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ePaper created 2015-03-07, 18:13:20 | version 1.33.01
I case report _ CT in treatment planning _Abstract We report the case of a 17-year-old patient who cameintotheclinicbecauseshehadnoticedacolour changetothemaxillaryleftcentralincisor(tooth#21) of 48-hour duration. During clinical examination, tooth #21 appeared darker than the rest of the teeth. Afterperformingacompleteexplorationandobtain- ing no response to vitality tests, a pulp necrosis of tooth #21 was diagnosed. Differential diagnosis began with the completion of the medical record. The patient had received or- thodontic treatment and a supernumerary tooth in theanteriorregionofthemaxillahadbeenextracted. The patient did not recall having suffered injuries or trauma in the incisal region. A dental panoramic tomogram was obtained, and ahigh-densityareawasobservedattheapicallevelin the area of tooth #21. A 3-D computed tomography (CT) scan was then obtained, and it showed the pres- ence of a supernumerary tooth in the periapical re- gion of tooth #21, palatally located and oriented up- wards.Necrosisbycompressionoftheneurovascular pedicle of tooth #21 due to the expansion of the erupting follicle of the supernumerary tooth was di- agnosed. Pulpectomy and surgical removal of the supernu- merarytoothwereperformed.Duringsurgicalremoval ofthesupernumerarytooth,theneurovascularpedicle appeared oedematous and congested and was the causeofthetoothpulpnecrosis. Supernumerary teeth: Diagnosis and treatment Authors_ Drs Javier Martínez Osorio & Sebastiana Arroyo Boté, Spain 26 I cone beam1_2015 Fig. 1 Fig. 2 Fig. 3