Therapeutic Approach to Pulp Canal Calcification as Sequelae of Dental Avulsion

Abstract

Tooth avulsion represents the most complicated dental injury, and the classic treatment is tooth replantation. The most common sequelae are pulp canal calcification (PCC) and pulp necrosis. The presence of pulp necrosis after PCC is reported in up to 30% of the cases and is a challenge due to the difficulty of endodontic treatment. This case report describes the surgical treatment of a replanted tooth presenting PCC and periapical pathology eight years after the trauma. An endodontic surgery was performed to remove the apical granuloma, to prepare the apical root, and to seal the apical region with an endodontic cement. In a three-year follow-up, there was an absence of inflammatory signs and symptoms or apical lesion. This report shows the importance of close follow-up after dentoalveolar injuries. After the initial dental trauma and its consequences to pulpal tissues, the executed procedures allowed a favourable outcome.

EDTA Combined with C-Pilot Files and Microultrasound for Root Canal Calcification: Dredging Effect and Safety Analysis

“…In addition, with the increase of age, dental pulp ages, restorative dentin and secondary dentine deposit, and the space of dental pulp cavity decreases, gradually increasing the number and degree of root canal calcification [ 12 ]. However, the operation of root canal dredging is difficult due to the special physiological structure of the mouth as well as the influence of operating instruments and surgical field of view, accompanied by large equipment consumption during the procedure and long operative time, which not only leads to strong discomfort in patients but also to high treatment cost that brings a greater economic pressure to patients [ 13 ]. This also makes root canal dredging a difficulty in the treatment of pulpal and periapical diseases.…”

Characterization of pulp calcifications and changes in their composition after treatments with citric acid and ethylenediaminetetraacetic acid solutions

“…Calcifications may occlude the pulp chamber and complicate root canal treatment (Bonilla‐Represa et al, 2021; Gabardo et al, 2020; Pietrzycka & Pawlicka, 2020). There are multiple factors related to its appearance, such as the natural aging process, the presence of infections and identification of nanoparticles and nanobacteria (caries and periodontal disease), a response to injuries (traumatic occlusion and orthodontic movement), therapeutic or iatrogenic processes (pulp coatings, dental preparation, revascularization in immature teeth) or genetic causes (Alenazy & Mosadomi, 2013; Bonilla‐Represa et al, 2021; Chen et al, 2020; Gabardo et al, 2020; McCabe & Dummer, 2012; Moura et al, 2017; Movahhedian et al, 2018; Song et al, 2017; Tarim Ertas et al, 2017; Tassoker, 2018).…”

“…Clinically, pulp stones are asymptomatic and often discovered during routine radiological examinations, which can only be observed like radiopaque structures when the calcification level is sufficiently high. They can be identified within the pulp chamber and root canals when they are at least 200 μm in size (Da Silva et al, 2017; Mello‐Moura et al, 2017; Moura et al, 2017; Movahhedian et al, 2018; Pietrzycka & Pawlicka, 2020; Tarim Ertas et al, 2017; Tassoker, 2018). According to their location, pulpal calcifications can be free, attached to, or embedded in dentin (Bonilla‐Represa et al, 2021; Chen et al, 2020; da Silva et al, 2017; Moura et al, 2017; Tassoker, 2018).…”

“…They can be identified within the pulp chamber and root canals when they are at least 200 μm in size (Da Silva et al, 2017; Mello‐Moura et al, 2017; Moura et al, 2017; Movahhedian et al, 2018; Pietrzycka & Pawlicka, 2020; Tarim Ertas et al, 2017; Tassoker, 2018). According to their location, pulpal calcifications can be free, attached to, or embedded in dentin (Bonilla‐Represa et al, 2021; Chen et al, 2020; da Silva et al, 2017; Moura et al, 2017; Tassoker, 2018).…”

Conservative esthetic management of post orthodontic treatment discolored tooth with calcified canal: a case report

“…The PCO is becoming increasingly common [ 1 ]. The presence of pulp necrosis after the PCO is reported in up to 30% of the cases [ 2 ]. Approximately 4-24% of the traumatized teeth develop varying degree of pulpal obliteration that is characterized by the apparent loss of pulp space radiographically and yellowish discoloration of crown [ 3 ].…”