A"borderline" dental trauma with 12 y of evolution justifying CBCT as diagnostic method

Abstract

The case of a female with a history of trauma to her maxillary central incisors 12 y ago is presented. The right tooth showed signs of root-fracture healing with a dislocated coronal fragment, total pulp canal obliteration (PCO) and contradictory signs and symptoms. The left tooth showed an indistinguishable fracture line but partial PCO in the apical fragment and normal clinical signs. Although the patient was referred for endodontic treatment of the right central incisor, Cone-beam computed tomography (CBCT) was suggested to confirm the nature of the condition. Because CBCT should not be used routinely for endodontic diagnosis but may be justified in "borderline" cases, it was performed in according to the current legal recommendations, avoiding the unnecessary endodontic treatment. PCO is discussed, as the condition involves not only a radiographic reduction of the pulp canal but also an adaptive morphological pattern of pulp response to trauma.