lecture 4 (part 2) Discoloration of Teeth (Slide)

8/3/2019 lecture 4 (part 2) Discoloration of Teeth (Slide)

1/19

Discoloration of TeethDr. Rima Safadi


2/19

Causes of Discoloration

Extrinsic staining

Changes in tooth structure

Diffusion of pigments after tooth formation

during tooth formation


3/19

Extrinsic staining Adsorption on tooth surface

Food, drinks, tobacco, mouth rinses

Bacteria: green and black pigments

Chromogenic bacteria


4/19

Changes in tooth structure Amelogenesis and dentinogenesis

imperfecta

White spot caries

Enamel hypoplasia


5/19

Dentinogenesis imperfecta


6/19

Diffusion of pigments after tooth

formation

From food and tobacco into dentinexposed by caries or tooth wear

From restorative and root filling materialand corrosion products

Pulp necrosis: lysis of necrotic tissuediffuses in dentine


7/19

Pink Tooth


8/19

Incorporation of pigments duringtooth formation

In congenital disorders:Neonatal jaundice (congenital

hyperbilirubineamia)

Deposition of bile pigments in calcifyingenamel and dentine

Mainly in dentine

Green to yellow brown


9/19

Heamolytic anemia teeth


10/19

Congenital Porphyria:

AR error in porphyrin metabolism

Escretion of porphyrin pigments (red) in urineand blood

Pink brown discoloration


11/19

Porpheria teeth


12/19

Extrinsic stain


13/19

Tetracycline pigmentation

Deposition in dental hard tissue (enamel,dentine, cementum) and bone More in dentine

Yellow bands Flouresce bright yellow under UV light

Yellow then darken with light

Severity depends on dose, age at time of

adminstration Cross placenta

Should not be given from 29 weeks-fullterm


14/19

Tetracyclin stain


15/19

Transplantation and Reimplantation

of Teeth

Transplanatation:

From one site to another

Extraction site or surgically prepared socket

Autotransplantation vs allografting(between individuals)

Autotransplant: no immune response

Traumatic severness of blood supply

In open apex: revascularization occur (>1mm foramenwidth)


16/19

Root resorption is most commoncomplication

Rapid or slow (10-15 years beforeexfoliation)

Pain is not a feature

Early acute inflammation leading to root

resorption then chronic inflammation RL bone area

Bony infilling: long term replacement resorption


17/19

Prevention of root resorption: RCT within 4weeks

Reimplanted teeth: worse prognosis than

transplanted


18/19

Root Fracture

Prognosis depends on presence and absence ofinfection Pulp vitality

Position of fragments

Mobility of coronal fragment 3 healing patterns if the fracture is sterile:

1. united totally by a tissue resembling bone or cementum

2. May be rounded off by cementum but not united bycalcified tissue

3. Rounded and coated by cementum but fragments arewidely seperated


19/19

Age changes:

Enamel: brittle, less permeable and darker

Dentine: Formation of secondary dentine:reduced or obliterated pulp chamber

Associated with caries and tooth waer

Cementum: hypercementosis

Compensate for tooth substance loss

lecture 4 (part 2) Discoloration of Teeth (Slide)

Documents