Of note is a case of a complicated fracture and root, in which intraalveolar transplantation was used, using Lemix paste mixed with crown hydroxide during four years as intra-conduct medication, following its provisional evolution.
Case description:.
In 1996, a 13-year-old boy presented with a 1-week history of a fracture of the upper right central lobe without having received dental treatment.
On physical examination, a complicated fracture of the root-coronary reaches up to two millimeters below the gingival marginal edge was observed.
Surgical extrusion of the root was chosen.
After anesthesia with 4% mepivacaine, an incision was made in the periodontal ligament and the root was dislocated with a elevator placed on the mesiopalatal and palatal sides, respectively.
The root was extracted and additional fractures were located.
The apical fragment was replaced, seeking that the tooth was stabilized and the fracture was optimally exposed with minimal extrusion.
The tooth was rotated to a position of 90o from the original, which was considered more stable and subsequently ferulized to adjacent teeth.
To avoid interferences during occlusion, part of the crown was removed.
1.
One week after the initial treatment, the pulp was removed and filled with Ledermix and calcium hydroxide to equal parts, temporarily restoring the crown with composite.
After six months, in the absence of signs of root resorption, the canal was permanently filled with crown-percha, but it had suffered a discoloration, acquiring an intense gray color.
The bleaching technique of non-vital teeth was performed, using a mixture of glycerin and peroxidamide peroxide (Endoperox®, Septodont France).
The patient has been controlled for four years, not observing signs of root resorption in this period of time.
