favorable outcomes at the end of 18 months without any statistically significant differences. Clinical significance: The results of the present study have demonstrated that SealBio technique gives similar results as that of conventional gutta-percha obturation. The shortcomings of obturation such as difficulty in obtaining a fluid-tight seal and difficulty in obturating tortuous canals can be overcome by the SealBio method. The SealBio method is cost effective, less technique sensitive, and takes lesser chair time.


Original Article

Catarina RB de Alencar, Gabriela C de Oliveira, Celso DV Tripodi Junior, Priscilla SP Gonçalves, Franciny Q Ionta, Heitor M Honorio, Thais M Oliveira, Daniela Rios

Dental Plaque Disclosing as an Auxiliary Method for Professional Dental Prophylaxis in Early Childhood

[Year:2019] [Month:May-June] [Volume:12] [Number:3] [Pages:5] [Pages No:189 - 193]

Keywords: Coloring agents, Dental care for children, Dental prophylaxis, Preventive dentistry, Professional education

   DOI: 10.5005/jp-journals-10005-1617  |  Open Access |  How to cite  | 


Aim: This study aimed to clarify whether dental plaque disclosing before professional prophylaxis would improve the visualization of dental plaque, therefore optimizing the procedure. Materials and methods: The sample comprised both the smooth and occlusal surfaces of the teeth of 25 children from 18 to 36 months. A randomized crossover clinical trial was conducted with two groups: GI—with disclosing and GII—without disclosing (washout/1 month). The teeth were stained with 1% malachite green solution to assess the amount of dental plaque on smooth and occlusal surfaces. Results: Dental plaque removal was more effective and statistically faster (391.27 seconds ±142.2) in GI. The plaque index and the prophylaxis duration were inversely related in GI. The child's behavior did not affect the plaque removal effectiveness, regardless of plaque disclosure (p > 0.05). Conclusion: Dental plaque disclosing in young children is an effective and less time-consuming method that improves the quality of the professional dental prophylaxis. Clinical significance: Biofilm control is important for the success of programs for prevention of early childhood caries (ECC) and considering the particularities inherent to the dental care of infants, it is necessary that periodic professional prophylaxis is effective in eliminating the oral biofilm, ideally reducing chair time. Although dental plaque disclosing has been traditionally performed on educational basis during oral hygiene instruction, this resource can be safely employed to help professional prophylaxis in infants.


Original Article

Eva Godbole, Sanjeev Tyagi, Parimala Kulkarni, Shikha Mali, Surabhi Helge

Efficacy of Liquorice and Propolis Extract Used as Cavity Cleaning Agents against Streptococcus mutans in Deciduous Molars Using Confocal Microscopy: An In Vitro Study

[Year:2019] [Month:May-June] [Volume:12] [Number:3] [Pages:7] [Pages No:194 - 200]

Keywords: CLSM, Liquorice, Propolis

   DOI: 10.5005/jp-journals-10005-1620  |  Open Access |  How to cite  | 


Background/introduction: Cavity disinfection before restoration aids in reducing the number of residual bacteria, thus, decreasing the rate of secondary caries. Propolis, at low concentrations, inhibits the growth of cariogenic bacteria. Liquorice roots are known to have antimicrobial, anti-inflammatory, and antioxidant properties. Aim and objectives: Evaluation and comparison of antimicrobial efficacy of liquorice and propolis extract gels used as cavity cleaning agents against Streptococcus mutans in deciduous molars by confocal laser scanning microscopy (in vitro study). Materials and methods: Liquorice and propolis extracts were converted into gels after recording the minimum inhibition concentration. Class I cavity was prepared on 135 extracted deciduous molars and subjected to inoculation with S. mutans. Teeth were randomly divided into groups I, II, and III which were treated with gels of liquorice, propolis, and distilled water, respectively, for 60, 120, and 180 seconds each. Specimens were sectioned and stained with fluorescent dyes and observed under a confocal laser scanning microscopy (CLSM). The data obtained were statistically evaluated. Results: The mean nonviable/viable bacterial count and the depth of penetration were found to be maximum in group I and minimum in group III. A statistically significant difference was found to be between groups I and II and groups I and III, while with groups II and III, it was nonsignificant at all 60, 120, and 180 seconds. The bacterial depth penetration between groups I and II at 180 seconds was nonsignificant. Conclusion and clinical significance: Though liquorice showed better antimicrobial potential as compared to propolis extract, both can be used efficiently as cavity disinfectants.


