Trauma- Resorption Flashcards
What are the outcomes to the pulp following tooth fracture?
Survival
Obliteration
Necrosis
What are the two types of pathological root resorption?
Inflammatory
Replacement
What happens when there is pulp obliteration following fracture ?
Tooth is re vascularised and there is deposition of hard tissue along the pulp wall
Tooth will appear yellowish
What happens when the pulp dies in tooth fracture ?
Failure to be revascularised and this need to do apexificatjon
What are the factors which will influence pupal healing in in tooth fracture?
Initial pulp status
Status of apex: open apex more likely to have survival or obliteration
Time since injury: longer the time increases risk of necrosis
Concurrent injuries: pdl damage increases rims of necrosis
What are the outcomes of pupal status following luxation injuries?
Survival
Obliteration
Internal resorption: confused healing
Necrosis
What factors indicate which type of healing will occur?
Status of the apex
Extent of injury: concomitant injury
What are the outcome of pdl healing following luxation injuries?
Survival
External resorption
What can pulpal necrosis following luxation injuries lead to?
Inflammatory resorption
What are the three types of external resorption following luxation injuries to the pdl ?
Surface
Inflamm
Replacement
What happens when there is inflamm resorption due to damage to the pulp due to luxation injuries how do you diagnose and treat it?
Also known as infection related and is confused he
- Internal surface is colonised by multinucleated giant cells
- these cells are activated by microbial products from an infected root canal or perio pocket propagated by non vital coronal tissue
Diagnosis: PA shows round symmetrical radiolucency centred in the root canal and may also be a pink discoloured crown too
Treatment: treatment without delay. RCT
What happens to the pdl in external surface resorption?
This is repair related and there is transient apical breakdown
It is a sign of normal healing
What happens to the pdl in external inflammatory resorption? How do you diagnose and treat it?
- Non vital teeth with infected pulp canal
- Process is initiated by damage to pdl but propagated by infected root canal products seeping to external root
Diagnosis: root becomes surrounded by radiolucency and differ to internal since it is not symmetrical and moves in relation to root canal when views in diff horizontal angles
Treatment: treat without delay, extirpate pulp and place CaOH in canal for several months to ensure lesion arrested
When is external inflammatory resorption likely?
Mature apex
Significant injuries
What is cervical resorption?
Unusual form of external inflam root resorption caused by damage to root surface at the cervical part and is progporated by periodontal flora or by infected root canal
What happens External replacement resorption?
Follows serious injuries eg Avulsion and damaged pdl. If more than 20% of pdl is lost then bone cells grow in contacts with the root more quickly then new pdl can colonise the root again
WHat is the consequence of replacement resorption?
The root becomes involved in bone remodelling and is gradually replaced over the next years
How can you diagnose replacement resorption?
Absent ligamentous join between the bone and root
Bright metallic tone heard when tapped
Ragged outline
How do you treat replacement resorption?
No treatment
Tooth maybe able to be retained for 10yrs
BUT in the growth child it maybe come severely infra occluded and theis means bone in that area does not grow
What is the treatment for an ankylosed tooth?
Once the discrepancy in gingival margin is 1-2 mm dirrernt compared to adjacent tooth then need to Decoronate and the root left behind must have the GP removed as it is slowly resorbed and replaced with bone maintaing bone height in that region
What should you avoid placing in the canal in a tooth that has been implanted less than 2 weeks ago?
Should avoid placing CaOH since the alkaline nature is thought to induce an inflam response in the pdl and make the replacement resorption worse
Should place leader mix down
