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Non carious lesions

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  • 1. Non carious destruction andNon carious destruction and disfigurement of teethdisfigurement of teeth
  • 2. Non carious destructionNon carious destruction  AttritionAttrition  AbrasionAbrasion  AbfractionAbfraction  ErosionErosion  Localized non-hereditary enamel hypoplasiaLocalized non-hereditary enamel hypoplasia  Localized non-hereditary enamel hypocalcificationLocalized non-hereditary enamel hypocalcification  Localized non-hereditary dentinal hypoplasiaLocalized non-hereditary dentinal hypoplasia  Localized non-hereditary dentin hypocalcificationLocalized non-hereditary dentin hypocalcification  DiscolorationDiscoloration  MalformationMalformation  Amelogenesis imperfectaAmelogenesis imperfecta  Dentinogenesis imperfectaDentinogenesis imperfecta  TraumaTrauma
  • 3. AttritionAttrition  It can be defined as surface tooth structure lossIt can be defined as surface tooth structure loss resulting from direct frictional forces betweenresulting from direct frictional forces between contacting teethcontacting teeth  Continuous ,age dependent process usuallyContinuous ,age dependent process usually physiologicphysiologic  Affects occluding surfaces and results in flattening ofAffects occluding surfaces and results in flattening of their inclined planes and in facet formationtheir inclined planes and in facet formation  ‘‘Reverse cusp’ is seen in severe casesReverse cusp’ is seen in severe cases  Accelerated by parafunctionaL mandibular movementAccelerated by parafunctionaL mandibular movement noticebly brusixmnoticebly brusixm
  • 4. Can precipitate any of following:Can precipitate any of following: A.A. Physiologic surface attrition (proximal surfacePhysiologic surface attrition (proximal surface faceting)faceting) • Results from surface tooth structure loss andResults from surface tooth structure loss and flattening wideni ng of the proximal contact areas.flattening wideni ng of the proximal contact areas. • Therefore area proximally is increased in dimensionTherefore area proximally is increased in dimension and is susceptible to decay.and is susceptible to decay.
  • 5. Mesiodistal dimension of teeth are decreasedMesiodistal dimension of teeth are decreased ↓↓ Overall reduction of arch lengthOverall reduction of arch length ↓↓ Interproximal space will be decreased in dimensionInterproximal space will be decreased in dimension ↓↓ Thereby interfering physiology of interdental papillaeThereby interfering physiology of interdental papillae ↓↓ More plaque accumulationMore plaque accumulation ↓↓ PeriodontitisPeriodontitis
  • 6. B.B. Occluding surface attritionOccluding surface attrition  Loss ,flattening, faceting and/or reverse cusping of occluding elementsLoss ,flattening, faceting and/or reverse cusping of occluding elements → loss of vertical dimension of tooth→ loss of vertical dimension of tooth  If wear is severe ,generalized and accomplished in relatively shorterIf wear is severe ,generalized and accomplished in relatively shorter time →vertical loss on face as well as loss of vertical dimensiontime →vertical loss on face as well as loss of vertical dimension  If wear is over a long period of time alveolar bone can grow occlusallyIf wear is over a long period of time alveolar bone can grow occlusally →vertical dimension loss is seen but not imparted to face.→vertical dimension loss is seen but not imparted to face.  Deficient masticatory capabilities ,blunting of cusps may compel patientDeficient masticatory capabilities ,blunting of cusps may compel patient to apply more force on teeth.to apply more force on teeth.  Cheek biting is sequelae of occlusal surface attritionCheek biting is sequelae of occlusal surface attrition  Decay at occluding area leads to more exposed dentinDecay at occluding area leads to more exposed dentin  Tooth sensitivityTooth sensitivity
  • 7. Severe generalized attrition fromSevere generalized attrition from tooth grinding with abrasion oftooth grinding with abrasion of exposed dentinexposed dentin The diestone cast shows flat enamel facet with well defined margins resulting from attrition Severe attrition
  • 8. Treatment modalitiesTreatment modalities 1.1. Extraction of pulpally involved teethExtraction of pulpally involved teeth 2.2. Parafunctional activities ,bruxism should be controlledParafunctional activities ,bruxism should be controlled 3.3. Myofunctional,TMJ,or any stomatognathic system disordersMyofunctional,TMJ,or any stomatognathic system disorders should be diagnosed and resolvedshould be diagnosed and resolved 4.4. Occlusal equilibrium should be performedOcclusal equilibrium should be performed 5.5. Protect sensitive dentinal areas and actual caries should beProtect sensitive dentinal areas and actual caries should be obliteratedobliterated 6.6. Restorative modalities should be done.Restorative modalities should be done.
