This may occur idiopathically or following direct pulp capping or trauma. Pulp obliteration is an extremely rare morphological type of pulp calcification, with calcified material completely occupying the pulp chamber and root canal spaces. Pulp obliteration may also be seen in dental anomalies such as. Pulp canal obliteration pco, is defined as a deposition of hard tissue within the root canal space. A retrospective descriptive study on 112 traumatized teeth was carried out 9year followup using the clinical and radiographic data from. Pulp canal obliteration after traumatic injuries in. The incidence of pulp canal obliteration following dental trauma has been reported to be approximately 4 24% and its management can be quite challenging for the practitioner.
Pdf this article describes four cases with safe and feasible clinical treatment strategies for anterior teeth with pulp canal obliteration pco using. The incidence of pulp canal obliteration following dental trauma has been reported to be approximately 4 24% and its management can be quite challenging. Complete radiographic obliteration of the root canal space does not necessarily mean the absence of the pulp or canal space. Oranmore endodontics, root canal treatment galway home. Pdf the incidence of pulp canal obliteration following dental trauma has been reported to be approximately 4 24% and its management can be quite. Pulp obliteration was evaluated on the final periapical radiographs in the togroup. Pulp canal definition of pulp canal by medical dictionary. Management of clinical complications following pulp canal. A referral was made to an endodontist and pulp testing deemed this tooth to be necrotic. Camp, dds, msd although preventive measures have reduced caries, premature loss of pulpally involved primary teeth remains a common problem. This article describes one case with a clinical treatment strategy using high technology for this second mandibular molar with pulp canal obliteration pco using digital radiography dr, dental operating microscopy dom, conebeam computed tomography cbct, and ultrasonic tips us.
We encounter partial and total pulp canal obliteration as well as obliteration in a form of pulp stones. Endodontic management of maxillary central incisor with. Pulp canal obliteration commonly occurs after dental trauma. Calcific metamorphosis, or pulp canal obliteration pco, is the pulp response to trauma, characterized by rapid deposition of mineralized tissue in the root canal space. To present various management approaches and treatment strategies in pulp canal obliteration. Review article channels to cruise the calcified canal sridevi n, puspha s, iqbal m, prasad a, singh p, singh r abstract. Summary pulp canal obliteration pco occurs commonly following traumatic injuries to teeth. These tissues can eventually produce the radiographic appearance of a root canal space that has become partial or completely calcified. Problemsolving challenges in dentin hypersensitivity and vital pulp therapy. Pulp vitality in teeth suffering trauma during orthodontic. Electric pulp testing ept is the most useful test to assess the neurovascular supply. I it has also been referred to as pulp canal obliteration. Pulp calcification leading to obliteration of the root canal may be an associated manifestation of this condition 6, 23.
Different factors, such as dental trauma, carious lesions, abfraction, abrasion, pulp capping, occlusal imbalance, orthodontic treatment, harmful oral habits and individual. This article presents case of pulp canal obliteration of maxillary central incisor that was managed with usage of cone beam ct cbct, microscopes, periodic radiographs and small sized hand files which helped in achieving patency to the pulp chamber and root canal. The incidence of pulp canal obliteration following dental trauma has been reported to be approximately 4 24%. Calcific metamorphosis, or pulp canal obliteration pco, is the pulp response to trauma, characterized by rapid deposition of mineralized tissue in the root canal. The underlying mechanisms of pco are still unclear, of a. Degree of pulp obliteration was rated according to jacobsen and kerekes19 as total obliteration pulp chamber and root canal hardly or not discernible or partial obliteration pulp chamber not discernible and root canal markedly narrowed but clearly visible. Calcific metamorphosis, cbct, dental trauma, pulp canal obliteration, rootfracture healing. It causes complete or partial obliteration of the root canal system which poses challenge for endodontic treatment. Pdf pulp canal obliteration in an unerupted permanent. Pulp canal obliteration after replantation of avulsed immature teeth. The resultant mesial drift of the permanent teeth frequently leads to. Pulp canal obliteration after traumatic injuries in permanent.
It can be caused due to other factors such as age, systemic factors, long standing low grade stimulus. It is characterized by apparent loss of the pulp space radiographically and a yellowish discoloration of the clinical crown. Sensibility tests should be considered in association with other clinical and radiographic. Nonsurgical treatment of pulp canal obliteration using.
