Case Report
CBCT-assisted diagnosis of transient apical breakdown and buccal cortical fracture following lateral luxation: A 24-month case report
Mario M. Betancourt, DDS 1
Marino V. Carcaño, DDS, MS 1
Jorge Vera, DDS, MS 2
https://doi.org/10.71347/afv594htw
1 Endodontics faculty, Posgrado de Endodoncia, Universidad Autonoma de Tlaxcala.
2 Director, Advanced Education Program in Endodontics, Department of Periodontics and Endodontics, University at Buffalo School of Dental Medicine.
Corresponding author:
Jorge Vera DDS, MS, Director of the Advanced Education Program in Endodontics, Department of Periodontics and Endodontics, University at Buffalo School of Dental Medicine Squire Hall - University at Buffalo, State University at Buffalo South Campus, 3435 Main St, Buffalo, NY 14215
e-mail: jveraro@yahoo.com.mx
Key words: Transient apical breakdown (TAB), Lateral luxation, CBCT, Dental trauma, Pulpal necrosis, Conservative management.
Acknowledgements: The authors deny any conflicts of interest.
Abstract
Introduction: Transient apical breakdown (TAB) is a rare, reversible condition following lateral luxation. It presents as resorption in the apical root and periapical area, often seen radiographically as a periapical radiolucency. Crown discoloration may be noted clinically but typically resolves. Although self-limiting, TAB can mimic apical periodontitis or pulp necrosis, risking misdiagnosis and unnecessary intervention. CBCT imaging plays a critical role in achieving diagnostic clarity.
Objective: To report a case of TAB associated with a buccal cortical fracture, initially missed on periapical radiographs, and highlight the diagnostic value of CBCT in avoiding overtreatment.
Case Report: A 38-year-old Hispanic female experienced trauma with lateral luxation of tooth #21. Initial radiographs were inconclusive, and endodontic treatment was suggested. A second opinion and CBCT imaging revealed TAB and a buccal cortical fracture. Conservative monitoring was adopted. After 24 months, the tooth showed clinical and radiographic resolution without intervention.
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