LESSON 2 Flashcards
Loss of tooth structure / degradative changes of tooth structure due to non-carious causes resulting in wear of tooth structure and loss of function
REGRESSIVE CHANGES
REGRESSIVE CHANGES IN ENAMEL
Attrition
Abrasion
Erosion
Abfraction
PHYSIOLOGIC wear of tooth due to tooth-to-tooth contact, mastication, or parafunction
ATTRITION
Appearance of small, polished facet on a cusp tip or ridge
or a slight flattening of an incisal edge
ATTRITION
People who like to constantly eat course or hard food that can cause the teeth to flatten out
Course foods: hard crunchy foods like chicharron
ATTRITION
ETIOLOGY OF ATTRITION
Diet
Age
Parafunctional occlusal forces
Contact with poorly polished ceramic restorations.
Accelerated by poor quality or absent enamel.
True or False
The older a person becomes; the more attrition is exhibited.
True
when the person is conscious, and they like to bite strongly on their teeth and they’re
not chewing. (Conscious: when they are stress)
Clenching will cause attrtion
when people grind. A condition wherein the person is not aware of (Unconscious:
sleeping)
Bruxism will cause attrition
TRUE or FALSE
Using hard bristles when toothbrushing for 2-3 mins can cause abrasion
True
V-shaped notches with sharply defined margins on the root side of the cementoenamel junction in teeth with some gingival recession
ABRASION
affects large areas and small polished facets at the cuspal tips
ATTRITION
Vigorous tooth brushing or flossing (and people who likes to use toothpicks)
Improper use of dental floss and toothpicks may produce
lesions on the proximal exposed root surface.
ABRASION
Habits of constant biting of hard objects
o Pen chewing/ biting.
o Habitual pipe smokers may develop notching of the teeth that conforms to the shape of the pipe stem.
o Bottle opening with teeth.
o Fingernail biting
ABRASION
loss of tooth structure due to mechanical reasons (root area)
ABRASION
Irreversible loss of tooth structure due to a chemical process (does not involve bacteria)
EROSION
Shallow, scooped-out (smooth) surfaces.
EROSION
Causes
Intrinsic:
Stomach acid reaching teeth
Obesity, Pregnancy
Excessive alcoholism
Eating disorder (bulimia nervosa, anorexia nervosa)
EROSION
Extrinsic:
o Occupational causes
People who work in factories.
Sometimes they are exposed to some chemicals. Chronically, can affect their teeth.
o Acidic foods and drinks (has low pH, high acidity)
Citrus fruits
Fruit juices
EROSION
a condition or erosion that affects the general lingual
surfaces of the teeth.
Perimolysis
loss of tooth structure both enamel and dentin or under the CEJ
Abfraction
True or false
PERIMOLYSIS’
- erosion at lingual surfaces due to intrinsic acid pH: 1-2)
True
• Deep, narrow, wedge-/ V-shaped only at cervical areas
• Subgingival
ABFRACTION
Abnormal biochemical (occlusal) stresses
o Swallowing, clenching, or cyclic
o Cervical lesion
ABFRACTION
MANAGEMENT OF ENAMEL REGRESSIVE CHANGES
- Know the cause of loss of tooth structure
- Immediate therapy for resolution of sensitivity and pain (desensitizers)
- mouth guards
- resto/prostho treatment
- relax
the dentin formed when the tooth is still developing.
Primary dentin
REGRESSIVE CHANGES IN DENTIN
Primary dentin
Secondary dentin
Tertiary dentin
formed when the root is completely formed.
Secondary dentin
also called reparative dentin. There is a cause. (Dead tracts, Sclerotic dentin)
Tertiary dentin
occurs when fluid found inside dentinal tubules dry up
Dead tracts ( black)
occurs when dentin becomes hypermineralized
Sclerotic dentin ( white )
Where does dead tracts can be found?
Found in incisal and cuspal tip areas.
TRANSPARENT DENTIN
SCLEROTIC DENTIN
A regressive alteration in tooth substance that is characterized by calcification of the dentinal tubules.
SCLEROTIC DENTIN
Will appear as black because the dentinal tubules which is normally filled with dentinal fluid, is now empty of that dentinal fluid.
DEAD TRACTS
T/F
In SCLEROTIC DENTIN, Dentinal tubules is filled with increased amount of mineral structures or even around your odontoblastic processes
True
Result of injury or manifestation of the normal aging process
SCLEROTIC DENTIN
True or false
The presence of dead tracts and sclerotic dentin is one reason why teeth that has attrition or abrasion will not have sensitivity because the areas are protected by these two areas especially the sclerotic dentin
True
MECHANISMS FOR SCLEROTIC DENTIN
- Increased deposition of intratubular dentin
- Tubule occlusion by precipitated mineral (whitlockite)
crystals
Fat droplet depositionk
Fatty degeneration
Earliest histology change that occurs int e pulp
tissue
Fatty degeneration
Just like in vacuolization but you have an increase in intercellular fluid but this time, because of _____________ the fibers in your pulp will look like as if they’re knitted.
