Dentinogenesis imperfecta (DI) is a hereditary disorder affecting both the deciduous and permanent dentition. Partially or totally obliterated root canals and the defective soft dentin structure present a challenge for root canal treatment. The following case report illustrates these difficulties and shares our experiences with root canal treatment of 2 teeth with apical pathosis in a 38-year-old female with type Ⅱ DI. Tooth #34 exhibited an occasional sinus tract and partially obliterated root canal. After regular cleaning and shaping, the problem with the sinus tract was resolved, but thin dentinal walls resulted. Tooth #46 with a metal crown exhibited apical rarefactions of both the medial and distal roots. The pulp chamber and root canals were totally obliterated. Since the canal orifices could not be identified, mishaps such as perforation and canal deviation resulted. The present case report demonstrates that early recognition and diagnosis of DI are important. When a DI patient requires endodontic treatment, gentle instrumentation force should be applied to conventional root canal preparations. Treatment options like periapical surgery should be considered when the canal is completely obstructed.
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