Original Article

Dilip Kumar

Primary Canine and Molar Relationships in Centric Occlusion in 3- to 6-year-old Children: A Cross-sectional Survey

[Year:2019] [Month:May-June] [Volume:12] [Number:3] [Pages:4] [Pages No:201 - 204]

Keywords: Centric relation, Primary dentition, Spacing

   DOI: 10.5005/jp-journals-10005-1622  |  Open Access |  How to cite  | 


Introduction: The occlusal relationship of primary dentition plays a vital role in predicting malocclusion in permanent dentition because primary dentition is the stepping stone for permanent dentition. Aim: The aim of the study was to assess the occlusal relationships between the primary canine and the primary molar in the primary dentition in centric occlusion and also spacing in primary dentition among a group of 3- to 6-year-old children. Materials and methods: The survey was based on examination of the primary dentition of 100 school children aged 3–6 years from Chennai, Tamil Nadu, India. The examination was done using pen light and mouth mirror. The occlusal assessment was done only on children who are healthy and free from extensive caries. The primary molar relationship and the canine relationship were assessed using Foster and Hamilton criteria with the teeth in centric occlusion. Results: The study showed that, out of 100 school children, the molar relationship 56% had mesial step followed by 36% with flush terminal relationship and 8% with distal step relationship and out of 100 children, the canine relationship 61% of children had class III relationship followed by 27% class I relationship and 12% class II relationship. And around 54% had spacing out of which, maximum spacing was found only in the upper anteriors. Conclusion: The survey concluded showing that the mesial step primary relationship was more common among 5- to 6-year-old children followed by flush terminal relationship and distal step relationship. The class III primary canine relationship was more common followed by classes I and II. Spacing was found more common in upper anteriors.


Original Article

Shagun Patanjali, Anshul Arora, Ashtha Arya, Mandeep S Grewal

An In Vitro Study of Effect of Beveling of Enamel on Microleakage and Shear Bond Strength of Adhesive Systems in Primary and Permanent Teeth

[Year:2019] [Month:May-June] [Volume:12] [Number:3] [Pages:6] [Pages No:205 - 210]

Keywords: Beveling, Bonding agent, Microleakage, Self-etch adhesive system, Shear bond strength, Total-etch adhesive system

   DOI: 10.5005/jp-journals-10005-1623  |  Open Access |  How to cite  | 


Aim and objectives: This in vitro study evaluated the effect of beveling of enamel on microleakage and shear bond strength of total-etch adhesive system: prime and bond NT and self-etch: adhesive system: XENO V in primary and permanent teeth. Materials and methods: A total of 120 extracted human molars (60 primary and 60 permanent) were selected for the study. For microleakage examination, a sample size of 40 was chosen. Two rectangular slots of equal dimensions were prepared on the buccal surface of each tooth and a bevel was given on either of the slots. Each slot was restored using a composite resin with prior application of the selected bonding agent following which all the samples were soaked in 1% methylene blue dye for 48 hours. Then each tooth was sectioned horizontally and evaluated. The remaining 80 samples were subjected to the shear bond strength test. Class II cavities of standard dimension were prepared and bevel was given on each sample following which selected bonding agent was applied and restored with a composite resin. The specimens were placed in a fixture and the shear bond strength was determined using the universal testing machine. Results: With respect to microleakage, the least was exhibited by beveled preparations in permanent teeth using the self-etch adhesive system and the highest shear bond strength was exhibited by beveled preparations using the total-etch adhesive system in permanent teeth. Conclusion: Beveling of enamel improved the marginal integrity and shear bond strength of self-etch and total-etch adhesive systems in both primary and permanent teeth.


Original Article

Ramanandvignesh Pandiyan, Sadhna Sharma

Molar Incisor Hypomineralization—An Emerging Burden: A Short Study on Prevalence and Clinical Characteristics in Central Delhi, India

[Year:2019] [Month:May-June] [Volume:12] [Number:3] [Pages:4] [Pages No:211 - 214]

