PMC9833915_01
Initial radiographic examination of SRA (age of patient: 11 years and 9 months). (a) Panoramic radiography. (b) Periapical radiograph of the maxillary incisors. (c) and (d) Periapical radiographs of the lower incisors. Notice the abnormally short roots with round apices of all teeth except first molars. Mandibular first premolars also have short roots, but their root to crown ratio is bigger than 1 : 1. Maxillary lateral incisors present intense root resorption and apical radiolucency.
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Initial radiographic evaluation included the OPG and periapical X-rays of the incisors (Figures 1(a), 1(b), 1(c), and 1(d)).
Passive splinting of maxillary lateral incisors to their adjacent teeth. Two separate palatally bonded wires were used.
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The placement of a single wire from tooth #13 to tooth #23 would irritate the incisal papilla and interfere in the occlusion; thus, two separate pieces of wire were used to splint the teeth #11-#12-#13 and #21-#22-#23 together, respectively (Figure 2).
(a) 3D-printed dental casts with the custom-made mouthguard. (b) Intraoral picture of the mouthguard.
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Therefore, it was decided to make 3D-printed dental casts instead (Figure 3(a)) using a computer-aided design - computer-aided manufacturing (CAD-CAM) system. The custom-made mouthguard was tried in the mouth (Figure 3(b)); instructions on how to put it on, remove, clean, and store were given.
(a) and (b) Periapical radiographs of the upper incisors at 6 months. Slight radiolucent lesions around lateral incisors still persist. (c) Periapical radiograph of the upper incisors at 24 months. Complete healing with no radiolucent area around maxillary lateral incisors.
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However, radiographic reevaluation with periapical radiographs revealed that the radiolucency at the maxillary lateral incisors persisted (Figures 4(a) and 4(b)). The 24-month radiographic re-evaluation showed complete healing of the periapical area of the upper lateral incisors and no further root resorption (Figure 4(c)).