Evaluation of radiographs, clinical signs and symptoms associated with pulp canal obliteration: an aid to treatment decision

Abstract

Pulp canal obliteration (PCO) is a sequela of tooth trauma. The dental clinician faced with this condition has to make a difficult decision. The aim of this study was to evaluate the clinical signs and symptoms associated with teeth with PCO and to assess the status of the periapical tissues using the periapical index (PAI) as an aid in making a treatment decision. The study included teeth diagnosed with PCO in patients with a history of traumatic injury to the involved teeth. Histories of associated signs and symptoms including pain, swelling and drainage from a sinus tract were elicited. Tooth color, sensibility to electric pulp testing, mobility and percussion tenderness were recorded. The periapical status was assessed using the PAI. Two hundred and seventy-six teeth were diagnosed with PCO. One hundred and fifty-seven (56.9%) and 119 (43.1%) demonstrated partial or total PCO, respectively. Yellow discoloration presented most frequently, occurring in 186 (67.4%) teeth. Sixty-two (33.3%) of these had developed periapical lesions and reacted negatively to sensibility testing. Fifty-seven (30.7%) of these teeth presented radiographically with a normal periapical appearance and reacted normally to sensibility testing, whereas 67 (36.0%) presented with small changes in the periapical bone pattern and reacted in the high normal range to sensibility testing. Teeth with PAI scores < or =2 presented with occasional spontaneous pain. Teeth with PAI scores > or =3 presented with clinical symptoms and signs ranging from pain on percussion to spontaneous pain, and slight swelling to sinus tract drainage. Based on the findings of this study, endodontic treatment should be initiated in teeth with tenderness to percussion, PAI scores > or =3 and a negative response to sensibility testing.

Discussing a Forensic Dental Examination of 1861 – A Scientific and Historic Overview

“…Men usually exhibit more attrition than women at a given age and so the phenomenon may aid in sex estimation, but this is a very poor discriminant [12]. Pulpal response to trauma is characterized by deposition of hard tissue in the root canal space and the affected crown is darker in color because of a decrease in dentine translucency [27]. Moreover, failure to protect the pulp can lead to infection caused by remaining bacteria.…”

Calcific Metamorphosis with Pathological Root Resorption in Permanent Teeth: Morphohistometric Evaluation of Two Cases

“…In a pulp with moderate or very good prognosis for healing, the tooth can show an obliteration of the pulp chamber and canal in periods of 18 months to five years or more. This is a common sequel to dental trauma and it was referred as Calcific Metamorphosis (CM) also called Pulp Canal Obliteration (Malhotra & Mala;Oginni et al, 2009). This condition is defined by the American Association of Endodontists as "…a pulpal response to trauma characterized by rapid deposition of hard tissue within the canal space" (Siddiqui, 2014).…”

Descoloração dentinária: aplicação de facetas Componeer®

“…A obliteração do canal radicular, também designada como metamorfose cálcica da polpa, resulta, frequentemente, da concussão, subluxação ou intrusão dos dentes 18,21,22 . Radiograficamente pode notar-se a redução do volume da câmara pulpar e/ou canal radicular.…”

“…Esta pode ser detetada precocemente, mas, na maioria dos casos, permanece indetetável até um ano 22 .…”