Trauma- Resorption

Question 0

What are the outcomes to the pulp following tooth fracture?

Answer 0

Survival
Obliteration
Necrosis

Question 1

What are the two types of pathological root resorption?

Answer 1

Inflammatory

Replacement

Question 2

What happens when there is pulp obliteration following fracture ?

Answer 2

Tooth is re vascularised and there is deposition of hard tissue along the pulp wall
Tooth will appear yellowish

Question 3

What happens when the pulp dies in tooth fracture ?

Answer 3

Failure to be revascularised and this need to do apexificatjon

Question 4

What are the factors which will influence pupal healing in in tooth fracture?

Answer 4

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

Question 5

What are the outcomes of pupal status following luxation injuries?

Answer 5

Survival
Obliteration
Internal resorption: confused healing
Necrosis

Question 6

What factors indicate which type of healing will occur?

Answer 6

Status of the apex

Extent of injury: concomitant injury

Question 7

What are the outcome of pdl healing following luxation injuries?

Answer 7

Survival

External resorption

Question 8

What can pulpal necrosis following luxation injuries lead to?

Answer 8

Inflammatory resorption

Question 9

What are the three types of external resorption following luxation injuries to the pdl ?

Answer 9

Surface
Inflamm
Replacement

Question 10

What happens when there is inflamm resorption due to damage to the pulp due to luxation injuries how do you diagnose and treat it?

Answer 10

Also known as infection related and is confused he

1. Internal surface is colonised by multinucleated giant cells
2. 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

Question 11

What happens to the pdl in external surface resorption?

Answer 11

This is repair related and there is transient apical breakdown
It is a sign of normal healing

Question 12

What happens to the pdl in external inflammatory resorption? How do you diagnose and treat it?

Answer 12

1. Non vital teeth with infected pulp canal
2. 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

Question 13

When is external inflammatory resorption likely?

Answer 13

Mature apex

Significant injuries

Question 14

What is cervical resorption?

Answer 14

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

Question 15

What happens External replacement resorption?

Answer 15

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

Question 16

WHat is the consequence of replacement resorption?

Answer 16

The root becomes involved in bone remodelling and is gradually replaced over the next years

Question 17

How can you diagnose replacement resorption?

Answer 17

Absent ligamentous join between the bone and root
Bright metallic tone heard when tapped
Ragged outline

Question 18

How do you treat replacement resorption?

Answer 18

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

Question 19

What is the treatment for an ankylosed tooth?

Answer 19

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

Question 20

What should you avoid placing in the canal in a tooth that has been implanted less than 2 weeks ago?

Answer 20

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