Pulp Canal Obliteration Case Study

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Pulp canal obliteration (PCO) is a condition which can occur in teeth where hard tissue is deposited along the internal walls of the root canal and fills most of the pulp system leaving it narrowed or completely obliterated. Signs and symptoms of obliteration may include Yellow tooth discoloration, Lack or response to pulp sensibility test (e.g. ethyl chloride, electric pulp test.(1) Pulp necrosis has also been reported as a complication with ranges varying from 1% to 16%(2). Periapical lesion develops in a range of 7.3% to 24% in these cases up to 4 years after initial traumatic injury, especially in completely calcified teeth(2). If root canal treatment is attempted it can be difficult or impossible on a tooth with pulp canal obliteration.[1] The present case report illustrates the successful management of an iatrogenic perforation with Biodentine (Septodont, St. MaurdesFossés,
France) at a level just apical to the cementoenamel junction on the labial aspect of an upper right central incisor with radiographic evidence of pulp canal obliteration.

Case report
A 25 year old male presented to us with chief complaint of pain, redness and laceration in gingiva in relation to the front tooth which
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If root canal treatment is selected as a routine procedure, most would be unnecessary as the majority of teeth with PCO will never suffer pulpal necrosis and periapical disease. Oginni et al recommended that root canal treatment should be initiated in teeth with tenderness to percussion, PAI scores >3 (The PAI quantifies periapical inflammation/disease and scores 2–5 represent disease) and a negative response to sensibility testing(4). However, elective or intentional root canal procedure can be considered in case of aesthetic concerns or when tooth is unresponsive to vital bleaching

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