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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 • • • • • 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)