Introduction. Restoration of immature teeth with open apices and thin dentinal walls with conventional post systems remains a challenge. The purpose of this study was to evaluate the fracture resistance of simulated immature teeth restored with different intraradicular posts and assess their stress distribution pattern using 3D Finite Element Analysis (FEA). Methods. Fracture strength testing using universal testing machine was carried out in simulated immature teeth restored with different intraradicular posts grouped as follows: Group A: teeth not restored with posts served as control group; Group B: Cast metal post (CMP); Group C: Customized Composite Post (CCP); Group D: Fiber post (FP). Four 3D FEA models of the above groups were created using CATIATM software and analyzed for stress distribution using ANSYSTM. The results of fracture strength testing and FEA were correlated. Multiple group comparisons were analyzed by one-way ANOVA followed by Tukey HSD post hoc test. Results. The CMP exhibited highest fracture resistance (336.43 N) but resulted in root fractures. The CCP exhibited lower fracture resistance (240.90 N) and favorable stress distribution as compared to CMP. The FP and control group exhibited lower fracture resistance values of 182.69 N and 130.46 N, respectively. The results of 3D FEA demonstrated higher stress concentration in model comprising metallic post and core. Conclusions. Teeth restored with cast metal posts and cores exhibited maximum fracture resistance followed by the customized composite posts, the fiber posts, and the control group. The cast metal posts indicated higher von Mises stresses concentrated in the radicular region; however, the customized composite posts, the fiber posts, and the control group demonstrated stress concentration in the coronal region.
Discovery of multiple foreign objects in the root canal is unusual and their removal is often difficult and challenging procedure. Entrapment of the foreign object in the pulp chamber or in root canal usually occur accidentally in children with the habit of chewing or placing various objects in the oral cavity. Clinically it was often encountered in tooth with wide carious lesion, exposed pulp chamber due to trauma or tooth left open for the drainage during root canal treatment. This impacted foreign body may act as a potential source of pain or infection. The attempt to retrieve such foreign object from the root canal with immature apex increases the risk of its displacement into periapical area. The present case report describes an unusual case of a patient with two metallic sewing needles inadvertently broken down in the root canal of the permanent maxillary left central incisor and it׳s successful retrieval by non-surgical endodontic treatment.
Maxillary incisors are the most commonly involved teeth in traumatic injuries. As their esthetic and functional value is unequivocal, their treatment becomes major concern for both, the patient as well as the dentist. Various treatment modalities have been practiced for fractured anterior teeth, including composites, laminates, esthetic crown or the reattachment of fractured fragment. Among which fragment reattachment is considered to be the most conservative, natural and an esthetic approach. Reattachment of fragment could be the viable treatment option only when the tooth fragment is intact and having its good clinical approximation with the remaining tooth structure. In addition, the overall success of this treatment modality depends upon the fragment's extend of dehydration (time lapsed), patient cooperation and also the skill of the operator for such case selection. This article discusses the management of complicated crown fractures of anterior teeth which were managed successfully in a conservative manner.
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