Results: Twenty case reports were selected, resulting in a total of 27 patients.

Quality assessment was performed using the JBI Critical Appraisal Tool for Case Reports. Regarding clinical approaches, only teeth managed with a вЂњwatchful waitingвЂќ approach, tooth bleaching or root canal treatment (RCT) were included. Only anterior permanent teeth with PCO due to dental trauma were included. Materials and Methods: An electronic search strategy was performed in Pubmed, EBSCOhost and LILACS from inception to March 2021. The present review follows the PRISMA guidelines and was registered on PROSPERO database (CRD42020200656). All rights reserved.Д«ackground and Objectives: This systematic review aimed to assess the literature focusing on the clinical management of traumatized teeth with Pulp Canal Obliteration (PCO) and propose an updated clinical decision-making algorithm. В© 2017, Iranian Association of Endodontics. It served as a guide for the direction of the ultrasonic tips to keep them within the pulp chamber safely, with a low risk of iatrogenic injury. If the canal was not identified, CBCT was mandatory in order to show more detailed view of the precise position of the canals, their directions, degrees of obstruction and dimensions. The clinical evaluation of the access cavity with the aid of MO was crucial. Complete root canal obliteration identified in radiography did not necessarily mean that pulp tissue was not visible clinically, either. In cases 2, 3 and 4, the canals were identified with DR, DOM, US tips and CBCT. In case 1, the canal was identified using DR, DOM and US tips. All four canals were successfully identified, with no complications. After identification of the canal, it was then negotiated and instrumented with the rotary instruments.

Sagittal and axial slices guided the direction of the ultrasonic tips. If the canal was not identified, CBCT was requested. Subsequently, the access cavity was performed with the aid of DOM. DR was taken with different angulations and analyzed with different filters.

Four anterior teeth with PCO were chosen. This article discusses the various management approaches and highlights treatment strategies for overcoming potential complications.This article describes four cases with safe and feasible clinical treatment strategies for anterior teeth with pulp canal obliteration (PCO) using cone-beam computed tomography (CBCT), digital radiography (DR), dental operating microscopy (DOM) and ultrasonic tips (US). Root canal treatment of teeth with pulpal obliteration is often challenging. The inevitable lack of responses to normal sensibility tests and the crown discoloration add uncertainty to the management however, only approximately 7вЂ“27% of teeth with PCO will develop pulp necrosis with radiographic signs of periapical disease. These teeth provide an endodontic treatment challenge the critical management decision being whether to treat these teeth endodontically immediately upon detection of the pulpal obliteration or to wait until symptoms or signs of pulp and or periapical disease occur. Approximately 4вЂ“24% of traumatized teeth develop varying degrees of pulpal obliteration that is characterized by the apparent loss of the pulp space radiographically and a yellow discoloration of the clinical crown. Summary Pulp canal obliteration (PCO) occurs commonly following traumatic injuries to teeth. AbstractДЄim To review the literature on pulp chamber and root canal obliteration in anterior teeth and to establish a clear protocol for managing teeth with fine, tortuous canal systems. Pulp canal obliteration: an endodontic diagnosis and treatment challenge.

Pulp obliteration