Abnormalities of the pulp I. Pulp Calcification(Ossification) - A condition in which there is hardening, or calcification of pulp tissue.

- This is purely coincidental finding.

Classification of Pulp Stones: 1. According to histology: a. True resembles secondary dentin because of its irregular tubular structure b. False made up of concentric layers around a central nidus. 2. According to location: a. Free lies enitrely within the pulp tissues and not attached to the dentinal walls. b. Attached continuous with dentinal walls. c. Interstitial ( Embedded) sorrounded or enclosed by secondary dentin. 3. According to form: a. Amorphous no definite shape b. Nodular round c. Fibrillar (Diffuse) also termed calcific degeneration. - Made up of unorganized linear strands or columns paralleling the blood vessels and nerves of the pulp. - Most commonly seen in the root canals or teeth. Diffuse Calcification Most commonly seen in root canals of teeth. Resembles the calcification seen in other tissues of t he body following degenaration. Also termed as Calcific degeneration Amorphous in pattern, unorganized linear strands or columns paralleling to the blood vessels and nerves of the pulp.

Etiology: Unkown; although the incidence appears inceease with the age of the individual. Chronic irritation of or inflammation in the tissue of the pulp arising from caries or trauma. Bacteria forced into the pulp tissues from deep cavity.

2 Chief morphologic forms: 1. Pulp stones (denticles; pulp nodules) 2. Diffuse calcification Pulp stones Are localized masses of calcified tissues in which are more common in the pulp chamber than in the root canal. Are hard, bone-like structures that form within the pulp of a tooth. Cause is Unknown

An x-ray of the maxillary right central incisor shows complete obliteration of the canal from tooth calcification secondary to a history of trauma. There was no pain. In the photo note the discolartion of the coronal portion of the tooth this is a common sign of calcification. This is a result of the breakdown of blood in the pulpal chamber.

External resorption and periapical bone loss in a patient with intrinsic dental discoloration caused by blunt trauma to the mandibular incissor that lead to pulpal necrosis.

III.

Internal Resorption ( Pink Spot) an idiopathic slow or fast progressive resorptive process occurring in the dentin of pulp chamber of root canals of teeth. Also known as Chronic Perforation Hyperplasia of the Pulp; Internal Granuloma; Odontoclastoma; Tooth of Mummery

Treatment: Rct is usually necessary to clear away hardened tissue. Because most pulp stones are attached to the dentin walls, they can make RCT very difficult and/or impossible.

Etiology: The cause can sometimes be attributed to trauma to the tooth, but other times there is no known etiology.

II.

External Resorption - Loss of calcified dental tissues arising as a result of a tissue reaction in the perodontal or pericoronal tissue.

Etiology: 1. 2. 3. 4. 5. 6. Periapical inflammation. Reimplatation of teeth Tumors and cysts Excessive mechanical or occlusal force. Impaction of teeth Idiopathic

Pink Spot

The internal resorption had destroyed the integrity of the tooth when it perforated through the root into the bone, this mean that the tooth was not savable and had to be extracted. Some of the hypertrophied pulpal tissue still remains clinging to the internal wall of the lession

Treatment: If the condition is discovered prior to the perforation of the crown or root has occured, endodontic therapy may be carried out with a fairly high success rate.

Internal and external resroption