Management of a complicated crown-root fracture using adhesive fragment reattachment and orthodontic extrusion

Dental trauma is more common in young patients and its sequelae may impair the establishment and accomplishment of an adequate treatment plan. This paper reports a case of complicated crown-root fracture in a young adult that was treated using adhesive tooth fragment reattachment and orthodontic root extrusion. Considering the time elapsed to follow up, the fracture extension, the amount of remaining root portion and the patient's low socioeconomic status, the treatment approach proposed for this case provided good functional and aesthetic outcomes. Clinical and radiographic results after 2 years were successful. This case report demonstrates the importance of establishing a multidisciplinary approach for a successful dental trauma management.

Six-year follow-up of maxillary anterior rehabilitation with forced orthodontic extrusion: Achieving esthetic excellence with a multidisciplinary approach

Orthodontic extrusion with multidisciplinary treatment can provide predictable outcomes in selected situations, reducing the costs and the adaptation times of gingival tissues after implant integration. Forced orthodontic extrusion is strongly related to interactions of teeth with their supportive periodontal tissues. This article reports a case of orthodontic extrusion of the maxillary incisors for later implant rehabilitation in a patient with periodontal disease. Slow forces were applied for 14 months. After this time, the teeth were extracted, and the implants were placed on the same day. Also in the same session, the provisional crown was fabricated for restoration of the anterior maxillary interdental papillae loss and for gingival contouring. Clinical and radiographic examinations at the 6-year follow-up showed successful tooth replacement and an improved esthetic appearance achieved by this multidisciplinary treatment. The decision to perform orthodontic extrusion for implant placement in adult patients should be multidisciplinary. Copyright © 2013 by the American Association of Orthodontists.

Orthodontic extrusion as treatment option for crown-root fracture: literature review with systematic criteria

To review the literature searching for a consensus for the choice of orthodontic extrusion as treatment for crown-root fracture. An electronic search was performed in the databases PubMed, Cochrane Central Register of Controlled Trials and Scopus and a manual search of the Journal Dental Traumatology. Forty articles were found in PubMed and 38 in Scopus and after removal of duplicate sample 51 contained articles. Of these, 48 were excluded for not having orthodontic treatment, no follow-up or follow-up less than 6 months, or not report the presence of crown-root fracture. In manual search in Dental Traumatology 20 articles were found, but none of them met the prerequisites established. So, three articles formed the basis of the study. The choice of how to treat orthodontic extrusion of crown-root fracture was effective and stable, without root and periodontal changes. Factors, such as root formation and presence of pulp vitality were decisive for determining the stages of treatment, however, there is no consensus based on scientific evidence about these protocols.

Forced orthodontic eruption for augmentation of soft and hard tissue prior to implant placement

Forced orthodontic eruption (FOE) is a non-surgical treatment option that allows modifying the osseous and gingival topography. The aim of this article is to present a clinical case of a FOE, which resulted in an improvement of the amount of available bone and soft-tissues for implant site development. Patient was referred for treatment of mobility and unesthetic appearance of their maxillary incisors. Clinical and radiographic examination revealed inflamed gingival tissue, horizontal and vertical tooth mobility and interproximal angular bone defects. It was chosen a multidisciplinary treatment approach using FOE, tooth extraction, and immediate implant placement to achieve better esthetic results. The use of FOE, in periodontally compromised teeth, promoted the formation of a new bone and soft-tissue in a coronal direction, without additional surgical procedures, enabling an esthetic, and functional implant-supported restoration.

Aesthetic rehabilitation of a complicated crown-root fracture of the maxillary incisor: combination of orthodontic and implant treatment

The aim of this paper is to present a complex rehabilitation, of fractured tooth, with implants in anterior region considering the orthodontics extrusion to clinical success. At 7 years old, the patient fractured the maxillary left central incisor and the dentist did a crown with the fragment. Twenty years later, the patient was referred to a dental clinic for orthodontic treatment, with the chief complaint related to an accentuated deep bite, and a professional started an orthodontic treatment. After sixteen months of orthodontic treatment, tooth 21 fractured. The treatment plan included an orthodontic extrusion of tooth 21 and implant placement. This case has been followed up and the clinical and radiographic examinations show excellence esthetic results and satisfaction of patient. The forced extrusion can be a viable treatment option in the management of crown root fracture of an anterior tooth to gain bone in a vertical direction. This case emphasizes that to achieve the esthetic result a multidisciplinary approach is necessary.

Multidisciplinary treatment approach for crown fracture and crown-root fracture - a case report

The increased incidence of traumatic injuries to anterior teeth is a consequence of leisure activities, where the most common injuries are crown fractures. Treatment of the dental trauma is complex and requires a comprehensive and accurate diagnostic and treatment plan. It is also important to consider the biological, functional, esthetic and economic aspects, as well as the patient's desire. The purpose of this article is to report a case that shows the multidisciplinary approach required to successfully manage the rehabilitation of a maxillary central incisor with a complex crown fracture and a maxillary lateral incisor, that at first presented an oblique crown-root fracture, and after the orthodontic extrusion, suffered a more apical new crown-root fracture.

