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Tooth discoloration

From: "Ilya Mer" To: "ROOTS" Sent: Saturday, May 29, 2010 7:48 PM Subject: [roots] Unusual situation after old trauma. Need your help and piece of advice. Patient 21 years old with complains for tooth discoloration was referred to consult to my office. There was trauma history about 14-15 years ago. She was taken to hospital but nothing was done and follow up was recommended. The status for today is following: no complains except for discoloration as a consequence of caries, percussion is painless, periodontal probing is normal. I did vitality test with cold spray and found it was positive (!) but very weak and appeared 4-5 sec after cold spray application, comparing to lateral incisors which reacted 1ces after the application. As far as I understand there is something that has a reaction for cold (Pulp? Can be something else?) but wasn’t able to complete the apexification (Why not? Microbial contamination?). What is the pulp condition? What should I do? Should I open it? Follow up? Apexification? Pulpotomy with calcium hydroxide? MTA apical plug? Best regards from Moscow. Ilya Mer

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