Transient apical breakdown associated with clear aligner therapy: a case report

Abstract

Transient apical breakdown (TAB) is widely reported in response to trauma, yet its occurrence due to orthodontic forces, particularly in aligner therapy, is less documented within current literature. TAB can easily be misdiagnosed as pulp necrosis, potentially leading to unnecessary and irreversible endodontic procedures. This case report describes an instance of TAB following the initiation of aligner treatment, where the affected tooth initially presented with signs suggesting pulp necrosis but regained normal coloration and pulpal response after six months of active monitoring. This case highlights the importance of raising awareness among dental practitioners, especially those providing aligner therapy, about the risk of TAB. This awareness is crucial given the increasing provision of aligner treatment in general practice settings and the associated medico-legal implications.