Edition V06N02 | Year 2016 | Editorial Original Article | Pages 41 to 46
Introduction: To describe the endodontic treatment of lower incisors with pulp canal obliteration (PCO) and apical periodontitis after dental trauma and long-term orthodontic treatment. Methods: A female 22-year-old patient sought dental care at the endodontic centre reporting to have suffered a dental trauma in the antero-inferior region, followed by a 5-year orthodontic treatment. Two years after the conclusion of an orthodontic treatment, radiolucent lesions involving the lower central incisors were observed and endodontic treatment was unsuccessfully initiated by a general practitioner, who could not locate the root canals due to PCO. The endodontic treatment was conducted and the root canals were located by using an optical microscope at 25x magnification. One-quarter clockwise and counter-clockwise insertion, retraction and rotation movements, all common to precurved #10 K-files, were performed until reaching the apical patency. Instrumentation of the root canals were carried out by using the pre-enlargement technique, with a calcium hydroxide, paramonochlorophenol and glycerine- based paste being used as intracanal medication for 15 days, followed by thermoplastified obturation and restoration with photopolymerisable resin. Results: After 12 months, the patient showed no signs or symptoms and the periradicular lesions of the lower central incisors were completely healed. Conclusions: The PCO caused by the association of dental trauma with longterm orthodontic treatment may have evolved into pulp necrosis and consequently to apical periodontitis. A protocol of localization, exploration, cleaning and shaping, plus use of intracanal medication and root canal filling, prevented iatrogenic complications and allowed the case to be successful.
Pacheco LC, Ormiga F, Gusman H, Risso PA. Chronic pulp canal obliteration after dental trauma and orthodontic treatment: a case report Dental Press Endod. 2016 May-Aug;6(2):41-6.