PMC4034634_01
Fracture involving permanent maxillary central incisors
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F1
Intraoral examination revealed permanent dentition with fracture of both maxillary permanent central incisors (Fig. 1) and pus discharge through the open pulp chambers of both centrals.
Periapical radiograph revealing inverted mesiodens apical to 11
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F2
IV injury was made as involving maxillary permanent central incisors. Intraoral periapical radiograph taken for maxillary central incisor area showed periapical radiolucency in relation to central incisors, presence of an inverted supernumerary tooth in the periapical area of the right central incisor and the presence of blunderbuss canal for left central incisor (Fig. 2).
Occlusal radiograph revealing endodontically treated 11
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F3
Treatment planning included, completion of root canal treatment in maxillary right central incisor (Fig. 3) followed by extraction of the inverted supernumerary tooth under local anesthesia and apexification for maxillary left central incisor.
Extracted supernumerary tooth
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F4
The crown of the supernumerary tooth was sectioned with a fissure bur and removed as first piece and the root is elevated into the space vacated by the crown and removed (Fig. 4).
Periapical radiograph revealing apexification with MTA and endodontic treatment of 21
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F5
Intraoral Periapical (IOPA) radiograph was taken after appropriate amount of MTA was condensed into the canal (Fig. 5).
Composite restoration in relation to 11 and 21
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F6
After 3 weeks of apexification composite build-up was done (Fig. 6).