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Pulp necrosis is a clinical diagnostic category indicating the death of cells and tissues in the pulp chamber of a tooth with or without bacterial invasion. [1] It is often the result of many cases of dental trauma , caries and irreversible pulpitis .
Potential sequelae can involve pulpal necrosis, pulp obliteration and root resorption. [10] Necrosis is the most common complication and an assessment is generally made based on the colour supplemented with radiograph monitoring. A change in colour may mean that the tooth is still vital but if this persists it is likely to be non-vital.
b) Pulp Necrosis: The pulp tissue dies as a result of untreated pulpitis or direct trauma. Tooth discoloration; Infection: If bacteria penetrate the dentin and reach the pulp, it can lead to abscess formation or other periapical (around the root tip) infections. This can result in swelling, pain, and possible tooth loss if left untreated.
In a periapical abscess, usually the origin is a bacterial infection that has accumulated in the soft, often dead, pulp of the tooth. This can be caused by tooth decay, broken teeth or extensive periodontal disease (or combinations of these factors). A failed root canal treatment may also create a similar abscess.
Inflammation therefore increases pressure in the pulp system, potentially compressing the blood vessels which supply the pulp. This may lead to ischemia (lack of oxygen) and necrosis (tissue death). Pulpitis is termed reversible when the inflamed pulp is capable of returning to a state of health, and irreversible when pulp necrosis is inevitable.
This has led to the popular belief that necrotizing gingivitis is contagious, but this is not the case. The main features of necrotizing gingivitis are painful, bleeding gums and ulceration and necrosis of the interdental papilla. There may also be intra-oral halitosis, cervical lymphadenitis (swollen lymph nodes in the neck) and malaise.
Most people enter military service “with the fundamental sense that they are good people and that they are doing this for good purposes, on the side of freedom and country and God,” said Dr. Wayne Jonas, a military physician for 24 years and president and CEO of the Samueli Institute, a non-profit health research organization.
Periapical periodontitis may develop into a periapical abscess, where a collection of pus forms at the end of the root, the consequence of spread of infection from the tooth pulp (odontogenic infection), or into a periapical cyst, where an epithelial lined, fluid-filled structure forms.