PMC4451656_01
Intra oral photograph of a patient showing missing anterior teeth in both jaws with rest of the dentition exhibiting normal coronal color and morphology
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F1
On intraoral examination [Figure 1] the morphologic appearance and color of the permanent teeth were normal.
Panoramic radiograph shows no root formation in most of the teeth with total obliteration of the pulp chambers and periapical radiolucency in lower right mandibular first molar, left mandibular first and second molar
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F2
Panoramic radiograph [Figure 2] revealed adequate enamel thickness on the cuspal tips of all the teeth.
Gross specimen of permanent right maxillary first molar tooth
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F3
Clinical examination of the gross specimen [Figure 3] revealed an intact tooth.
Stereomicroscopic view of ground section of permanent right maxillary first molar showing obliteration of pulp chamber with abnormal dentin formation (Ground section, x20)
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F4
The ground section [Figure 4a and b] showed normal crown outline with normal enamel covering.
Stereomicroscopic view of hematoxylin-eosin stained permanent right maxillary first molar showing obliteration of pulp chamber with abnormal dentin formation (H&E stain, x20)
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F5
Normal dentinal tubule formation appeared to have been blocked and the new dentin so formed around obstacle, gave rise to the characteristic appearance of "lava flow around the boulder" [Figure 5].
Photomicrograph of ground section showing polarized view of permanent maxillary first molar showing classic "lava flowing around boulders" appearance. (Polarizing microscopy, x 100)
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F6
Histopathologic examination of the decalcified hematoxylin-eosin section [Figure 6] showed total obliteration of pulp that was filled with tubular dentin, osteodentin and irregular, globular masses of dentin [Figure 7 and 8].
Photomicrograph showing decalcified section showing abnormal dentin formed around the obstacles (H&E stain, x100)
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F7
Histopathologic examination of the decalcified hematoxylin-eosin section [Figure 6] showed total obliteration of pulp that was filled with tubular dentin, osteodentin and irregular, globular masses of dentin [Figure 7 and 8].
Photomicrograph of decalcified section showing osteodentin with empty lacunae devoid of osteocytes (H&E stain, x100)
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F8
Histopathologic examination of the decalcified hematoxylin-eosin section [Figure 6] showed total obliteration of pulp that was filled with tubular dentin, osteodentin and irregular, globular masses of dentin [Figure 7 and 8].