Minimally Invasive Management of a Dental Trauma: Two Years of Follow‑up in Biodentine‑Induced Maturogenesis

Authors

1 Department of Pediatric Dentistry, School of Dentistry, Arak University of Medical Sciences, Arak, Iran

2 Department of Restorative, Dental Research Center, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Dental trauma is an ordinary complication in childhood period. Most of the traumas are crown fractures in the permanent dentition. Complicated crown fracture, introduced as a crown fracture accompanied by pulp exposure. Treatment plan and long‑term prognosis could be modified
by different factors, such as fracture line position, root development, alveolar bone fracture, and occlusion. In traumatized open apices teeth, apexogenesis can be occurred after traumatic exposure by vital pulp therapy procedures such as pulp capping, partial or complete pulpotomy in pertinent to the size of the exposure. In this complicated crown fracture case, cervical pulpotomy was performed with a silicate‑based biomaterial. Patients smile and esthetic demands play an important role in the perception and judgment that people have of others appearance and character. To reconstruct the patient’s smile line, the adhesive reattachment of the coronal fractured fragment to the remaining tooth structure was planned. Reattachment could be suggested as an ideal treatment procedure for crown fracture cases. This technique could be applied to achieve excellent esthetic outcomes and normal function. At 1‑year follow‑up visit, the patient had no complaints of pain. The clinical and
radiographic examination showed a stable reattachment and good periodontal health. Apex diameter was decreased significantly. Physiological root‑end closure was obvious. Secondary dentin and calcific barrier were also observed on the radiograph below the Biodentine layer.

