A 16 year old female was referred to an oral and maxillofacial radiologist for evaluation of a radiolucent area at mesial radicular aspect of right maxillary central incisor which was detected accidentally during pre-orthodontic treatment check ups. Clinical examination showed no particular signs or symptoms except for slightly tenderness to lateral percussion. Second radiograph with altered horizontal angulations showed a mesial supernumerary root which the radiolucency seemed to be associated with that. In order to treat the tooth, the composite filling was removed and canals were cleaned, shaped, and obturated by lateral condensation technique.

Objectives: This study aimed to evaluate the effect of labiopalatal inclination of maxillary right central incisor on palatal bone width using cone-beam computed tomography (CBCT). Methods: The angle formed between the longitudinal axis of the right central incisor and the palatal plane was measured on 75 CBCT images, and classified into three groups of labially-inclined, lingually-inclined, and normal groups. The total palatal bone thickness in the apical region of the upper right central incisor was linearly measured perpendicular to the tooth axis on sagittal slices. The intraclass correlation coefficient, Kolmogorov-Smirnov test, one-way ANOVA, and Pearson’, s and Spearman’, s correlation coefficients were used for data analysis (alpha=0. 05). Results: A significant difference was noted among the groups in the total apical palatal bone thickness (P<0. 05). The labially-inclined group had significantly lower bone thickness than the other two groups (P=0. 002, 95% CI: 5. 5-7. 38),however, this correlation was inverse (Pearson’, s R=-0. 58), which means that as the angle between the upper central incisor axis and the palatal plane increased, the bone thickness significantly decreased. No correlation was found between the palatal bone thickness (cancellous or cortical) and tooth inclination (P>0. 05). Arch length was not correlated with any group either (P>0. 05). Conclusion: Labial inclination of upper central incisor causes the root apex to be closer to the palatal alveolar bone, resulting in less apical bone support in the palatal area.

Aim: We have reported a case of a 17-year-old patient with impaction of element 2. 1 and severe incisors crowding and the treatment plan involved traction of the impacted teeth. Methods: First, rapid maxillary expansion was performed. Then elements 1. 4, 2. 4, 3. 4, and 4. 4 were extracted to dissolve the crowding, and the fixed appliances were bonded. A NiTi coil spring was used to open the needed space for traction, and surgical exposure of the tooth for bonding a traction device was done. After the tooth erupted in the oral cavity, overlay mechanics was used to align and level it. Results: Despite being challenging, the conservative treatment resulted in satisfactory outcomes, and the objectives were achieved, restoring the patient's aesthetics and function. Conclusion: After correct planning of the case, the impacted central incisor was pulled, restoring the patient's function and aesthetics, with good preservation of the supporting structures.

Background and Aim: Tooth shade selection has long been a challenge in dentistry. According to huge number of edentulous people, in need for prosthetic treatment, determination of natural teeth shade distribution is necessary. Based on deficiencies in regard to prevalence of tooth shade and their matching shade guides, this study was designed to compare upper central incisors shade with three different shade guides. Methods and Materials: This cross-sectional study was conducted on 120 maxillary central incisors of dental students, all over 18 years old. Census of the students was performed to complete sampling. After stain and plaque removal two observers (a dental student and a prosthodontic) determined the shade of upper right or left incisor visually and then by aid of three different shade guides (Polident, Ivoclar Chromascop, Vitapan classic). In order to compare the chosen shades by the two observers and also to with the shade guides kappa coefficient was used.Results: 58.3 % of the samples were female and 41.7% were male. The average age was 24±3.5 years with minimum 19 and maximum 41 years. The highest rank reported by the two observers in Vitaclassic shade was A hue (prevalence: 77-78%) followed by A2 (42.9%, 45.9%) and A1 (23.5%, 25%). Hue C had the least prevalence (1.2%). Shade selection by Ivoclar chromascop shade guide revealed that the color (120) and the color (110) had the greatest prevalence (44.2% and 41.7% respectively). In Polident shade guide group, the color (Y1) had the highest prevalence (71.7%).Conclusion: According to the findings distribution of natural teeth shade is higher in Vitaclassic shade guide which makes it a more practical guide. The shades in Ivoclar and Polident guides were found in smaller proportion of natural teeth determining their lower matching to natural teeth.

Background: Intrusive luxation is apical displacement of tooth into the alveolar bone due to bicycle accidents, sports accidents, falls, and fights. Intruded tooth is driven into the socket, compressing the periodontal ligament. Intrusion is considered as one of the most severe luxation injuries to affect permanent dentition. Intrusion injuries are often associated with severe damage to the tooth, periodontium, and pulpal tissue. The rare occurrence of this injury in the permanent dentition has resulted in limited studies to support suggested treatment regimens. Clinical treatment for intrusion is especially important because of the severe complications accompanying trauma. Case Report: This article reports traumatically intrusion of permanent maxillary central incisor which was followed by definite guidelines existed in management of traumatically Intruded permanent teeth. Also article is an overview of all available articles which are relevant with intrusion and provides all treatment modalities which are considered beneficial up today. Conclusion: Instant care and root canal treatment for intruded tooth can play a major role in correcting the tooth position and subsequently improving function and appearance. Therefore, clinician's knowledge and skills has a crucial role in managing intrusive luxation.

