Endodontic management of maxillary central incisor with pulp canal obliteration

Lakinepally, Abishek; Poonia, Anish; Samarthy, Dileep Kishore; Edulapalli, Keerthi

doi:10.1136/bcr-2018-227318

Cited by 1 publication

(2 citation statements)

References 4 publications

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“…Consistent with previous reports [18,44], this study presents several cases that highlight the difficulty of performing RCT in teeth with pulp obliteration. The most mentioned problems relate to the need for significant removal of the tooth structure during conventional access opening [24,30,35] and to the difficulty in locating the root canal [38,41], which can be overcome with several safe and feasible clinical strategies, such as CBCT scans, magnification with microscopy and ultrasonic tips [10]. When conservative attempts to locate the canal are unsuccessful, two other treatment options have been advocated in the literature: RCT with guided access [45] and endodontic (root end) surgery [46,47].…”

Section: Discussionmentioning

confidence: 99%

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Management of Pulp Canal Obliteration—Systematic Review of Case Reports

et al. 2021

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Background and Objectives: This systematic review aimed to assess the literature focusing on the clinical management of traumatized teeth with Pulp Canal Obliteration (PCO) and propose an updated clinical decision-making algorithm. The present review follows the PRISMA guidelines and was registered on PROSPERO database (CRD42020200656). Materials and Methods: An electronic search strategy was performed in Pubmed, EBSCOhost and LILACS from inception to March 2021. Only anterior permanent teeth with PCO due to dental trauma were included. Regarding clinical approaches, only teeth managed with a “watchful waiting” approach, tooth bleaching or root canal treatment (RCT) were included. Quality assessment was performed using the JBI Critical Appraisal Tool for Case Reports. Results: Twenty case reports were selected, resulting in a total of 27 patients. The number of traumatized teeth diagnosed with PCO was 33. The “watchful waiting” approach was the most implemented clinical strategy. Discolored non-symptomatic PCO teeth were mostly managed with external bleaching. The prevalence of pulp necrosis (PN) was 36.4%. For teeth diagnosed with PN, non-surgical RCT was performed in 10 teeth and surgical RCT in one tooth. Guided endodontic technique was performed in six of those teeth. Conclusions: For discolored non-symptomatic PCO teeth, external bleaching is advocated and the RCT approach should not be implemented as a preventive intervention strategy. Symptomatic PCO teeth should follow regular endodontic treatment pathways. Clinical approach of teeth with PCO should follow a decision-making algorithm incorporating clinical and radiographic signs and patient-reported symptoms.

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Section: Discussionmentioning

confidence: 99%

“…A total of 20 articles were included [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41]. Figure 1 describes the selection process.…”

Section: Study Selectionmentioning

confidence: 99%