From: Ahmad Tehrani
To: ROOTS
Sent: Friday, September 15, 2006 4:29 AM
Subject: [roots] AP case

17 year old female reports history of playground accident when she was 12.
fractured UL central incisor and had a crown placed.
she was under orthodontic treatment and she developed a ST and was referred for evaluation.
Necrotic pulp with chronic AP #9...NSRT started 3 months ago.
It was decided to open the space between 9 & 10 to facilitate margination of the new crown.
3 visit endodontic treatment with CH/CHX changes every 3 weeks, tooth was totally asymptomatic
afterwards and ST closed.
Canal was obturated today and she will have the bracket and arch wired removed next week so
we can access the crown.
The plan is to temporize the tooth after a post/core buildup, so the orthodontist can close
the exaggerated space between 9 & 10.
There is 6mm of GP in this canal now....
Is this length of GP satisfactory or does it need to be extended? - ahmad




Necrotic pulp with chronic AP #9...NSRT started 3 months ago.
>>>>> Is it typical that such a tooth would not suffer the apical resorption
of the other teeth in such a situation?? - Kevin

I can't tell you if this is typical, however, the laterals are frequently resorbed during ortho tx.
Laterals have a tiny sharp root tip with  an abrupt curvature that flattens out with excessive
movements or force.

I don't know enough about orthodontics to offer a more intelligent answer than that,
perhaps I should take a weekend course to become an expert......))

I will ask my orthodontist and post his comment - ahmad

Ahmad, Thanks for sharing!
Pretty resorptions on teeth around 9th... How long she's been in ortho tx?
What would be your prognosis for all the anterior teeth? -  Dmtri.

she has been in active treatment ~ 18 months.
The prognosis of other anterior teeth at this time is quite favorable.
since they are responsive to thermal stimuli and EPT with no mobility or periodontal involvement.

but, she is only 17 years old. - ahmad

that is classic!! - Fred