The knowledge of anatomical variations in the morphology of root canal systems can affect the successful diagnosis to deliver proper endodontic treatment. The current case report enlightens the endodontic management of an anomalous maxillary left central incisor with two roots/root canals, a C-shaped root canal configuration in a maxillary left lateral incisor identified by three-dimensional cone-beam computed tomography imaging as well as the successful aesthetic rehabilitation of maxillary fractured incisors. The chief complaint of patient was a history of trauma during his outdoor play and consequent broken upper front teeth. Tooth #9 was diagnosed with pulpal necrosis accompanied by asymptomatic apical periodontitis with two relatively dilacerated roots while the maxillary left lateral incisor (tooth #10) was diagnosed with necrotic pulp and asymptomatic apical periodontitis having a C-shaped canal. Endodontic treatment for teeth #9 and #10 were performed, followed by post and core fabrication. Tooth reinforcement was achieved with prefabricated un-polymerized glass fiber post for lateral incisor and Interlig Fiber for central incisor. Intentional root canal treatment of tooth #8 was considered to reduce labial inclination. The anomalous maxillary central incisor with two roots is an unexpected variant during endodontic treatment, and the presence of C-shaped canal in lateral incisors is extremely rare requiring careful diagnosis with radiographs, clinical examination along with additional aids,e. g. Three-dimensional (3-D) cone-beam computed tomography. 3-D imaging has added the advantages of appropriate identification of anomalous anterior teeth and careful location of additional root canal(s) during endodontic treatment.

Introduction: Estimating the width of maxillary central incisor may be difficult when an artificial tooth is selected for edentulous patients. One of the ways to choose a good size for this tooth is using extra-oral landmarks in face. This study examined the relationship between mesiodistal (MD) width of maxillary central incisor and interpupillary distance (IPD) which is a stable landmark in lifetime.Materials & Methods: In this descriptive cross sectional study, 100 Iranian subjects (50 males and 50 females, mean age 23±6.3 years) without ocular and dental deformities were selected. The MD width of upper central incisor and IPD were measured three times for each subject using Boley Gauge with 0.1 mm accuracy and then, the mean values were calculated. A mathematic equation to evaluate correlation between MD width of upper central incisor and IPD was calculated and then examined in the other 20 subjects (10 males and 10 females, mean age 24.8±1.56 years) by statistically comparing the difference between calculated and real size of tooth with paired t-test. Results: In the first stage, these results were obtained: the mean MD width of maxillary central incisor was 8.6±0.4mm and the mean IPD was 62.1±2.8mm. The correlation coefficient between these two parameters was r=0.446 (P<0.05). The calculated equations for this relationship were: (Y=0.15x–0.0002x² in men and Y=0.22x–0.0014x² in women, “y” represents MD width of maxillary central incisor and “x” represents IPD). In the second stage, these equations were applicable in 90% of subjects (18 from 20 subjects) with 0.5mm of accuracy. Conclusion: IPD is a good landmark for estimating MD width of maxillary central incisor in edentulous patients.

Trauma to primary teeth can lead to devastating sequels in development of permanent successors. The disturbance may range from enamel hypoplasia and/or hypo-calcification to arrest of dental bud development. Crown dilaceration of permanent teeth is one of the consequences of trauma to deciduous teeth mainly due to intrusion or avulsion. This report presents a mandibular central incisor with dilacerated crown and yellowish discoloration with symptomatic apical abscess. History revealed avulsion of primary mandibular central incisors. The purpose of this report is to present: 1. Reasons of dilacerated crown, yellowish discoloration and necrotic pulp in this case, 2. Treatment options in different types of crown dilacerations and also in this case. The tooth was successfully managed by nonsurgical root canal therapy and restoration with composite resin to restore esthetics. We emphasize that trauma to deciduous teeth should not be understated, and regular follow up is essential.

Introduction: Treatment of immature permanent teeth damaged by caries or trauma is usually a challenge to a dentist. Recently, revascularization process is performed to induce root development in immature necrotic teeth. The purpose of this report was to present a case of pulp revascularization in an immature necrotic tooth.Case Report: An 8-year-old boy was presented to the pediatric Department of Mashhad dental school with the chief Complaint of localized swelling on the anterior region of maxilla and a history of trauma to the maxillary right central incisor. Based on clinical and radiographic Findings, the diagnosis was pulpal necrosis with symptomatic apical abscess. Revascularization therapy was performed over multiple visits. At 6- month follow-up, in addition to complete healing of the periapical lesion, apex had been closed and dentinal wall thickness had been increased. At 12-month follow-up, pulp canal obliteration (PCO) was observed. At 24-month follow-up; tooth was asymptomatic and PCO had been.Conclusion: Considering the loss of periapical radiolucencies and root development of this tooth after a short period of time, it could be concluded that revascularization was an appropriate treatment method in immature necrotic teeth.

A case involving the replantation of an avulsed incisor after long extra-oral period (8 days) is reported. After cleaning the root surface, the tooth was soaked in fluoride gel for 20 minutes and root canal therapy was performed extra orally. The tooth was stabilized by wire and composite for six weeks.The patient has been periodically recalled and the tooth monitored for 36 months after replantation. Only minor external surface resorption was observed in the periodical area on the radiograph, which was taken immediately before removal of the splint and the rate of subsequent replacement resorption has been acceptable. It should be considered that and extended extra oral period is not an absolute contraindication to replantation. Teeth replanted after long extra- alveolar periods can function for a long period of time and thus postpone prosthetic treatment.