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

• Change in normal outline

• Flat occlusal plane

• Loss of mamelon

• Pulp chamber, canal size

• Hypercementosis

Attrition

Attrition

Abrasion

• 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

• 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

• 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

• 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)