title: Natural reversal of tooth discoloration and pulpal response to testing following removal of a miniscrew implant for orthodontic anchorage: a case report.
abstract: OBJECTIVE
  To highlight the reversal of signs suggesting pulpal necrosis following removal of a mini-implant without endodontic intervention.
  
  
  CONCLUSIONS
  A 23-year-old woman presented with a class III malocclusion, with crowded and malformed teeth and excessive gingival display. During orthodontic treatment, a Tomas orthodontic miniscrew was placed between the root apices of the maxillary central incisors. This was carried out by an orthodontic specialist who had treated more than 700 patients (with more than 2000 mini-implants) over the past 9 years. After 2 weeks of treatment, the right maxillary central incisor discoloured and did not respond to electrical pulp tests (EPT) but was sensitive to endo-ice. The miniscrew was removed under local anaesthesia. Teeth 11 and 21 were fixed with ligation wire, and glass-ionomer cement (GIC) was added to the occlusal surfaces of the first and second maxillary molars to heighten the occlusion and disclude the maxillary anterior teeth. After 4 months, the colour and pulp reactions to EPT and endo-ice of tooth 11 returned to normal. Because the use of a miniscrew had appeared to damage the pulp, subsequent a conservative orthodontic treatment using, traditional 'J' hooks was used and achieved satisfactory results. After 23 months of orthodontic treatment, the treatment was complete and a 15-month follow-up showed a successful outcome.
authors: Department of Orthodontics, Changzhou Stomatological Hospital, Changzhou, China.
authors: Y J
authors: YJ
authors: Qin
authors: Department of Orthodontics, Institute of Stomatology, Nanjing Medical University, Nanjing, China.
authors: G D
authors: GD
authors: Zhang
authors: Department of Orthodontics, Institute of Stomatology, Nanjing Medical University, Nanjing, China.
authors: Y
authors: Y
authors: Zhang
authors: Department of Orthodontics, Institute of Stomatology, Nanjing Medical University, Nanjing, China.
authors: Y F
authors: YF
authors: Ping
authors: Department of Orthodontics, Institute of Stomatology, Nanjing Medical University, Nanjing, China.
authors: C Y
authors: CY
authors: Zhao
mesh_terms: D001863:Bone Screws / Q000009:adverse effects*; D015921:Dental Implants / Q000009:adverse effects*; D003790:Dental Pulp Necrosis / Q000209:etiology / Q000517:prevention & control*; D020878:Device Removal; D005260:Female; D006801:Humans; D007180:Incisor; D008313:Malocclusion, Angle Class III / Q000628:therapy; D008437:Maxilla; D052280:Orthodontic Anchorage Procedures / Q000009:adverse effects* / Q000295:instrumentation*; D014075:Tooth Discoloration / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D015921:Dental Implants
keywords: follow-up; miniscrews; orthodontic anchorage; pulpal necrosis