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Transient apical breakdown associated with clear aligner therapy: a case report.

Br Dent J

January 2025

Reader in Orthodontics and Honorary Consultant in Orthodontics, Centre for Oral Bioengineering, Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, Whitechapel, London, E1 2AD, UK.

Transient apical breakdown (TAB) is widely reported in response to trauma, yet its occurrence due to orthodontic forces, particularly in aligner therapy, is less documented within current literature. TAB can easily be misdiagnosed as pulp necrosis, potentially leading to unnecessary and irreversible endodontic procedures. This case report describes an instance of TAB following the initiation of aligner treatment, where the affected tooth initially presented with signs suggesting pulp necrosis but regained normal coloration and pulpal response after six months of active monitoring.

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Mandibular and maxillary fractures are common in small animals and present significant challenges for repair due to the intricate anatomical features involved. This retrospective case series describes a technique for achieving rigid open mouth maxillomandibular fixation using interarch wiring while maintaining correct alignment between the upper and lower teeth with polymethylmethacrylate (PMMA) moulds of the canine teeth for treating maxillomandibular fractures in cats. The study includes a description of the postoperative outcomes and complications encountered.

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Background: Dental treatment may not be possible for patients with a profound acquired brain injury without pharmacological support. Intravenous (IV) sedation with midazolam is a widely accepted, safe, and effective mode of treatment for people with a disability, but there is limited evidence in this patient cohort.

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