Regressive and traumatic alterations of teeth
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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.

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Regressive Alteration

  • Attrition

  • Abrasion

  • Erosion


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Attrition

  • Physiologic wearing away

  • Incisal, occlusal and interproximal surfaces

  • Part of aging process

  • Bruxism – pathologic attrition


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Attrition – Radiologic Features

  • Change in normal outline

  • Flat occlusal plane

  • Loss of mamelon

  • Pulp chamber, canal size

  • Hypercementosis




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Abrasion

  • Non-physiologic wearing away

  • Habits

  • Toothbrush trauma

  • Dental floss injury

  • Occupational hazards


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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


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You will write cases today

  • Describe

    • Type of film(s)

    • Location / number of lesions (problem)

    • Size

    • Shape

    • Border

    • Content

    • Effects on neighboring structures



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March 2000

May 2003


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Erosion

  • Chemical cause

  • No bacteria involved

  • Diet

  • Regurgitation

  • Occupational hazards


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Erosion - Radiologic Features

  • Radiolucent defects

  • Dietary acids – labial surface

  • Regurgitation – mandibular lingual surface

  • Occupational – all surfaces


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Resorption Phenomenon

  • External

  • Internal


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External Resorption

  • Periapical pathology

  • Trauma

  • Mechanical forces

  • Tumors and cysts

  • Impacted teeth

  • Osteosclerosis

  • Idiopathic














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Internal Resorption

  • Trauma

  • Idiopathic




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Traumatic Injury to Teeth

  • Concussion

  • Luxation

  • Avulsion


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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


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Luxation

  • Dislocation of teeth: intrusion, extrusion, lateral, lingual or buccal

  • Early radiographic observation: widened PDL spaces

  • Long term effect: pulpal sclerosis, necrosis, periapical lesion


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Avulsion

  • Loss of tooth

  • Socket outline

  • Fracture of alveolar bone

  • Possibility of reimplantation


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Fracture of Teeth

  • Coronal fracture

    • Cusp

    • Pulp

  • Root fracture

    • Horizontal

    • Vertical

  • (Details of fracture in Unit 11)


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