![]() In all instances, pulpal obliteration to some degree is described however, the rate and extent of pulpal obliteration in the mature dentition seem greater than those occurring in the immature dentition. Pulpal obliteration was assessed by radiographic records. Calcific Metamorphosis (Pulpal Obliteration) and I. Three case reports of patients on long-term GCS therapy are presented.Long term recall to monitor vitality will be done with this type of approach.Īdeleke O Oginni and Comfort A Adekoya-Sofowora "Pulpal sequelae after trauma to anterior teeth among adult Nigerian dental patients", BMC Oral Health 2007, 7 :11 doi:10.1186/1472. If a coronal barrier can be placed, without exposure (and possible contamination) of the pulpal tissue, then it would seem that internal bleaching could be performed without the need for complete endodontic therapy. If pulpal obliteration occurs without necrosis, there may not be a need for endodontic therapy prior to internal bleaching. This refers to a pulp that has mild inflammation due to pulpal irritation that is capable of healing and returning to a clinically normal pulp if appropriate treatment therapy is performed. This tooth will be recalled to monitor vitality over time. (Opalesence Endo)Īfter 1 week, pt returns and the internal bleach is removed. It was decided to perform the internal bleaching without endodontic therapy.Ī standard internal coronal barrier (glass ionomer) is placed over the calcific barrier to prevent internal bleach from exiting through cervical dentinal tubules and causing an inflammatory reaction in the pdl. 2-17 for canal obliteration and 1-14 for pulpal necrosis.8 Changes occurred in the pulp are considered to be reversible most of the time unless the pulp. RCT is initiated and a complete calcific barrier is noted. A 1mm thick calcific barrier is found just below the level of the CEJ. Summary Pulp canal obliteration (PCO) occurs commonly following traumatic injuries to teeth. It was decided to perform endodontic therapy, prior to internal bleaching to improve the esthetics of this tooth. Non-responsive to thermal testing, normal to percussion and probing. This 13 year old boy previously suffered a traumatic injury. The following case is a variation of this procedure. To remove this discoloration, typically endodontic therapy is performed and internal, non-vital bleaching is performed. It was also noted that injuries suffered in the 1st and 2nd decades of life resulted in more pulpal obliteration, while those suffered in the 3rd decade resulted in necrosis more often. Pulpal obliteration is characterized by the apparent loss of the pulp space radiographically and a yellow discoloration of the crown clinically 8. Necrosis was more associated with fractured teeth, while pulpal obliteration was associated with subluxation and concussion injury. An interesting study of 168 traumatized, discolored, anterior teeth found that 47.6% were partially obliterated, 31.6% were totally obliterated, and 20.8% were found necrotic. Calcific metamorphosis is the partial or complete obliteration of the pulp following dental trauma. ![]() ![]() Internal staining is common following a traumatic injury to a tooth. It has been reported that 11.6% - 33% of boys and 3.6% - 19% of girls suffer some kind of dental trauma before age 12. ![]()
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