Management of pulp canal obliteration using the modifiedtip. Approximately 424% of traumatized teeth develop varying degrees of pulpal obliteration that is characterized by the. Pulp canal obliteration pco is a frequent finding associated with pulpal revascularization after luxation injuries of young permanent teeth. Different factors, such as dental trauma, carious lesions, abfraction, abrasion, pulp capping, occlusal imbalance. Locating the canal and negotiating it to full working length may lead. Root canal therapy was completed on september 15, 2011 figures 9, 10. Locating the canal and negotiating it to full working length may lead to. Pulp canal obliteration may affect all teeth and take various forms. Problem solving in endodontics fifth edition, 2011. Although radiographs may reveal what appears to be total obliteration of the pulp canal, generally there remains clinical evidence of a pulp canal and pulpal tissue. Pdf management of pulp canal obliteration using the modified. Endodontics also known as root canal treatment rct is that specialty that deals with the tooth, the dental pulp and the surrounding tissues. The etiology of pulp obliteration may be trauma or systemic diseases such as secondary hyperparathyroidism.
Alcocks canal a tunnel formed by a splitting of the obturator fascia, which encloses the pudendal vessels and nerve. Pulp obliteration in a patient with sclerodermatous. Pulpal necrosis secondary to orthodontic tooth movement. Received a call today about pulp canal obliteration dug through the archives and here is the most definitive article i could find.
Pulp canal obliteration pco occurs commonly following traumatic injuries to teeth. Partial or total pulpal canal obliteration is a common sequel of a traumatic injury. Discussion irreversible pulpal changes are very rare with orthodontic movement of normal, healthy teeth. Pulp canal obliteration is defined as a deposition of hard tissue within the root canal space. Summary pulp canal obliteration pco occurs commonly. International endodontic journal, 45, 177197, 2012. This is the first report of a patient with extensive sclerodermatous cgvhd who developed generalized dental pulp obliteration. Avulsion of permanent teeth is one of the most serious dentoalveolar traumatic injuries.
Review article channels to cruise the calcified canal. The purpose of this study was to determine the occurrence of pulp canal obliteration pco in traumatized primary maxillary central incisors and its association with secondary pulp necrosis, type of trauma, and further incidence of trauma. Pulp canal obliteration after traumatic injuries in permanent teeth scientific fact or fiction. Pulp canal obliteration following trauma to primary. Pulp canal obliteration pco is defined as a deposition of hard tissue within the root canal space. Paul mccabe is a registered endodontic specialist located in oranmore, co. The various challenges in endodontic treatment is difficulty in identifying the canal orifice which can be achieved. Diagnosis of symptomatic apical periodontitis with partial obliteration of the pulp canal was made and non surgical root canal treatment was advised to the patient. Management of iatrogenic root perforation with pulp canal.
Locating the canal and negotiating it to full working length may lead to iatrogenic errors such as fractured instrument and perforation. Reasons for failure of pulpotomy therapy erroneous diagnosis of a chronically inflamed radicular pulp as non inflame and noninfected. Success in root canal treatment is based on proper debridement, disinfection and obturation of the root canal. Clinical update naval postgraduate dental schoolnational. Approximately 424% of traumatized teeth develop varying degrees of pulpal obliteration that is characterized by the apparent loss of the pulp space radiographically and a yellow discoloration of the clinical crown. Endodontic management of maxillary central incisor with pulp canal. Pulp canal obliteration in an unerupted permanent incisor following trauma to its primary predecessor. Europe pmc is an archive of life sciences journal literature.
Symmetrical pulp obliteration in mandibular first molars. In such situations, the clinician may be faced to a difficult or impossible to negotiate root canal and there is clearly a potential for a higher frequency. Root canal treatment of teeth with pulpal obliteration is often challenging. Management of iatrogenic root perforation with pulp canal obliteration aishvarya kaushik, sangeeta talwar, seema yadav, sarika chaudhary, ruchika roongta nawal departments of conservative dentistry and endodontics, maulana azad institute of dental sciences, new delhi, india. The scope of endodontics includes, but is not limited to. The irritating effect of eugenol as a component of the pulp space filling material. No other symptoms such as hot, cold or percussion sensitivity were present. Pulpotomy is the term for removal of the coronal pulp with the intent of maintaining the vitality of the remaining radicular pulp tissue. Pulp canal obliteration pulp canal obliteration pco occurs more frequently in teeth with open apices which have suffered a severe luxation injury.
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