Abstract
Background: Ectodermal dysplasia has intraoral symptoms of missing teeth or teeth with an abnormal morphology.
Case Presentation: We experienced a case of pulpal infection caused by a pulpal morphological defect with an abnormal morphology in the left maxillary central incisor of a 10-year-old boy with ectodermal dysplasia. We report this case since CBCT was effective in detecting the cause of infection and for developing a therapeutic strategy.
Conclusion: CBCT revealed two prominent pulp cavities extending to the incisal margin of the left maxillary central incisor, and the patient was thus diagnosed with chronic suppurative apical periodontitis with apical lesions. The apical lesion in this case could be eliminated at an early phase because all tooth pulps including the two prominent parts could be removed.
Four months after covering with an apical barrier, root canal obturation was performed using a bioactive glass based sealer and gutta-percha points. Restoration of the resin jacket crown was then performed for both maxillary central incisors.
Since the timing of occlusal contact development and fistulation was close, the infection may have developed due to tooth pulp exposure when thinning enamel was exfoliated. This case also shows that abnormal tooth pulp morphology can be confirmed together with abnormal tooth morphology, and that pulp exposure caused by abnormal pulp morphology can be prevented and sensitivity can be improved by composite resin jacket crown restoration. For patients with ectodermal dysplasia with a prominent region for which future occlusal contact may occur, it is useful to confirm abnormal pulp morphology based on dental cone beam CT in addition to intraoral findings and dental/panoramic X-ray images.
