Transcript Regressive and Traumatic Alterations of Teeth

Regressive and Traumatic Alterations of
Teeth
Unit 4
Regressive Alteration
• Attrition
• Abrasion
• Erosion
Attrition
• Physiologic wearing away
• Incisal, occlusal and interproximal
surfaces
• Part of aging process
• Bruxism – pathologic attrition
Attrition – Radiologic Features
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Change in normal outline
Flat occlusal plane
Loss of mamelon
Pulp chamber, canal size
Hypercementosis
Attrition
Attrition
Abrasion
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Non-physiologic wearing away
Habits
Toothbrush trauma
Dental floss injury
Occupational hazards
Abrasion – Radiologic Features
• Radiolucent defects at the cervical
region
• Well-defined semilunar defects
• Pulp chambers sclerosed
• In case of dental floss injury, distal
surfaces more involved
You will write cases today
• Describe
– Type of film(s)
– Location / number of lesions (problem)
– Size
– Shape
– Border
– Content
– Effects on neighboring structures
Case 1 for write-up
March 2000
May 2003
Erosion
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Chemical cause
No bacteria involved
Diet
Regurgitation
Occupational hazards
Erosion - Radiologic Features
• Radiolucent defects
• Dietary acids – labial surface
• Regurgitation – mandibular lingual
surface
• Occupational – all surfaces
Resorption Phenomenon
• External
• Internal
External Resorption
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Periapical pathology
Trauma
Mechanical forces
Tumors and cysts
Impacted teeth
Osteosclerosis
Idiopathic
Ext. Resorption: Periapical Path
Ext. Resorption: Trauma
Case for Brett Moore
Ext. Resorption: Orthodontic
Ext. Resorption: Tumors/cysts
Ext. Resorption: Tumors/cysts
Ext. Resorption:
Ext. Resorption: Impacted Tooth
Ext. Resorption: Impacted Tooth
Ext. Resorption: Osteosclerosis
Ext. Resorption: Idiopathic
Case for Ruth Atterberg
Internal Resorption
• Trauma
• Idiopathic
Int. Resorption: Idiopathic
Internal Resorption: Trauma
Traumatic Injury to Teeth
• Concussion
• Luxation
• Avulsion
Concussion
• No displacement or loosening
• Crushing injury to adjoining areas
• Early radiographic changes may be
minimal
• Widened PDL spaces: few days to weeks
• Long term effects: pulpal sclerosis,
necrosis, periapical lesions
Luxation
• Dislocation of teeth: intrusion, extrusion,
lateral, lingual or buccal
• Early radiographic observation: widened
PDL spaces
• Long term effect: pulpal sclerosis,
necrosis, periapical lesion
Avulsion
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Loss of tooth
Socket outline
Fracture of alveolar bone
Possibility of reimplantation
Fracture of Teeth
• Coronal fracture
– Cusp
– Pulp
• Root fracture
– Horizontal
– Vertical
• (Details of fracture in Unit 11)