Endontic Pathology

Pulpitis

Pulpitis is the inflammation of the pulpal tissue, often discolouring the tooth.

Pink discoloration

 

Purple discoloration

 

Yellow discoloration

 

Grey discoloration


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Abnormal Wear

Teeth can be worn by abnormal contact with opposing teeth or by chewing.

Worn maxillary incisor teeth (AT)

 

Wear facet of the mandibular right canine (AT)


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Luxation/Avulsion

Luxation is a partial displacement of the tooth out of its socket. Avulsion is the complete displacement of a tooth from its socket.

Luxated maxillary right

 

Avulsion gingival injury

 

Avulsed tooth (T/A)


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Tooth Fracture

Tooth fractures are either uncomplicated (the pulp is not exposed) or complicated (the pulp is exposed to the oral environment).

Uncomplicated – enamel only (mandibular incisor)

 

Uncomplicated crown fracture without pulp exposure

 

Mandibular canine chronic fracture (brown pulp)

 

Complicated – enters the pulp chamber (maxillary fourth premolar acute fracture (red pulp))

 

Complicated – crown/root fracture (slab fracture of maxillary fourth premolar)

 

Pulp exposed after slab removed (white arrow)/black arrows indicate subgingival involvement

 

Root fracture


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Tooth Resorption

Tooth resorption is internal and/or external loss of the tooth hard tissue.

  • Stage 1 (TR 1) – Mild dental hard tissue loss (cementum or cementum and enamel).
  • Stage 2 (TR 2) – Moderate dental hard tissue loss (cementum or cementum and enamel with loss of dentin that does not extend to the pulp cavity).

     
  • Stage 3 (TR 3) – Deep dental hard tissue loss (cementum or cementum and enamel with loss of dentin that extends to the pulp cavity). Most of the tooth retains its integrity.

     
  • Stage 4 (TR 4) – Extensive dental hard tissue loss (cementum or cementum and enamel with loss of dentin that extends to the pulp cavity). Most of the tooth has lost its integrity.
    1. Crown and root are equally affected.
    2. Crown is more severely affected than the root.
    3. Root is more severely affected than the crown.
  • Stage 5 (TR 5) – Remnants of dental hard tissue are visible only as irregular radiopacities and gingival covering is complete.


    Stage 5 crown cannot be visualized (RL5)

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