Keywords: Masticatory functions, Molar incisor hypomineralization, Public health

   DOI: 10.5005/jp-journals-10005-1624  |  Open Access |  How to cite  | 


Aim: To determine the prevalence of molar incisor hypomineralization (MIH) in 6–12 years old children of the Central Delhi area. Materials and methods: This cross-sectional descriptive short study consisted of 1,026 children aged 6–12 years selected by a random sampling procedure. The parents were interviewed and relevant prenatal, perinatal, and postnatal history was recorded. The dental examination was carried out by well-trained pediatric dentists. Full mouth examination of teeth was conducted including the European Academy of Pediatric Dentistry (EAPD) 2003 criteria for the diagnosis of MIH. The results were documented and statistically analyzed using the Chi-square test. Results: The prevalence of MIH was found to be 1.17%. There was statistically significant difference in prevalence related to gender (p < 0.05) with a higher number of males affected with MIH. A total of 77 teeth (44 molars and 32 incisors) were observed with MIH. The severity of MIH was more in molars (52.27%) when compared to incisors (24.24%). All the four first permanent molars were affected in 83.3% of children with MIH. Conclusion: The prevalence of MIH in a small sample of 1,026 children aged 6–12 years in Central Delhi was 1.17%. A significant male predilection was reported. MIH is a developmental disturbance occurring during the maturation phase of enamel formation, which requires a multidisciplinary treatment approach. The high esthetic demand and the inability to deliver successful restorative care to the hypomineralized teeth can pose great difficulties. Hence, more studies related to prevalence, nature, and severity of MIH and awareness regarding the associated risk factors are required to reveal the hidden burden across the country and to further prevent the occurrence of MIH.


Original Article

Amrita Jaggi, Sukhvinder S Oberoi, Pratibha Taneja

Impact of Early Childhood Caries on Oral Health-related Quality of Life Among 4–6-year-old Children Attending Delhi Schools: A Cross-sectional Study

[Year:2019] [Month:May-June] [Volume:12] [Number:3] [Pages:7] [Pages No:215 - 221]

Keywords: Early childhood caries, Early childhood oral health impact scale, Oral health-related quality of life

   DOI: 10.5005/jp-journals-10005-1626  |  Open Access |  How to cite  | 


Introduction: Oral diseases like early childhood caries (ECC), trauma, teething pain, and eruption disturbances are widely prevalent among the 4–6-year subgroup of population and are considered a public health problem worldwide. Aim: To assess the impact of ECC on oral health-related quality of life (OHRQoL) among 4–6-year-old children attending schools in Delhi. Materials and methods: A cross-sectional epidemiological study was carried out to assess the impact of ECC on OHRQoL among 4–6-year old children. Data were collected by a combination of the structured questionnaire of sociodemographic details and early childhood oral health impact scale (ECOHIS). The clinical examination was conducted for the assessment of dentition status and pufa index according to WHO criteria 2013. Statistical analysis was performed using the Chi-square test, the Kruskal–Wallis test, and the Mann–Whitney U test. Results: The prevalence of ECC was found to be 20% among preschoolers which was lower among younger children and increased with age. The ECOHIS responses reported that items related to pain, irritation, difficulty in eating some foods, and difficulty to drink hot or cold beverages, felt guilty, feeling of frustration, and been upset were the most frequent on the child impact section (CIS).


Original Article

Elisa Rota

Dentofacial Effects of Modified Alt-RAMEC Protocol Combined with the Facial Mask for Treatment of Preadolescent Caucasian Class III Patients

[Year:2019] [Month:May-June] [Volume:12] [Number:3] [Pages:7] [Pages No:222 - 228]

Keywords: Alt-RAMEC, Facial mask, Maxillary expansion, Maxillary growth, Third class

   DOI: 10.5005/jp-journals-10005-1627  |  Open Access |  How to cite  | 


Introduction: In this study we analyzed dentoskeletal effects of orthopedic therapy with rapid palatal expander (RME), used according to modified Alt-RAMEC protocol, followed by facial mask in preadolescent patients with class III malocclusion. Materials and methods: The sample consisted of 10 patients treated consecutively with the alternate rapid maxillary expansions and constrictions (Alt-RAMEC) protocol and facial mask before the pubertal growth spur the patients were re-evaluated after about one year of treatment. We compared the cephalometric analyses at T0 (before the treatment) and T1 (just after the end of the treatment—about 1 year), evaluating 18 parameters. The normality of each distribution was assessed with D'Agostino-Pearson normality test and significative differences between T0 and T1 were assessed with paired t test (p < 0.05). Results: Sagittal measurements of the maxilla (SNpSNa distance) showed significant improvements (p < 0.0001) with protraction effect at point A. Significant improvements were recorded also at Wits appraisal and overjet. Measures of the mandibular growth (Co-Gn) showed increased values at T1, as well as vertical dimension (SNpSNa-GoGn). No significant variations were recorded at the dental parameters. Conclusion: This protocol induces important skeletal effects, like advancement of the maxilla, also in preadolescent patients, while dental changes are minimal. Alt-RAMEC protocol seem to modulate maxillary development in patients near the pubertal growth spurt.


