Pulp necrosis

Necrotic pulp is a finding in dentistry to describe dental pulp within a tooth which has become necrotic. It is a finding of interest to dentists as the process of pulp death may be painful causing a toothache.

Sequelae of a necrotic pulp include acute apical periodontitis, dental abscess or radicular cyst and discolouration of the tooth that may require tooth bleaching.

Tests for a necrotic pulp include: vitality testing using a thermal test or an electric pulp tester. Discolouration may be visually obvious, or more subtle.

Treatment usually involves endodontics or extraction.

Acquired tooth disease (K02–K05, 521–525)

Hard tissues

Pulp/periapical (Endodontal)

Pulpal	External resorption Internal resorption Irreversible pulpitis Reversible pulpitis Pulp necrosis Pink tooth of Mummery

Periapical	Acute apical periodontitis Chronic apical periodontitis Combined periodontic-endodontic lesions Fistula Periapical abscess Phoenix abscess Vertical root fracture

Ungrouped	Pulpitis Radicular cyst Periapical abscess

Gingiva/periodontal
(Periodontal)

Bone cyst

Other

Cracked tooth syndrome

To be grouped
from periodontology

Diagnoses	Chronic periodontitis Localized aggressive periodontitis Generalized aggressive periodontitis Periodontitis as a manifestation of systemic disease Necrotizing periodontal diseases Abscesses of the periodontium Combined periodontic-endodontic lesions

Pathogenesis	A. actinomycetemcomitans Capnocytophaga sp. F. nucleatum P. gingivalis P. intermedia T. forsythia T. denticola

Pathologic entities	Calculus Edentulism Fremitus Furcation defect Gingival enlargement Gingival pocket Gingivitis Horizontal bony defect Linear gingival erythema Occlusal trauma Periodontal pocket Periodontal disease Periodontitis Plaque Recession Vertical bony defect

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