Comments on The Endo Blog: Calcific Metamorphosis (Pulpal Obliteration) and I...

Not too surprising that kids under 12 suffer tooth...

2011-09-21T14:18:43.811-07:00

Not too surprising that kids under 12 suffer tooth trauma so frequently...I chipped three teeth before I was eight!

With regards to Ake-Punyawee's comment: I must...

2011-09-19T18:55:00.947-07:00

With regards to Ake-Punyawee's comment:
I must say that external bleaching will not achieve the desired result in this case because the problem is the loss of translucency and matt appearance more so than color. Agree on EPT though. I say if PCO continues then there is vitality (odontoblasts are alive, so there is blood supply).

Ake-Punyawee, Thanks for your thoughtful question...

2011-09-19T12:45:29.196-07:00

Ake-Punyawee,

Thanks for your thoughtful questions. In this particular case, I did thermal testing during diagnostics. However, in retrospect, I should have done electric pulp testing.
We will monitor vitality at recall using EPT.
If additional treatment is needed, a non-surgical retreatment is easily performed. No need for surgery.

This is a nice blog..this is what i was searching....

2011-09-19T06:35:28.918-07:00

This is a nice blog..this is what i was searching..thanks alot fr sharing this..

I have some questions about the case. In this case...

2011-09-17T23:05:48.117-07:00

I have some questions about the case. In this case, how can we observe or test the pulp vitality. We can only assume that the pulp is already necrotic after the periapical lesion was present, right? My questions are...
- if the periapical lesion was preesent, how to treat it? Only apical surgery can be done. Orthograde treatment is not the candidate, isn't it?
- from the literature of andreason 1985 and robertson 1996, necrotic and periapical lesion were developed after the pulp canal obliteraton in a small percentage. But when the the present of bleaching agent as a stimuli, the percentage might be increased. Then the external bleaching might be preferred.

Great example of thinking out of the box!!!! It st...

2011-09-17T10:55:12.425-07:00

Great example of thinking out of the box!!!! It steers dentists away from the "tunnel vision" that every tooth has to have a root canal before internal bleaching, and makes a clinician evaluate each case carefully and think it through! Occasionally, on PCO teeth, just an access opening (with out bleaching agent) may make the tooth look more esthetic and gain some translucency. It would be nice to see this in a year. Nice result!