40 © 2006 The Authors Journal compilation © 2006 Australian Society of Endodontology Aust Endod J 2006; 32: 40–42 Blackwell Publishing AsiaMelbourne, AustraliaAEJAustralian Endodontic Journal1329-19472006 The Authors. Journal compilation © 2006 Australian Society of EndodontologyApril 20063214042Case Report Endodontic Therapy on a DentitionS. Ravanshad and A. Khayat CASE REPORT Endodontic therapy on a dentition exhibiting multiple periapical radiolucencies associated with dentinal dysplasia Type 1 Shohreh Ravanshad, DMD, MScD and Akbar Khayat, DMD, MScD School of Dental Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Abstract Dentinal dysplasia (DD) Type I, is a hereditary disturbance in dentine formation. In this anomaly, teeth in both primary and secondary dentitions are affected, and radiographically show short and blunted roots with obliterated root canals and periapical pathosis. Management of patients with DD has presented dentists with problems. Extraction has been suggested as a treatment alternative for teeth with pulp necrosis and periapical abscess. Follow-up and routine conser- vative treatment is another choice of treatment plan in DD. Another approach for the treatment of teeth with DD has included periapical surgery and retro- grade filling, which is recommended in the teeth with long roots. The purpose of this report is to present an unusual case of dentinal dysplasia Type I in a 22- year-old woman showing upper and lower teeth with obliterated root canals and periapical radiolucencies. In this case, conventional endodontic treatment was performed. Postoperative radiographs and clinical evaluation demonstrated periapical healing and successful results. Based on the results of this case report, conventional endodontic treatment for cases with pulp necrosis and periapical radiolucencies in dentinal dysplasia is highly recommended. Introduction Dentinal dysplasia (DD) is a rare hereditary disease, trans- mitted as an autosomal dominant character gene. Rushton used this term in 1939 (1) and characterised it as abnormal dentine that contains an enormous number of spherical bodies. In dentinal dysplasia, both the deciduous and per- manent dentitions are affected and the teeth become loose and are exfoliated prematurely. Witkop (2) in 1972 classified dentinal dysplasia into two types, radicular DD for Type I and coronal DD for Type II. In Type I DD, both the deciduous and permanent denti- tions are affected. The crowns of the teeth appear clinically normal in morphology. Defects in dentine formation and pulp obliteration are present. In Type I DD, obliteration of root canals occurs much earlier by deposition of amor- phous dentine or pulp stones (3). Radiography shows short, pointed or blunted roots and periapical radiolucen- cies despite the absence of dental caries (4–6). In Type II DD, the primary teeth are brown or opalescent blue in colour, similar to those seen in dentinogenesis imperfecta, and the pulp chambers are completely obliterated, but these findings are not present in permanent teeth. No multiple periapical radiolucencies associated with den- tinal dysplasia Type II have been reported (3). In patients with dentinal dysplasia Type I, the pulps of the affected teeth tend to become necrotic following calci- fication, probably as a result of a deficiency in the nourish- ment and oxygen supply to the pulp. Periapical pathosis may then develop and result in apical resorption and tooth exfoliation. Management of patients with DD has pre- sented dentists with problems. Extraction has been sug- gested as the treatment of choice for teeth with pulp necrosis and periapical abscess (5). Follow-up and routine conservation is an alternative treatment plan in order to retain the teeth as long as possible (6). Tidwell and Cunningham (7) reported a case of Type II DD with relatively long roots treated by conventional endodontic therapy with short-term success. Coke et al. (8) managed a case of Type I DD with periapical curettage and retrograde root filling with 2 months of follow-up. Our report is of is an unusual case that presented with Keywords dentinal dysplasia, endodontic therapy, hereditary disturbance, pulp calcification. Correspondence Dr Akbar Khayat, School of Dental Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Email: khayata@sums.ac.ir doi: 10.1111/j.1747-4477.2006.00008.x