Reticular atrophy
thickening or increase in number
Pulpal Fibrosis
REGRESSIVE CHANGES IN THE PULP
- Fatty degeneration
- Vacuolization of Odontoblastic layer
- Reticular atrophy
- Pulpal Fibrosis
- Denticles/ Pulp Stone
Hardened or mineralized structures found within your pulp area
PULP STONE / DENTICLES
Why are they called denticles?
Their structure on a cross section can resemble your
dentinal structure.
o In cross section resembles dentin
o Since these are mineralized structures, it appears
radiopaque or white in radiographs.
True denticle
Doesn’t resemble dentin.
False denticle
Found free located in the pulp tissue.
Free
Part of it is in the pulp tissue, part of it is in the
dentin surface
Attached
Completely found in dentin
Embedded
o Round in structure or circular
o Can be found anywhere.
Nodular
o Irregular in shape
o Can be found anywhere.
Amorphous
o Elongated or fibrous in form
o Usually found in root canal area
Diffuse or fibrillar
The increase or thickening of cementum
HYPERCEMENTOSIS
Conditions ex. Paget’s disease
HYPERCEMENTOSIS
ETIOLOGY:
• Accelerated tooth elongation.
• Periapical inflammation
• Tooth repair in trauma
• Conditions ex. Paget’s disease
HYPERCEMENTOSIS
True or false
CEMENTICLES
• Can be free, embedded or attached.
True
Breakdown or destruction and loss of root structure of a tooth
ROOT RESORPTION
Is one condition that can be seen clinically because the tooth will appear pink.
INTERNAL RESORPTION
Sometimes called pink tooth of Mummery.
INTERNAL RESORPTION
Pink hue because of increase granulation of tissue within
the chamber or the root
INTERNAL RESORPTION
True or false
INTERNAL RESORPTION
Needs to undergo root canal treatment
True
Etiology
• Pulpal inflammation
• Periodontal infection
• Pressure from orthodontic movement, impacted tooth, or
tumors.
• Traumatic injuries
• Presence of cementicles on root surface
EXTERNAL RESORPTION
increase of intracellular liquid
Vacuolization of Odontoblastic Layer
- occurs with time due to aging
Pulp Fibrosis
- difficulty in root canal treatment but not a cause for alarm
Denticles/Pulp Stones
calcific structures forming inside PDL space
( no clinical sognificance unless exposed to oral environment w/c can cause accumulation of dental plaque leading to cavities/periodontal disease)
CEMENTICLES
loss of root structure starts inside of tooth (dentin)
INTERNAL RESORPTION
loss of root structure starts outside of tooth (cementum)
EXTERNAL RESORPTION
-anything with excessive outside force may cause this
- needs to undego tooth extraction
EXTERNAL RESORPTION
Severe jarring of a tooth with a contusion of the periodontal ligament
CONCUSSION
• Simplest form of traumatic injuries
• The structures are still in place, but they are jilted from their
normal position.
• In the apical part you have a radiolucency
CONCUSSION
A TRAUMATIC INJURIES with no change in tooth position and no gingival bleeding
CONCUSSION
- dislocation of tooth from sockets
- presence of sensitivity to percussion, increased mobility but no displacement
LUXATION
“Loosen”
LUXATION
- break in the continuity of dental hard tissues
- will appear greyish or radioluscent
FRACTURE
(root has severe abrupt curves along the root)
- deformity of tooth characterized by a sharp bend at the neck or root part of the tooth
- happens when developing tooth undergo some form of traume during developing stage
Dilaceration
- forceful displacement of a tooth from the socket
Avulsion
True or false
Avulsed teeth depending on the time can not be returned to
the socket
False
Avulsed teeth depending on the time can still be returned to
the socket
A SUPERNUMERARY TOOTH
extra tooth between maxillary central incisors
Mesiodens
SUPERNUMERARY TOOTH
extra tooth found elsewhere than in the midline of the arch
Peridens
SUPERNUMERARY TOOTH
extra teeth distal to 3rd molars
Distomolar
extra teeth on the buccal or lingual side of the maxillary molar
Paramolar
all teeth are missing, may involve both deciduous and permanent dentition
Total Anodontia
occurs as a result of extraction of all teeth
False Anodontia
sometimes applied to multiple unerupted teeth
Pseudoanodontia
common in central or lateral incisors; usually central incisors with a notch on the incisal edge
Hutchinson’s Teeth
usually found on the upper central incisors on the lingual side; these are over-developed cingulum
Talon’s Cusps
crossing the line of occlusion
Supraversion
