![]() Size 8 K file (Mani, Japan) was introduced into the root canal with which obliteration was felt in the middle third. 6 Scouting of the root canal orifices was done using a DG 16 explorer and visualised under surgical operating microscope (Carl Zeiss Surgical, Oberkochen, Germany) ( figure 3). Access cavity was prepared close to incisal edge using extended shank round burs (Brasseler, Savannah, GA, USA) and ultrasonic BUC 1 tips (SybronEndo, Orange, California, USA) which facilitated straight line access. 5 After obtaining consent, the tooth was anaesthetised and isolated under rubber dam. This may or may not be associated with radiographic changes. ![]() History of trauma 3 months ago may be the reason for symptomatic apical periodontitis which represents inflammation of apical periodontium producing a painful response to biting or percussion. 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. Axial section of coronal, middle and apical third of root revealed partially obliterated pulp chamber and pulp canal ( figure 2). CBCT (Carestream, Rochester, NY) was taken to check the continuity and patency of canal in different levels of root. Preoperative radiograph revealed partial pulp canal obliteration with periodontal ligament widening in the apical region ( figure 1). Thermal and electric pulp response was negative with tooth 11 whereas adjacent teeth showed normal response. Intraoral examination revealed discoloration of tooth 11 with tenderness to vertical percussion. Pissiotis et al 4 showed that repeated traumatic episodes have an effect on pulpal healing which increases the risk of developing pulp canal obliteration and pulp necrosis. 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. 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. 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.Ī 35 year old male patient reported with pain in upper front region of jaw since 3 months. 3 Proper debridement, disinfection and obturation of root canal is difficult in such cases thus compromising root canal treatment. 1 2 The American Association of Endodontists included teeth with radiographic indiscernible root canals requiring treatment in high difficulty criteria. Traumatised teeth usually develop pulp canal obliterations and are characterised by radiographic loss of pulp space and yellowish discoloration of clinical crown. ![]()
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