Discoloration of Teeth

Dr. Rima Safadi

Causes of Discoloration
Extrinsic staining Changes in tooth structure Diffusion of pigments
after tooth formation during tooth formation

Extrinsic staining
Adsorption on tooth surface
Food, drinks, tobacco, mouth rinses Bacteria: green and black pigments Chromogenic bacteria

Changes in tooth structure

Amelogenesis and dentinogenesis
imperfecta
White spot caries Enamel hypoplasia

Dentinogenesis imperfecta

Diffusion of pigments after tooth formation

From food and tobacco into dentin
exposed by caries or tooth wear From restorative and root filling material and corrosion products Pulp necrosis: lysis of necrotic tissue diffuses in dentine

Pink Tooth

Incorporation of pigments during tooth formation

In congenital disorders:
Neonatal jaundice (congenital hyperbilirubineamia)
Deposition of bile pigments in calcifying enamel and dentine Mainly in dentine Green to yellow brown

Heamolytic anemia teeth

 Congenital Porphyria: AR error in porphyrin metabolism

Escretion of porphyrin pigments (red) in urine and blood Pink brown discoloration

Porpheria teeth

Extrinsic stain

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

Tetracyclin stain

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 foramen width)

 Root resorption is most common

complication Rapid or slow (10-15 years before exfoliation)
Pain is not a feature Early acute inflammation leading to root resorption then chronic inflammation RL bone area Bony infilling: long term replacement resorption

 Prevention of root resorption: RCT within 4

weeks
Reimplanted teeth: worse prognosis than transplanted

Root Fracture
Prognosis depends on presence and absence of
infection
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 by calcified tissue 3. Rounded and coated by cementum but fragments are widely seperated

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