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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 .
The pulp cannot recover from the insult and damage. For example, decay that has reached the pulp of the tooth introduces bacteria into the pulp. The pulp is still alive, but the introduction of bacteria into the pulp will not allow the pulp to heal and it will ultimately result in necrosis, or death, of the pulp tissue. [11]
Pulp necrosis is when the pulp has died/dying. Causes include untreated caries, trauma or bacterial infection. It is often subsequent to chronic pulpitis. Teeth with pulp necrosis undergo a root canal or extraction to prevent further spread of the infection, which may lead to an abscess.
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.
It is a likely outcome of untreated dental caries (tooth decay), and in such cases it can be considered a sequela in the natural history of tooth decay, irreversible pulpitis and pulpal necrosis. Other causes can include occlusal trauma due to 'high spots' after restoration work, extrusion from the tooth of root filling material, or bacterial ...
Secondary [clarification needed] symptoms of periapical cysts include inflammation and infection of the pulp causing dental caries. This infection is what causes necrosis of the pulp. [4] Larger cysts may cause bone expansion or displace roots. Discoloration of the affected tooth may also occur.
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.
Histologically the pulp is vital and exhibits an intense inflammatory response; Pulpal necrosis: Area of exposed dentine that has resulted in pulp exposure to the oral environment; Usually no true symptoms as the pulpal sensory nerves have been destroyed; Histologically the pulp is non-vital and usually is heavily infiltrated with bacteria ...