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ePaper created 2015-03-07, 18:13:20 | version 1.33.01
I case report _ CT in treatment planning vitality tests. During the visit, the endodontist per- formed periapical radiographs of the area (Fig. 2), and based on this the existence of a supernumerary tooth at the apical level of the incisor growing to- wards the floor of the nasal cavity was confirmed. The endodontist requested a CT scan to study the position and assess the possibility of surgical ex- traction. The CT scan showed the position of the supernu- merary tooth relative to the roots of the adjacent teeth, confirming growth towards the periapical re- gion of tooth #21, that is, a 180-degree deviation from the correct orientation for eruption in the den- talarch.Reconstructionin3-Dshowedthisphenom- enon clearly (Figs. 3–6). Endodontictreatmentoftooth#21wasperformed, during which the congested pulp was removed and some bleeding was observed. The length of the gutta- percha obturation was deliberately longer than re- quiredinordertofacilitatesurgery(Figs.7–9). Surgical treatment was planned and consisted of raising a semilunar flap on the periapical region of tooth #21 and performing a minimum root resection of 2 mm approximately without a bevel, using a size 0.23 round bur with a straight handpiece, to expose the supernumerary tooth’s crown. The crown was sectioned at the coronal middle third and the incisal portion was removed (Fig. 11). A hole was made in what would be the middle and cervical thirds of the supernumerarytoothtoforceitup(Fig.12)andmake the extraction through the osteotomy created for apicectomy, thereby achieving a complete extraction (Fig. 13) with minimal trauma to bone and the roots of the incisors. The oedematous pedicle that was compressed by the erupting follicle of the supernumerary tooth and 28 I cone beam1_2015 Fig. 6 Fig. 7 Fig. 8 Fig. 9