Keywords


1. Ghadimi S, Seraj B, Keshavarz H, Shamshiri AR, Abiri R. The effect of using an educational poster on elementary school health teachers’ knowledge of emergency management of traumatic dental injuries. J Dent (Tehran) 2014;11:620‑8. 
2. Singh TK, Passi D, Aggarwal S, Mohan S, Sharma A, Gupta U. Esthetic management of complicated crown fracture of three permanent maxillary teeth by grout technique -A case report. J Family Med Prim Care 2019;8:2538–41. 
3. Goenka P, Marwah N, Dutta S. Biological approach for management of anterior tooth trauma: Triple case report. J Indian Soc Pedod Prev Dent 2010;28:223‑9. 
4. Zerman N, Cavalleri G. Traumatic injuries to permanent incisors. Endod Dent Traumatol 1993;9:61‑4. 
5. Ghorbanzadeh A, Ghorbanzadeh A. Maturogenesis of two maxillary central incisors: ACase report with 10 years of follow up. J Dent (Tehran) 2015;12:306‑15. 
6. Scholtes E, Suttorp CM, Loomans BA, Van Elsas P, Schols JG. Combined orthodontic, surgical, and restorative approach to treat a complicated crown‑root fracture in a maxillary central incisor. Am J Orthod Dentofacial Orthop 2018;154:570‑82. 
7. Cavalleri G, Zerman N. Traumatic crown fractures in permanent incisors with immature roots: A follow‑up study. Endod Dent Traumatol 1995;11:294‑6. 
8. Martens L, Rajasekharan S, Cauwels R. Pulp management after traumatic injuries with a tricalcium silicate-based cement (Biodentine™): a report of two cases, up to 48 months follow-up. Eur Arch Paediatr Dent 2015;16:491-1. 
9. Weisleder R, Benitez CR. Maturogenesis: Is it a new concept? J Endod 2003;29:776‑8. 
10. Khedmat S, Aminipor M, Pourhajibagher M, Kharazifar MJ, Bahador A. Comparison of antibacterial activities of ProRoot MTA, OrthoMTA, and RetroMTA against three anaerobic endodontic bacteria. J Dent (Tehran) 2018;15:294‑9. 
11. Kazemipoor M, Azizi N, Farahat F. Evaluation of microhardness of mineral trioxide aggregate after immediate placement of different coronal restorations: An in vitro study. J Dent (Tehran) 2018;15:116‑22. 
12. Dianat O, Naseri M, Tabatabaei SF. Evaluation of properties of mineral trioxide aggregate with methyl cellulose as liquid. J Dent (Tehran) 2017;14:7‑2. 
13. Han L, Okiji T. Bioactivity evaluation of three calcium silicate‑based endodontic materials. Int Endod J 2013;46:808‑14. 
14. Grech L, Mallia B, Camilleri J. Investigation of the physical properties of tricalcium silicate cement‑based root‑end filling materials. Dent Mater 2013;29:e20‑8. 
15. Zhou HM, Shen Y, Wang ZJ, Li L, Zheng YF, Häkkinen L, et al. In vitro cytotoxicity evaluation of a novel root repair material. J Endod 2013;39:478‑83. 
16. Han L, Okiji T. Uptake of calcium and silicon released from calcium silicate‑based endodontic materials into root canal dentine. Int Endod J 2011;44:1081‑7. 
17. Saffarpour A, Ghavam M, Saffarpour A, Dayani R, Fard MJ. Perception of laypeople and dental professionals of smile esthetics. J Dent (Tehran) 2016;13:85‑91. 
18. Magno MB, de Paiva Cabral Tristão SK, Jural LA, Aguiar Sales Lima SO, Coqueiro RDS, Maia LC, et al. Does dental trauma influence the social judgment and motivation to seek dental treatment by children and adolescents? Development, validation, and application of an instrument for the evaluation of traumatic dental injuries and their consequences. Int J Paediatr Dent 2019;29:474‑88. 
19. Berk N, Berk G, Uluçam S. Case report: laser-assisted rebonding of a central incisor tooth due to a severe trauma - 4 years of follow-up. Eur Arch Paediatr Dent 2011;12:96. 
20. Mahesh Patni P, Jain P, Jain Patni M. A conservative approach to the management of a dental trauma for immediate natural esthetics. Arch Trauma Res 2016;5:e29042. 
21. Enshaei Z, Ghasemi M. Multidisciplinary management of complicated crown‑root fracture: A case report. J Dent (Tehran) 2018;15:193‑6. 
22. Hamilton FA, Hill FJ, Holloway PJ. An investigation of dento‑alveolar trauma and its treatment in an adolescent population. Part 2: Dentists’ knowledge of management methods and their perceptions of barriers to providing care. Br Dent J 1997;182:129‑33. 
23. Vâlceanu AS, Stratul SI. Multidisciplinary approach of complicated crown fractures of both superior central incisors: A case report. Dent Traumatol 2008;24:482‑6. 
24. Davari A, Sadeghi M. Influence of different bonding agents and composite resins on fracture resistance of reattached incisal tooth fragment. J Dent (Shiraz) 2014;15:6‑14. 
25. Murchison DF, Burke FJ, Worthington RB. Incisal edge reattachment: Indications for use and clinical technique. Br Dent J 1999;186:614‑9. 
26. Akhoundi MS, Etemadi A, Nasiri M, Borujeni ES. Comparison of enamel morphologic characteristics after conditioning with various combinations of acid etchant and Er: YAG laser in bonding and rebonding procedures: A SEM analysis. J Dent (Tehran) 2017;14:144‑52. 
27. Macedo GV, Diaz PI, De O Fernandes CA, Ritter AV. Reattachment of anterior teeth fragments: A conservative approach. J Esthet Restor Dent 2008;20:5‑18. 
28. Tonini R. An innovative method for fragment reattachment after complicated crown fracture. J Esthet Restor Dent 2017;29:172‑7. 
29. Qudeimat MA, Barrieshi-Nusair, KM, Owais AI. Calcium hydroxide vs mineral trioxide aggregates for partial pulpotomy of permanent molars with deep caries. Eur Arch Paediatr Dent 2007;8:99. 
30. Wang G, Wang C, Qin M. Pulp prognosis following conservative pulp treatment in teeth with complicated crown fractures: A retrospective study. Dent Traumatol 2017;33:255‑60. 
31. Khoshkhounejad M, Shokouhinejad N, Pirmoazen S. Regenerative endodontic treatment: Report of two cases with different clinical management and outcomes. J Dent (Tehran) 2015;12:460‑8. 
32. Gandolfi MG, Van Landuyt K, Taddei P, Modena E, Van Meerbeek B, Prati C. Environmental scanning electron microscopy connected with energy dispersive X‑ray analysis and Raman techniques to study ProRoot mineral trioxide aggregate and calcium silicate cements in wet conditions and in real time. J Endod 2010;36:851‑7. 
33. Saito T, Toyooka H, Ito S, Crenshaw MA. In vitro study of remineralization of dentin: Effects of ions on mineral induction by decalcified dentin matrix. Caries Res 2003;37:445‑9. 
34. Soundappan S, Sundaramurthy JL, Raghu S, Natanasabapathy V. Biodentine versus mineral trioxide aggregate versus intermediate restorative material for retrograde root end filling: An in vitro study. J Dent (Tehran) 2014;11:143‑9. 
35. Rajasekharan S, Martens LC, Cauwels RGEC,Anthonappa RP, Verbeeck RMH. Biodentine™ material characteristics and clinical applications: a 3 year literature review and update. Eur Arch Paediatr Dent 2018;19:122. 
36. Bolhari B, Ashofteh Yazdi K, Sharifi F, Pirmoazen S. Comparative scanning electron microscopic study of the marginal adaptation of four root‑end filling materials in presence and absence of blood. J Dent (Tehran) 2015;12:226‑34.