root canals-from concretion to patency

Teeth with calcification provide an endodontic treatment challenge; traumatized teeth usually develop partial or total pulpal obliteration which is characterized by apparent loss of the pulp space radiographically and a yellow discoloration of the clinical crown. Since only 7-27% of such teeth develop pulp necrosis with radiographic signs of apical periodontitis, it is difficult to decide whether to treat these teeth immediately upon detection of the pulpal obliteration or to wait until signs and symptoms of pulp and/or apical periodontitis occur. This article reviews the etiology, prevalence, classification, mechanism, diagnosis as well as treatment options for teeth with pulp obliteration and the various management approaches and treatment strategies for overcoming potential complications. A search of articles from "PubMed" and "Medline" from 1965 to present was done with the keywords dental trauma, discoloration, pathfinding instruments, pulp canal obliteration, and root canal treatment was conducted. A total of 94 abstracts were collected, of which 70 relevant articles were read and 31 most relevant articles were included in this article.