Calcium Metapmorphosis (Pulpal obliteration) and Internal Bleachingd

From The Endo Blog.com by Jason Hales

It has been reported that 11.6% – 33% of boys and 3.6% – 19% of girls suffer some kind of dental trauma before age 12. Internal staining is common following a traumatic injury to a tooth. Calcific metamorphosis is the partial or complete obliteration of the pulp following dental trauma. An interesting study of 168 traumatized, discolored, anterior teeth found that 47.6% were partially obliterated, 31.6% were totally obliterated, and 20.8% were found necrotic. Necrosis was more associated with fractured teeth, while pulpal obliteration was associated with subluxation and concussion injury. It was also noted that injuries suffered in the 1st and 2nd decades of life resulted in more pulpal obliteration, while those suffered in the 3rd decade resulted in necrosis more often. To remove this discoloration, typically endodontic therapy is performed and internal, non-vital bleaching is performed. The following case is a variation of this procedure.

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