Endodontic Mx of maxillary cental incisor with pulp canal ob
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The present case has been reported in BMJ. This article presents case of pulp canal obliteration of maxillary central incisor that was managed with usage of cone beam CT (CBCT), microscopes, periodic radiographs and small sized hand files which helped in achieving patency to the pulp chamber and root canal.

A 35 year old male patient reported with pain in upper front region of jaw since 3 months. The patient gave history of trauma 3 years ago when he met with an accident, thereafter he noticed gradual change in the transparency of the crown but there was no pain. The patient elicited history of trauma again on the same tooth 3 months back when he was playing games after which he developed pain on biting.

Intraoral examination revealed discoloration of tooth 11 with tenderness to vertical percussion. Thermal and electric pulp response was negative with tooth 11 whereas adjacent teeth showed normal response. Preoperative radiograph revealed partial pulp canal obliteration with periodontal ligament widening in the apical region.

CBCT was taken to check the continuity and patency of canal in different levels of root. Axial section of coronal, middle and apical third of root revealed partially obliterated pulp chamber and pulp canal. Diagnosis of symptomatic apical periodontitis with partial obliteration of the pulp canal was made and non surgical root canal treatment was advised to the patient.

Learning points
• Radiographic obliteration of pulp space does not imply an absence of pulp tissue or space clinically.

• Clinical symptoms or definite radiographic findings suggestive of periapical disease are indications of root canal treatment.

• Diagnostic aids like cone beam CT, operating microscopes and proper armamentarium are the requisites to overcome the difficulties posed by pulp canal obliterations.

Continue reading about the case here: http://casereports.bmj.com/content/2018/bcr-2018-227318.full
Dr. B●●●●●h K●●●r S R and 1 others like this