Sobremordida exagerada: diagnóstico e estratégias de tratamento

A sobremordida exagerada é um tipo de má oclusão que apresenta etiologia multifatorial e necessita de um diagnóstico diferencial elaborado e específico. O objetivo desse artigo é descrever os principais elementos de diagnóstico facial, cefalométrico e dentário e as principais estratégias de tratamento, como a extrusão de dentes posteriores, a intrusão de dentes anteriores ou a combinação dessas. Serão apresentados seis casos clínicos, auxiliando o ortodontista no diagnóstico e na seleção da estratégia de tratamento individualizada para cada situação clínica.

Integrated clinical treatment of gingival recession secondary to root perforation: case report.

Among the factors that influence the success of treatment of a root perforation, its location and possibility of contamination are determinant because the interaction of these 2 factors may result in significant periodontal injury. The management of cases of hard-to-reach contaminated perforations depends on the choice of an adequate technique. In the case reported in this article, controlled orthodontic tooth extrusion was successfully performed to treat gingival recession secondary to root perforation. The outcomes showed that this technique preserves the zone of attached gingiva, maintains the crown height, and prevents the involvement of the supporting bone tissue. The favorable clinical and radio?graphic conditions after 7 years of follow-up demonstrate the viability of this treatment approach.

Continuous torque system with control of the reaction unit

This article describes an orthodontic system used to obtain active continuous torque with movement control of both active and reactive units; the system relies on principles of the segmented technique. A cantilever system with .017 x .025-in beta-titanium alloy wire was designed to provide the desirable moment on the active unit. A transpalatal bar or a lingual arch increases the anchorage and neutralizes the side effects on the reactive unit. This technique is an efficient approach for major corrections of buccolingual inclinations of certain teeth. © 2010 American Association of Orthodontists.

Amylase utilization for the extrusion of dog diets

Effects of amylase addition on extruder parameters, cost of extrusion, kibble quality and digestibility of dog food were measured in two separate experiments. In experiment 1, 120 kilo-novo-alpha-amilase-unit (KNU)/kg of heat stable alpha-amylase produced by Bacillus licheniformis was added in liquid form during a preconditioning period. In experiment 23684 KNU/kg of heat stable alpha-amylase produced by Aspergillus oryzae was mixed with the ingredients before extrusion. The diets were processed in a single screw extruder and submitted to digestibility and on experiment 1 also to palatability tests. Digestibility was tested using 12 dogs, six per diet. Data were submitted to analysis of variance followed by F-test. Amylase addition altered extrusion parameters in both experiments (P<0.05), with higher output (kg of dry matter [DM]/h: 28% and 43% higher in experiments 1 and 2) and less electric energy consumption (kW to produce 100 kg DM: 22% and 29% lower in experiments 1 and 2). Kibble appearance and quality [density (g/L), cutting force (g), and starch gelatinization degree (%)] did not change with enzyme treatment (P>0.05). Likewise, enzyme addition did not change nutrient digestibility, fecal dry matter or food palatability (P<0.05). Taken together our results suggest that amylase promoted the breakdown of amylose chains, thereby reducing the dough viscosity and resistance inside the extruder which allowed for higher product flow and less electricity energy consumption without altering food quality. (C) 2012 Elsevier B.V. All rights reserved.

Production of reinforced composites with natural fibers for industrial applications - Extrusion and injection WPC

The aim of this work is to study the replacement of currently used thermoplastics by composites reinforced with vegetable fibers with several advantages, mainly better mechanical properties, low weight and competitive cost compared to its counterparts. Extrusion and injection molding processes were studied using polypropylene (PP) matrix. The raw materials used were sugar cane bagasse, elephant grass, wood, milk cartons and recycled polypropylene. The composites were tested for bending, tension, hardness and impact resistance, following ASTM standards. The results obtained were extremely positive since they proved that natural fibers as reinforcement can be an important alternative to replace talc and other fillers.

State-of-the-art for extrusion and injection moulding FPC: natural Fibre Plastics Composites in Brazil

Environmental and economical concerns are stimulating research of new materials for construction, furniture, packaging and automotive industries. Particularly attractive are the new materials. This paper presents results about the properties of composites of polyhydroxybutyrate (PHB), polypropylene (PP) and High Density Polyethylene (HDPE) reinforced with natural fibres. The composites were prepared through the extrusion with natural fibres, in an ratio of 30% by weight. The quality of samples was tested utilising injection moulded samples, according to ASTM standards. Results showed that natural fibres can act as an excellent reinforcing material, resulting in low cost composites and improving economical and ecological interests.

Sugarcane bagasse cellulose/HDPE composites obtained by extrusion

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Glass transition and degree of conversion of a light-cured orthodontic composite

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)