J Korean Acad Conserv Dent.  2011 Mar;36(2):149-153. 10.5395/JKACD.2011.36.2.149.

Partial pulp necrosis caused by excessive orthodontic force

• Kim MY
• Lee SJ
• Jung IY
• Kim E

• KMID: 2251820
• DOI: http://doi.org/10.5395/JKACD.2011.36.2.149

Abstract

As the dental pulp is encased with a rigid, noncompliant shell, changes in pulpal blood flow or vascular tissue pressure can have serious implication for the health of pulp. Numerous studies have demonstrated that orthodontic force application may influence both blood flow and cellular metabolism, leading degenerative and/or inflammatory responses in the dental pulp. The aim of this case report is to present a case about tooth with chronic periapical abscess which showed normal vital responses. Excessive orthodontic force is thought to be the prime cause of partial pulp necrosis. Owing to remaining vital tissue, wrong dianosis can be made, and tooth falsely diagnosed as vital may be left untreated, causing the necrotic tissue to destroy the supporting tissuses. Clinician should be able to utilize various diagnostic tools for the precise diagnosis, and be aware of the endodontic-orthodontic inter-relationship.

Keyword

Diagnosis; Endodontic-orthodontic interrelation; Orthodontic force; Pulp necrosis

MeSH Terms

Dental Pulp
Dental Pulp Necrosis
Periapical Abscess
Tooth

Figure

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  Figure 1 Pre-operative clinical photo.

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  Figure 2 Pre-operative periapical x-ray.

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  Figure 3 Pre-operative conebeam CT image. CT, computed tomograph.

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  Figure 4 Pre-operative conebeam CT image. CT, computed tomograph.

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  Figure 5 Cavity after IRM removal. IRM, intermediate restorative material.

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  Figure 6 Pulp chamber immediate after access opening.

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  Figure 7 Periapical x-ray after canal filling.

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  Figure 8 6 month follow up-periapical x-ray.

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  Figure 9 6 month follow up-conebeam CT image. CT, computed tomograph.

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