Pulp canal obliteration

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Pulp canal obliteration (also termed pulp chamber obliteration [1] or root canal obliteration) [1] 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 and restricted. [2]

The exact causes of pulp obliteration are unclear [2] but it typically occurs in response to dental trauma, [1] especially following luxation injuries involving displacement, particularly if a tooth is replanted after being completely avulsed (knocked out) [3] This response is common in this scenario and typically starts to occur several months after replantation. [3] In other cases obliteration can occur if the tooth is drilled down extensively during dental treatment, e.g. during crown preparation. [2]

Signs and symptoms of obliteration include:

Most of the time this condition is painless [1] and is managed conservatively by monitoring the tooth with routine radiographs. [1] There is a small risk of pulp necrosis. [2] If root canal treatment is attempted it can be difficult or impossible on a tooth with pulp canal obliteration. [1]

See also

Related Research Articles

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A root canal is the naturally occurring anatomic space within the root of a tooth. It consists of the pulp chamber, the main canal(s), and more intricate anatomical branches that may connect the root canals to each other or to the surface of the root.

<span class="mw-page-title-main">Endodontics</span> Field of dentistry

Endodontics is the dental specialty concerned with the study and treatment of the dental pulp.

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<span class="mw-page-title-main">Pulp (tooth)</span> Part in the center of a tooth made up of living connective tissue and cells called odontoblasts

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<span class="mw-page-title-main">Root canal treatment</span> Dental treatment

Root canal treatment is a treatment sequence for the infected pulp of a tooth which is intended to result in the elimination of infection and the protection of the decontaminated tooth from future microbial invasion. Root canals, and their associated pulp chamber, are the physical hollows within a tooth that are naturally inhabited by nerve tissue, blood vessels and other cellular entities. Together, these items constitute the dental pulp.

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Resorption of the root of the tooth, or root resorption, is the progressive loss of dentin and cementum by the action of odontoclasts. Root resorption is a normal physiological process that occurs in the exfoliation of the primary dentition. However, pathological root resorption occurs in the permanent or secondary dentition and sometimes in the primary dentition.

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<span class="mw-page-title-main">Dental trauma</span> Medical condition

Dental trauma refers to trauma (injury) to the teeth and/or periodontium, and nearby soft tissues such as the lips, tongue, etc. The study of dental trauma is called dental traumatology.

Dental subluxation is a traumatic injury to the periodontal tissue in which the tooth has increased mobility but has not been displaced from its tooth socket.

<span class="mw-page-title-main">Dental avulsion</span> Medical condition

Dental avulsion is the complete displacement of a tooth from its socket in alveolar bone owing to trauma. Normally, a tooth is connected to the socket by the periodontal ligament. When a tooth is knocked out, the ligament is torn.

<span class="mw-page-title-main">Regenerative endodontics</span> Dental specialty

Regenerative endodontic procedures is defined as biologically based procedures designed to replace damaged structures such as dentin, root structures, and cells of the pulp-dentin complex. This new treatment modality aims to promote normal function of the pulp. It has become an alternative to heal apical periodontitis. Regenerative endodontics is the extension of root canal therapy. Conventional root canal therapy cleans and fills the pulp chamber with biologically inert material after destruction of the pulp due to dental caries, congenital deformity or trauma. Regenerative endodontics instead seeks to replace live tissue in the pulp chamber. The ultimate goal of regenerative endodontic procedures is to regenerate the tissues and the normal function of the dentin-pulp complex.

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Root fracture of the tooth is a dentine cementum fracture involving the pulp.

Dental intrusion is an apical displacement of the tooth into the alveolar bone. This injury is accompanied by extensive damage to periodontal ligament, cementum, disruption of the neurovascular supply to the pulp, and communication or fracture of the alveolar socket.

Tooth replantation is a form of restorative dentistry in which an avulsed or luxated tooth is reinserted and secured into its socket through a combination of dental procedures. The purposes of tooth replantation is to resolve tooth loss and preserve the natural landscape of the teeth. Whilst variations of the procedure exist including, Allotransplantation, where a tooth is transferred from one individual to another individual of the same species. It is a largely defunct practice due to the improvements made within the field of dentistry and due to the risks and complications involved including the transmission of diseases such as syphilis, histocompatibility, as well as the low success rate of the procedure, has resulted in its practice being largely abandoned. Autotransplantation, otherwise known as intentional replantation in dentistry, is defined as the surgical movement of a tooth from one site on an individual to another location in the same individual. While rare, modern dentistry uses replantation as a form of proactive care to prevent future complications and protect the natural dentition in cases where root canal and surgical endodontic treatments are problematic. In the modern context, tooth replantation most often refers to reattachment of an avulsed or luxated permanent tooth into its original socket.

Apexification is a method of dental treatment to induce a calcific barrier in a root with incomplete formation or open apex of a tooth with necrotic pulp. Pulpal involvement usually occurs as a consequence of trauma or caries involvement of young or immature permanent teeth. As a sequelae of untreated pulp involvement, loss of pulp vitality or necrotic pulp took place for the involved teeth.

References

  1. 1 2 3 4 5 6 7 8 McCabe, PS; Dummer, PM (February 2012). "Pulp canal obliteration: an endodontic diagnosis and treatment challenge". International Endodontic Journal. 45 (2): 177–97. doi:10.1111/j.1365-2591.2011.01963.x. PMID   21999441.
  2. 1 2 3 4 "The Dental Trauma Guide". dentaltraumaguide.org. Copenhagen University Hospital and the International Association of Dental Traumatology. Archived from the original on 12 October 2015. Retrieved 21 October 2015.
  3. 1 2 Abd-Elmeguid, A; ElSalhy, M; Yu, DC (2 July 2015). "Pulp canal obliteration after replantation of avulsed immature teeth: a systematic review". Dental Traumatology. 31 (6): 437–441. doi: 10.1111/edt.12199 . PMID   26134760.