Original Article

Teena Gupta, Hashmit K Rai

Effect of Esthetic Defects in Anterior Teeth on the Emotional and Social Well-being of Children: A Survey

[Year:2019] [Month:May-June] [Volume:12] [Number:3] [Pages:4] [Pages No:229 - 232]

Keywords: Anterior teeth, Esthetics, Psychological impact, School-going children, Social impact

   DOI: 10.5005/jp-journals-10005-1628  |  Open Access |  How to cite  | 


Objectives: This study aimed to determine whether imperfections in the anterior dentition affect the emotional and/or social well being of school going children in Amritsar district of Punjab, India. Methods: A total of 2582 children between the ages 10 and 15 years of both genders were examined. Of these, 528 children with esthetic imperfections were asked a series of questions to assess their emotional and social disposition, with respect to children with no esthetic defects. Results: Females were more shy if they did not have a perfect anterior dentition (p = 0.000). Low socioeconomic status corresponded with gender (females) in determining emotional insecurity. Malocclusion was the most common cause of aesthetic defects (291/528 children), followed by causes such as, hypoplasisa/ hypocalcification, stains, peg shaped, microdontia, congenitally missing (46.4%), trauma (30.5%) and caries (1.2%). Irrespective of cause of defect, 53.8% of children were emotionally affected, in that, were fearful of being teased by other children (77.1%).


Original Article

Venu Varma, K Sundeep Hegde

Comparative Evaluation of Remineralization Potential of Two Varnishes Containing CPP–ACP and Tricalcium Phosphate: An In Vitro Study

[Year:2019] [Month:May-June] [Volume:12] [Number:3] [Pages:4] [Pages No:233 - 236]

Keywords: Clinpro varnish, MI varnish with CPP–ACP, Tooth remineralization

   DOI: 10.5005/jp-journals-10005-1629  |  Open Access |  How to cite  | 


Aim: The aim of this study is to evaluate the remineralization potential of Clinpro XT varnish containing tricalcium phosphate (TCP) and MI varnish containing casein phosphopeptide (casein phosphopeptide–amorphous calcium phosphate, CPP–ACP). Materials and methods: Thirty premolar teeth were taken and divided into three groups. Samples were sliced mesiodistally into buccal and lingual halves using a diamond disk bur. The buccal halves of the teeth were used for the study. Artificial caries like lesions were produced and evaluated with Diagnodent. The samples in each group were treated with the respective remineralizing agent (except for the control group) at every 24 hours for 7 days and the surfaces were assessed using Diagnodent to record the values after the remineralization procedure. The Diagnodent values obtained were tabulated and statistically analyzed using one-way ANOVA and Tukey's multiple comparison tests. Results: There was a significant difference between the values calculated before and after remineralization in all the three groups. Conclusion: The study findings showed that MI varnish containing CPP–ACP had the highest release of fluoride as compared to the Clinpro fluoride releasing varnish. Clinical significance: MI varnish is a 5% NaF varnish containing CPP–ACP to give an exceptional fluoride varnish that releases more bioavailable fluoride, calcium, and phosphate, hence, can be used successfully in remineralization of early carious lesions. CPP–ACP can be used in the clinical practice for reversing or arresting the early carious lesions.


Original Article

Monika P Gupta, Vishal Puri, Dilip Kumar

Dermatoglyphics as a Noninvasive Tool for Predicting Dental Caries in Cerebral Palsy and Healthy Children: An In Vivo Study

[Year:2019] [Month:May-June] [Volume:12] [Number:3] [Pages:6] [Pages No:237 - 242]

