Rare spontaneous formation of a dentin bridge post-dental trauma: A cone beam computed tomography-based case report with root canal therapy

牙外伤后罕见自发性牙本质桥形成:基于锥形束计算机断层扫描的根管治疗病例报告

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Abstract

Spontaneous dentin bridge formation in mature teeth without pulp exposure or therapeutic intervention is an exceedingly rare phenomenon. This case report describes a 54-year-old male patient presenting with gray discoloration of the right maxillary central incisor (tooth #11) following dental trauma in 2019. Clinical examination indicated coronal pulp necrosis, while periapical radiography and cone-beam computed tomography (CBCT) confirmed internal resorption in the coronal pulp chamber with a thick, regular dentin bridge formed spontaneously beneath the resorbed area. The dentin bridge preserved the vitality of the apical pulp, as evidenced by a normal apical root canal. Treatment involved root canal therapy limited to the necrotic coronal pulp up to the dentin bridge, followed by internal bleaching to improve tooth color and esthetic restoration with composite resin. A 3-month follow-up radiograph showed treatment stability with no pathological changes. This case highlights the reparative potential of vital apical pulp in traumatized teeth and the critical role of cone-beam computed tomography (CBCT) in diagnosing such rare occurrences. However, the absence of histological confirmation and short follow-up duration limit conclusions on long-term stability.

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