Metamorfosis calcificante asociada a reabsorción patológica radicular en dientes permanentes: evaluación morfohistométrica de dos casos.

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Gabriel M. Fonseca & Miguel M. Fonseca


Calcific Metamorphosis (CM) is a pulpal response to dental trauma characterized by a deposition of hard tissue within the canal space. A tooth with CM usually presents a discoloration and a partial or total obliteration of the pulp canal space, and its vital pulp tests and symptoms are difficult. Since pulp necrosis cannot be supposed even the negative responses, the periradicular status is the only reliable criterion. Two permanent teeth diagnosed as CM and pathological root resorption, extracted from two males (22 and 53 years of age) due to severe mobility were prepared and sectioned for histological and histometrical evaluation. Images were captured, processed and measured in a total mapping of each specimen with software Pinnacle Studio 9.4® (Pinnacle Systems Inc.), Adobe® Photoshop® (CS 8.0.1, Adobe Systems Inc.) and Image J® (National Institute of Health, Bethesda, MD, USA). The images showed the simultaneous occurrence of CM and root resorption. The means of the total measurements showed that the area of radicular affection (R) was higher than the coronal affection (C), both in quantity (R: 13.75 mm2 -28.75%-/C: 4.7 mm2 -5.47%-) and quality (R: absence of CM / C: presence of CM). CM showed a fibrotic pattern, a cortical bone-like pattern and a cancellous bone-like pattern, representing a kind of reparative reaction probably initiated by the resorption process. Concurrent CM and pathological root resorption are uncommon in the same tooth, and the possibility to obtain specimens of permanent teeth to make histological and histometric evaluations of them represents a situation even more infrequent. This morphohistometric evaluation can expand the spectrum of useful variables to make clinical and therapeutic odontological decisions.

KEY WORDS: Dental pulp; Calcific metamorphosis; Pathological root resorption; Diagnoses; Endodontics.

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FONSECA, G. M. & FONSECA, M. M. Calcific metamorphosis with pathological root resorption in permanent teeth: morphohistometric evaluation of two cases. Int. J. Morphol., 33(2):712-718, 2015.