Permanent Maxillary Central Incisor with Dilacerated Crown and Root and C-Shaped Root Canal

This is a case report for a 16-year-old male patient who had chief complaint of pain and discoloration in 21. He suffered a trauma to the anterior maxilla at the age of 2-3 years due to a stair fall that resulted in loosing his left primary central incisor. On examination, the maxillary left central incisor had short clinical crown and altered incisal and middle thirds of the crown which were hypoplastic, palatally displaced and darkly discolored. It also exhibited some gingival inflammation on the labial side and gingival overgrowth on the palatal cervical margin. The tooth had –ve response to electrical/thermal sensitivity tests and +ve response to percussion test. It possessed traumatic occlusion with opposing teeth. Periapical radiographs showed periodontal ligament widening in the apical third of the root, radiopaque area at the middle portion of the crown, which was assumed to be dens in dent, and distinct pulp chamber and root canal. CBCT (Planmecaromexis with slice of 0.1mm FOV 60x4 for 60 seconds) was taken which revealed crown dilaceration along with root dilaceration at the middle third of the root, absence of dens in dent, C-shaped canal (semicolon). Clinical examination, history taking and radiological findings confirmed the diagnosis of pulp necrosis, symptomatic apical periodontitis with “C-shape” canal and crown/root dilaceration.