Abstract

Pulp canal obliteration (PCO) is a frequent finding associated with pulpal revascularization after luxation injuries of young permanent teeth. The underlying mechanisms of PCO are still unclear, and no experimental scientific evidence is available, except the results of a single histopathological study. The lack of sound knowledge concerning this process gives rise to controversies, including the most suitable denomination. More than a mere semantic question, the denomination is an important issue, because it reflects the nature of this process, and directly impacts the treatment plan decision. The hypothesis that accelerated dentin deposition is related to the loss of neural control over odontoblastic secretory activity is well accepted, but demands further supportive studies. PCO is seen radiographically as a rapid narrowing of pulp canal space, whereas common clinical features are yellow crown discoloration and a lower or non-response to sensibility tests. Late development of pulp necrosis and periapical disease are rare complications after PCO, rendering prophylactic endodontic intervention useless. Indeed, yellowish or gray crown discoloration may pose a challenge to clinicians, and may demand endodontic intervention to help restore aesthetics. This literature review was conducted to discuss currently available information concerning PCO after traumatic dental injuries (TDI), and was gathered according to three topics: I) physiopathology of PCO after TDI; II) frequency and predictors of pulpal healing induced by PCO; and III) clinical findings related to PCO. Review articles, original studies and case reports were included aiming to support clinical decisions during the follow-up of teeth with PCO, and highlight future research strategies.

Highlights

  • Critical Review Endodontic TherapyPulp canal obliteration after traumatic injuries in permanent teeth – scientific fact or fiction?

  • Dentin synthesis and apposition along dental pulp cavity walls occur throughout the life of a vital tooth

  • The American Association of Endodontists defines calcific metamorphosis as “...A pulpal response to trauma characterized by rapid deposition of hard tissue within the canal space.”[16]. This denomination was adopted by several authors, including Patterson and Mitchell,[17] who mentioned the expression pulp canal obliteration in their paper; Holcomb and Gregory Junior;[18] Smith,[19] Schlinder and Gullickson,[20] West,[21] Amir et al.,[22] Gopkrisna et al.,[23] Malhotra and Mala,[24] and Siddiqui and Mohamed.[5]

Read more

Summary

Critical Review Endodontic Therapy

Pulp canal obliteration after traumatic injuries in permanent teeth – scientific fact or fiction?. Juliana Vilela BASTOS(a) Maria Ilma de Souza CÔRTES(b) (a)Universidade Federal de Minas Gerais UFMG, School of Dentistry, Department of Restorative Dentistry, Belo Horizonte, MG, Brazil. (b)Pontifícia Universidade Católica de Minas Gerais – PUC-MG, Department of Dentistry, Belo Horizonte, MG, Brazil. Declaration of Interests: The authors certify that they have no commercial or associative interest that represents a conflict of interest in connection with the manuscript

Introduction
Physiopathology of PCO after TDI
Frequency and predictors of pulpal healing with PCO after TDI
Clinical findings
Radiographical signs
Findings
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call