Risk of exposure
Preparing teeth for crowning in order to align them in the dental arch can risk traumatic expo-sure. In some cases these teeth should be electively root-treated.
Fig. 10 A 23-year-old female patient suffered trauma to tooth UL1 (21) when aged 16, and is complaining about the yellow discoloration of the tooth (a). A radiograph (b) reveals that the pulp space has sclerosed.
Fig. 10 A 23-year-old female patient suffered trauma to tooth UL1 (21) when aged 16, and is complaining about the yellow discoloration of the tooth (a). A radiograph (b) reveals that the pulp space has sclerosed.
sure. In some cases these teeth should be electively root-treated.
In multirooted teeth there may be deep pocketing associated with one root or the furcation. The possibility of elective devitalisation following the resection of a root should be considered (see Part 9).
Pulpal sclerosis following trauma
Review periapical radiographs should be taken of teeth which have been subject to trauma. If progressive narrowing of the pulp space is seen due to secondary dentine, elective root canal treatment may be considered while the coronal portion of the root canal is still patent. This may occasionally apply after a pulpotomy has been carried out. However, Andreasen
refers to a range of studies that show a maximum of 16% of sclerosed teeth subsequently cause problems, and the decision over root canal treatment must be arrived at after full consultation with the patient. If the sclerosing tooth is showing the classic associated discoloration the patient may elect for treatment, but otherwise the tooth may better be left alone (Fig. 10).