Documente Academic
Documente Profesional
Documente Cultură
MORNING
PULP CALCIFICATIONS
(Pulpstones,Denticles,Nodules)
Occurs in any portion of the teeth
Depending on the morphologic forms of pulp calcifications
True stones
False stones
TRUE DENTICLES:
Localized mass of calcified tissue that resemble dentine because of their
tubular structure.
Resemble secondary dentine, because of few dentinal tubules and
irregular arrangement.
Site : More common in pulp chambers than root canals.
False denticles:
Dont exhibit dentinal tubules
They are larger than true denticles
Nodules appear to be made up of concentric layers or
lamellae deposited around the nidus
1.Free
2.Attached type
3. Interstitial denticle
PULP
STONE
Etiology
1)Increases with age of the patient
2)It is not associated with inflammation,caries or trauma since
pulpal calcifications are also seen in unerupted teeth.
3)There is also certain hypothesis about various local or
systemic diseases which include cholelithiasis, acromegaly,
hypercementosis, toruspalatinus or mandibularis. But none of
there relationship is not clear.
4)There is high percentage of pulp stones resulting in growth of
streptococci bacteria upon culturing. This hypothesis was not
true, as the bacteria were forced in to the pulpal tissue at the
time of tooth extraction .
Etiology
Local metabolic dysfunction
Trauma
Hyalinization of injured cells
Vascular
damage
Fibrosis
RESORPTION OF TEETH
Types: External resorption
Internal resorption
INTERNAL RESORPTION:
(Chronic perforating hyperplasia of pulp, Internal granuloma,
Odontoclastoma, Pink tooth of mummery.)
Characteristic feature:
Unusual form of tooth resorption that begins centrally with in
the tooth associated with peculiar inflammatory hyperplasia
of pulp.
Cause pulpal inflammation / unknown.
INFLAMMATORY RESORPTION:
Resorbed dentin is replaced by inflamed granulation tissue.
Site cervical zone
Resorption continues as long as vital pulp remains
Coronal pulp necrotic and apical pulp vital
Appear as uniform , well circumscribed symmetric
INTERNAL RESORPTION
H/F:
Variable degree of resorption of the inner or pulpal surface
of the dentine and proliferation of pulp tissue filling the
defect.
Lacunae shows - odontoclasts or osteoclasts so called as
odontoclastoma.
Ch. Inflammatory cells are present.
Lacunae like areas in the dentin or osteodentin
Enamel is also resorbed when the internal resorption occurs
in the crown portion.
EXTERNAL RESORPTION
Resorption begins on the external surface of teeth
ETIOLOGY:
Periapical inflammation
Reimplantation of teeth
Tumors and cysts
Excessive mechanical or occlusal forceses
Impaction of teeth
Dental trauma
Hormonal imbalance
Intra coronal bleaching of pulp less teeth
Local involvement of herpes zoster
Paget's disease of bone
PDL treatment
periapical granuloma
resorption
Early stages - slight raggedness or blunting of the root
apex
Later stages resorption is apparent.
Reimplanted tooth:
Severe resorption of root
Replaced by bone ankylosis
Complete resorption exfoliation
Tumors and cysts:
Pressure phenomenon
Benign lesions displacement of tooth
Common in epithelial tumors
osteoclasts
resorption
Occasionally , neoplastic cells are found adjacent to and with
in the ragged resorption lacunae on the root surface.
Cysts:
Displacement is more common than resorption
Pulp infection
apical periodontal cyst
pressure
CT bet cysts
osteoclasts
resorption
Excessive mechanical or occlusal forceses:
Orthodontic treatment - multiple areas of root resorption
irrespective of manner of treatment
Resorption is variable
First bone resorption occurs
Impacted tooth:
Resorption of crown or resorption of both crown and root may
occur
C.T coming in contact with the tooth due to resorption of
epithelium initiates resorptive process
Cuspid > molars
Mesodense - prone for resorption
Horizontal/ mesoangular impaction resorption of the
adjacent tooth
Idiopathic resorption:
82% men & 91% women resorption
Max cuspids most common
Man incisors and molars least common
Normally less than 4 mm at the apex
May be due to systemic disorders endocrine disturbances
Genetic disturbances
May begin at CEJ or root apex
ER begins in the cervical area and extend from a small
Tooth repair:
Occlusal trauma results in mild root resorption which is
repaired by secondary cementum
Root fracture repaired by deposition of cementum
between the tooth fragments and the periphery.
Cemental tear, detachment of strip of cementum from
the root due to trauma are repaired by cementum growing
in to and filling the defect and uniting with the torn
cementum.
Ostitis deformans/ pagets disease:
Generalized skeletal disease characterized by deposition of
excess amount of secondary cementum on the roots of the
teeth and by apparent disappearance of laminadura.
Generalized hyper cementosis is suggestive of osteitis
deformans
Spike formation:
Characterized by the occurrence of small spikes or out
growths of cementum on the root surface.
Cause :
Excessive occlusal trauma
May occur due to deposition of irregular cementum in focal
groups of periodontal ligament fibers
Exact mechanism not known
C/F:
No significant clinical signs and symptoms
When these teeth are extracted roots appear larger in
diameter than normal and present round apices
R/F:
Thickening and apparent blunting of roots by loss in their
typical sharpened or spiked appearance.
It is impossible to distinguish it from dentine so diagnosis is
made on shape or out line of root.
cementicles
Cementicles are small foci of calcified tissue which are not