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