Keywords: Cerebral palsy, Dental caries, Dermatoglyphics, Fingerprint patterns

   DOI: 10.5005/jp-journals-10005-1630  |  Open Access |  How to cite  | 


Aim: To find the association of dermatoglyphics and dental caries in normal and cerebral palsy (CP) children. Materials and methods: A total of 150 children of age group 6–12 years were selected and divided into three equal groups. Group I constituted of 50 CP caries-active children, group II constituted of 50 healthy caries active children, and group III consisted of 50 healthy caries-free children. World Health Organization (WHO) criteria were used for diagnosis and recording of decayed, missing, filled teeth (DMFT)/deft scores. Fingerprints of both hands were taken using a stamp pad and analyzed using the Cummin and Midlo method. Results: The results were statistically analyzed using one-way analysis of variance (ANOVA) and post hoc Tukey's honestly significant difference (HSD). The data for the entire study were calculated using statistical package for social sciences (SPSS) statistical software 19.0 version. The mean DMFT/deft score was the highest for the CP caries-active group compared to the healthy caries-active and healthy caries-free children. Dermatoglyphic pattern distribution in the CP caries-active group showed more whorls and that in the healthy caries-free group showed more arches. Intergroup comparisons for DMFT/deft and dermatoglyphic patterns were significant except between CP caries-active children and healthy caries-active children. Conclusion: Association of dermatoglyphics and dental caries was observed among CP caries-active children, healthy caries-active children, and healthy caries-free children. This association can be helpful in identifying the possible genetic predisposition and early prediction of dental caries in CP children, so as to initiate oral health measures at an early stage. Clinical significance: Maintaining oral hygiene has always been a challenge in children because of many difficulties like behavior management and lack of dexterity, and it becomes all the more difficult in the case of children with special needs. Dermatoglyphics can be proven to be a very useful, noninvasive, and economical tool for the preliminary diagnosis of diseases of suspected genetic origin like dental caries and CP.



Magali Hernandez, Cécile Pochon, Pascal Chastagner, Dominique Droz

Long-term Adverse Effects of Acute Myeloid Leukemia Treatment on Odontogenesis in a Child

[Year:2019] [Month:May-June] [Volume:12] [Number:3] [Pages:4] [Pages No:243 - 246]

Keywords: Childhood cancer, Long-term survivors, Tooth abnormalities

   DOI: 10.5005/jp-journals-10005-1614  |  Open Access |  How to cite  | 


Background: Several studies showed that cancer therapies during tooth development are associated with dental abnormalities, including enamel defects, arrested tooth development, microdontic teeth, and agenesis. Study design: We describe the case of a nine-year-old boy treated for acute myeloid leukemia at 15 months of age, who presents several dental abnormalities resulting from anticancer treatment. Results: The patient was included and treated according to the ELAM 02 French protocol. Six years after allogenic hematopoietic stem cell transplantation, the intraoral and radiographic examination highlighted the agenesis of the second permanent molars and three of the four second premolars, microdontia of the first premolars, root stunting of the central incisors and first premolars, rootlessness of the first permanent molars, and enamel defects localized at the permanent incisors and canines. As a first step to reduce enamel defects, restorations with resin composite (Tetric EvoCeram® A2, Ivoclar Vivadent) were performed under a dental dam. Orthodontic treatment was contraindicated due to arrested tooth development, short roots, and a risk of resorption is considered too important. Conclusion: The young age at diagnosis (<5 years of age) and intensive chemotherapy (especially myeloablative conditioning with high doses of cyclophosphamide and Busulfan) could explain the severity of the dental abnormalities. This case illustrates the importance of systematically scheduling a dental follow-up in parallel with the onco-hematologic follow-up allowing the clinicians to prevent, detect, and propose early intervention for dental late effects.



Saeedeh Mokhtari, Shima Hajian, Iman Sanati

Complicated Crown-root Fracture Management Using the 180-degree Rotation Method

[Year:2019] [Month:May-June] [Volume:12] [Number:3] [Pages:4] [Pages No:247 - 250]

Keywords: Case report, Tooth crown/injuries, Tooth fractures/surgery, Tooth replantation

   DOI: 10.5005/jp-journals-10005-1625  |  Open Access |  How to cite  | 


Aim: The aim of this article is to report a successful treatment of a complicated crown-root fracture. Background: The management of complicated crown-root fracture in young patients is challenging as the fracture line is below the bone crest and the pulp is exposed. Treatment options include crown lengthening, orthodontic extrusion, and intentional replantation. Case description: Here, a case of complicated crown-root fracture of tooth number 11 in a ten-year-old boy is presented. Intentional replantation with 180° rotation and slight extrusion and fixation was performed. In addition, root canal therapy was done and tooth was restored with a composite resin after four weeks. The patient was asymptomatic clinically and radiographically after three-year follow-up. Conclusion: Intentional replantation with 180° rotation is a valuable treatment for crown root fractures. Clinical significance: The management of complicated crown-root fracture using intentional replantation with 180° rotation can help to maintain natural dentition and interdental papilla.


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