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Fracture on palatal: Tooth #23 - Courtesy ROOTS

The opinions and photographs within this web page are not ours. Authors have been
credited for the individual posts where they are - www.rxroots.com
From: "Ilya Mer"
To: "ROOTS"
Sent: Tuesday, February 16, 2010 4:43 PM
Subject: [roots] What made the tooth become necrotic?

Patient came with emergency case, #23 was cause of pain. Cold 
test was negative, sensitivity to warm water and percussion +++.  
Pulp was necrotic and I performed routine protocol of abscess, 
shaping, irrigation and calcium hydroxide dressing. The pain was 
gone but what made the pulp become necrotic? I tried to stain the 
coronal part with caries marker. The only sign I have found was 
small fracture on palatal. What is your opinion? Best regards 
from  Moscow - Ilya Mer.

I have a lower cuspid in my own mouth that became necrotic 20 years after minor ortho and 1 year after minor trauma. Who know why these things happen but my guess is either trauma or ortho. With the lateral root canal treated, was there a history of trauma? Great case and great photos by the way - Paul Jones Great case, Ilya! Last week I had just the same case with tooh 21, cold test - negative, electric pulp test - doesn't respond, mild sensitivity to heat, no periodontal probing! The rascal had even a fistula! When I've opened the pulp chamber there was a lot of pus, pulp was necrotic. And I really do not know what was the cause for this necrosis - no trauma, no fracture...the tooth was intact! So maybe those kind of cases will remain a little mistery. I will post radiographs ASAP.- Bojidar Kafelov, Sofia, Bulgaria History of trauma, ortho, external bleaching, lasers? :) Good to rule out any and everything in the dental history regardless of how it may hurt someone's feelings. :):):) - Terry

Protaper flaring

6 yr old Empress

Cvek pulpotomy

Middle mesial

Endo misdiagnosis

MTA retrofill

Resin core

BW importance

Bicuspid tooth

Necrotic #8 treatment

Finding MB2 / MB3

Deep in a canal

Broken file retrieval

Molar cases

Pushed over apex

MB2 and palatal canal

Long lower third

Veneer cases

CT Implant surgury

Weird Anatomy

Apical trifurcation

Canal and Ultrasonics

Cotton stuffed chamber

Pulp floor sandblasting

Silver point removal

Difficult acute curve

Marked swelling

5 canaled premolar

Sealer overextension

Complex anatomy

Secondary caries

Zygomatic arch

Confluent mesials

LL 1st molar (#19)

Shaping vs Cleaning

First bicuspid

In Vivo mesial view

Inaccesible canals

Premolar 45

Ortho and implant

Radioluscency

Lateral incisor

Obturation

Churning irrigant

Cold lateral

Tipped to lingual

Acute pulpitis images

Middle distal canal

Silver point

Crown preparation

Epiphany healing

Weird anatomy

Dual Xenon

Looking for MB2

Upper molar resorption

Acute apical abcess

Finding MB2

Gingival inflammation

Irreversible pulpitis

AG BU ortho band

TF Files

using TF files

Broken bur

Warm technique

Restorative prognosis

Tooth # 20 and #30

Apical third

3 canal premolar

Severe curvature

Interesting anatomy

Chamber floor

Zirconia crown

Dycal matrix

Cracked tooth

Tooth structure loss

Multiplanar curves