Pulp vitality and coronal discoloration following traumatic injuries

Tae-Sun Yoon; Hyung-Gyu Kong; Euiseong Kim

doi:10.5395/JKACD.2010.35.6.492

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Case Report Pulp vitality and coronal discoloration following traumatic injuries: Tae-Sun Yoon, DDS, Hyung-Gyu Kong, DDS, MSD, Euiseong Kim, DDS, MSD, PhD; 2010;35(6):-496.
DOI: https://doi.org/10.5395/JKACD.2010.35.6.492
Published online: November 30, 2010

Microscope Center, Department of Conservative Dentistry, Yonsei University, Seoul, Korea.

Correspondence to Euiseong Kim, DDS, MSD, PhD. Professor, Microscope Center, Department of Conservative Dentistry, Yonsei University School of Dentistry, 250 Seongsanno, Seodaemun-gu, Seoul, Korea 120-752. TEL, +82-2-2228-3150; FAX, +82-2-313-7575; andyendo@yuhs.ac

• Received: August 26, 2010 • Revised: September 13, 2010 • Accepted: October 19, 2010

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Abstract
REFERENCES

Abstract

Coronal discoloration is a common sequela to traumatic injuries. In subluxation cases, although the injury is not strong enough to rupture the apical vessels, discoloration may appear by tearing thin walls or occluding small capillaries. In absence of infection pulpal regeneration can occur, and as a result discoloration may completely or partially subside. But judging pulpal status by coronal discoloration can be dangerous and it may lead to unnecessary treatment.

This case presents coronal discoloration and recovery following traumatic injury of maxillary anterior teeth. In diagnosing traumatized teeth routine cold tests or electric pulp tests are known to be unreliable, but with the aid of ultrasound doppler imaging, assessing pulp vitality of traumatized teeth can be more accurate.
Keywords: Discoloration; Pulp vitality; Trauma; Ultrasound doppler

Figure 1

Periapical view at the first exam and after tooth reduction.

Figure 2

Periapical view and clinical photo at 2 weeks follow-up (discoloration on #21).

Figure 3

Periapical view and clinical photo at 6 weeks follow-up (discoloration on #21).

Figure 4

Ultrasound doppler graphy imaging on #11, 21, 22 (from top).

Figure 5

Periapical view and clinical photo at 6 weeks follow-up (regain the color on #21).

REFERENCES

1. Andreasen FM, Vestergaard Pedersen B. Prognosis of luxated permanent teeth: the development of pulp necrosis. Endod Dent Traumatol. 1985;1(6):207-220.Article PubMed
2. Yu DC, Abd-Elmeguid A. Dental pulp neurophysiology: Part 2. Current diagnostic tests to assess pulp vitality. J Can Dent Assoc. 2009;75(2):139-143.PubMed
3. Aguiló L, Gandía JL. Transient red discoloration: report of case. ASDC J Dent Child. 1998 Sep-Oct;65(5):346-348. 356.PubMed
4. Yoon MJ, Kim E, Lee SJ, Bae YM, Kim S, Park SH. Pulpal blood flow measurement with ultrasound Doppler imaging. J Endod. 2010;36(3):419-422.Article PubMed
5. Andreasen JO. Textbook and color atlas of Traumatic injuries to the teeth. 4th ed. UK: Oxford.
6. Ozçelik B, Kuraner T, Kendir B, Aşan E. Histopathological evaluation of the dental pulps in crown-fractured teeth. J Endod. 2000;26(5):271-273.Article PubMed
7. Andreasen FM. Pulpal healing after luxation injuries and root fracture in the permanent dentition. Endod Dent Traumatol. 1989;5(3):111-131.Article PubMed
8. Cohen S, et al. Pathways of the pulp. 9th ed. St. Louis: Mosby.
9. Petersson K, Söderström C, Kiani-Anaraki M, Lévy G. Evaluation of the ability of thermal and electrical tests to register pulp vitality. Endod Dent Traumatol. 1999;15(3):127-131.PubMed
10. Berson M, Grégoire JM, Gens F, Rateau J, Jamet F, Vaillant L, Tranquart F, Pourcelot L. High frequency(20MHz) ultrasonic devices : advantages and applications. Eur J Ultrasound. 1999;10(1):53-63.Article PubMed

Tables & Figures

Figure 1

Periapical view at the first exam and after tooth reduction.

Figure 2

Periapical view and clinical photo at 2 weeks follow-up (discoloration on #21).

Figure 3

Periapical view and clinical photo at 6 weeks follow-up (discoloration on #21).

Figure 4

Ultrasound doppler graphy imaging on #11, 21, 22 (from top).

Figure 5

Periapical view and clinical photo at 6 weeks follow-up (regain the color on #21).

REFERENCES

1. Andreasen FM, Vestergaard Pedersen B. Prognosis of luxated permanent teeth: the development of pulp necrosis. Endod Dent Traumatol. 1985;1(6):207-220.Article PubMed
2. Yu DC, Abd-Elmeguid A. Dental pulp neurophysiology: Part 2. Current diagnostic tests to assess pulp vitality. J Can Dent Assoc. 2009;75(2):139-143.PubMed
3. Aguiló L, Gandía JL. Transient red discoloration: report of case. ASDC J Dent Child. 1998 Sep-Oct;65(5):346-348. 356.PubMed
4. Yoon MJ, Kim E, Lee SJ, Bae YM, Kim S, Park SH. Pulpal blood flow measurement with ultrasound Doppler imaging. J Endod. 2010;36(3):419-422.Article PubMed
5. Andreasen JO. Textbook and color atlas of Traumatic injuries to the teeth. 4th ed. UK: Oxford.
6. Ozçelik B, Kuraner T, Kendir B, Aşan E. Histopathological evaluation of the dental pulps in crown-fractured teeth. J Endod. 2000;26(5):271-273.Article PubMed
7. Andreasen FM. Pulpal healing after luxation injuries and root fracture in the permanent dentition. Endod Dent Traumatol. 1989;5(3):111-131.Article PubMed
8. Cohen S, et al. Pathways of the pulp. 9th ed. St. Louis: Mosby.
9. Petersson K, Söderström C, Kiani-Anaraki M, Lévy G. Evaluation of the ability of thermal and electrical tests to register pulp vitality. Endod Dent Traumatol. 1999;15(3):127-131.PubMed
10. Berson M, Grégoire JM, Gens F, Rateau J, Jamet F, Vaillant L, Tranquart F, Pourcelot L. High frequency(20MHz) ultrasonic devices : advantages and applications. Eur J Ultrasound. 1999;10(1):53-63.Article PubMed

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Pulp necrosis following luxated injury to teeth in a patient with uncontrolled type II diabetes mellitus: a case report
Haneol Shin, Seung-Jong Lee, Il-Young Jung, Chan-Young Lee
Restorative Dentistry & Endodontics.2012; 37(1): 61. CrossRef

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Pulp vitality and coronal discoloration following traumatic injuries

J Korean Acad Conserv Dent. 2010;35(6):492-496. Published online November 30, 2010

DOI: https://doi.org/10.5395/JKACD.2010.35.6.492

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Figure

Pulp vitality and coronal discoloration following traumatic injuries

Figure 1 Periapical view at the first exam and after tooth reduction.

Figure 2 Periapical view and clinical photo at 2 weeks follow-up (discoloration on #21).

Figure 3 Periapical view and clinical photo at 6 weeks follow-up (discoloration on #21).

Figure 4 Ultrasound doppler graphy imaging on #11, 21, 22 (from top).

Figure 5 Periapical view and clinical photo at 6 weeks follow-up (regain the color on #21).