Calcific metamorphosis: a challenge in endodontic diagnosis and treatment.KEY LEARNING POINTS: Up to 25% of traumatized anterior teeth can develop pulp canal obliteration Discolouration is a common clinical finding in teeth with pulp canal obliteration Up to 75% of teeth with pulp canal obliterations are symptom-free and require no treatment other than radiographic monitoring Routine pulp sensibility tests are unreliable in the presence of pulp canal obliteration Teeth with pulp canal obliteration in need of root canal treatment pose particular diagnostic and treatment challenges. This article discusses the various management approaches and highlights treatment strategies for overcoming potential complications. Root canal treatment of teeth with pulpal obliteration is often challenging. The inevitable lack of responses to normal sensibility tests and the crown discoloration add uncertainty to the management however, only approximately 7-27% of teeth with PCO will develop pulp necrosis with radiographic signs of periapical disease. These teeth provide an endodontic treatment challenge the critical management decision being whether to treat these teeth endodontically immediately upon detection of the pulpal obliteration or to wait until symptoms or signs of pulp and or periapical disease occur. Approximately 4-24% of traumatized teeth develop varying degrees of pulpal obliteration that is characterized by the apparent loss of the pulp space radiographically and a yellow discoloration of the clinical crown. SUMMARY: Pulp canal obliteration (PCO) occurs commonly following traumatic injuries to teeth. N2 - AIM: To review the literature on pulp chamber and root canal obliteration in anterior teeth and to establish a clear protocol for managing teeth with fine, tortuous canal systems. T1 - Pulp canal obliteration: an endodontic diagnosis and treatment challenge. Pulp canal obliteration (PCO) occurs commonly following traumatic injuries to teeth.
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