  • 9. An acrylic resin maxillary occlusal splint for correction of bruxism
  • 10. AbrasionAbrasion  Defined as surface loss of tooth structure resulting fromDefined as surface loss of tooth structure resulting from direct friction forces between the teeth and external objects ordirect friction forces between the teeth and external objects or from frictional forces between contacting teeth components infrom frictional forces between contacting teeth components in the presence of an abrasive medicinethe presence of an abrasive medicine  Pathologic processPathologic process  Sometimes abrasion rate is faster than the dentin depositionSometimes abrasion rate is faster than the dentin deposition raterate →direct or indirect pulpal involvement→direct or indirect pulpal involvement
  • 11. Cervical abrasion in unopposed premolar tooth resulting from incorrect tooth brushing and dentifrices Abrasion results in a more rounded and less well defined occlusal appearance
  • 12.  Toothbrush abrasion most predominantToothbrush abrasion most predominant  Occur cervically,usually to the most facially prominent teethOccur cervically,usually to the most facially prominent teeth in the archin the arch  Its surface extent, depth and rate of formation is dictated by:Its surface extent, depth and rate of formation is dictated by: a.a. The direction of brushing strokes.The direction of brushing strokes. b.b. The size of the abrasive.The size of the abrasive. c.c. The percentage of abrasives in the dentrificeThe percentage of abrasives in the dentrifice d.d. Type of abrasiveType of abrasive e.e. Diameter of brush bristlesDiameter of brush bristles f.f. Type of bristleType of bristle g.g. Forces used in brushingForces used in brushing h.h. Type of tooth tissues being abradedType of tooth tissues being abraded
  • 13. Signs and symptoms of toothbrush abrasion:Signs and symptoms of toothbrush abrasion: 1.1. The lesion may be linear in outline, following the path ofThe lesion may be linear in outline, following the path of brush bristles.brush bristles. 2.2. The peripheries of the lesion are very angularly demarcatedThe peripheries of the lesion are very angularly demarcated from the adjacent tooth surface.from the adjacent tooth surface. 3.3. The surface of the lesion is extremely smooth and polished,The surface of the lesion is extremely smooth and polished, and it seldom has any plaque accumulation or carious activityand it seldom has any plaque accumulation or carious activity in it.in it. 4.4. The surrounding walls of abrasive lesion tend to make a v-The surrounding walls of abrasive lesion tend to make a v- shape ,by meeting at an acute angle axially.shape ,by meeting at an acute angle axially. 5.5. Probing or stimulating (hot, cold or sweets) the lesion canProbing or stimulating (hot, cold or sweets) the lesion can elicit pain.elicit pain.
  • 14.  Other oral habits which create abrasion:Other oral habits which create abrasion: a.Chewing tobaccoa.Chewing tobacco b.Toothpickb.Toothpick c.Cutting sewing thread with incisor teethc.Cutting sewing thread with incisor teeth d.Holding and pulling nails with front teethd.Holding and pulling nails with front teeth  IatrogenicIatrogenic 1.1. Dentures with porcelain teeth opposing natural teethDentures with porcelain teeth opposing natural teeth 2.2. Use of cast alloy with higher abrasive resistance than toothUse of cast alloy with higher abrasive resistance than tooth enamel in a restoration opposing natural teethenamel in a restoration opposing natural teeth
  • 15. Treatment modalitiesTreatment modalities 1.1. Diagnose the cause of the presented abrasion.Diagnose the cause of the presented abrasion. 2.2. Correct or replace the iatrogenic dental work,habitCorrect or replace the iatrogenic dental work,habit 3.3. Restorative treatment if habits are not broken.Restorative treatment if habits are not broken. 4.4. Abrasive lesions at non occluding tooth surfaces should beAbrasive lesions at non occluding tooth surfaces should be critically evaluatedcritically evaluated 5.5. If teeth are sensitive ,desensitize exposed dentin beforeIf teeth are sensitive ,desensitize exposed dentin before starting restorative treatment is startedstarting restorative treatment is started 6.6. Restorative treatmentRestorative treatment
  • 16. AbfractionAbfraction  Syn.idiopathic erosionSyn.idiopathic erosion  Cervical wedge shaped defects or abfractures caused by strongCervical wedge shaped defects or abfractures caused by strong eccentric occlusal forceseccentric occlusal forces  Caused due to excessive occlusal stresses andCaused due to excessive occlusal stresses and  Only a single tooth may b affected leaving the neighbouringOnly a single tooth may b affected leaving the neighbouring teeth uninvolvedteeth uninvolved  More number of teeth are affected in bruxists and in olderMore number of teeth are affected in bruxists and in older patientspatients  These lesions can progress around existing cervicalThese lesions can progress around existing cervical restorations and extend subgingivallyrestorations and extend subgingivally  The lingual surfaces of mandibular teeth are rarely affected.The lingual surfaces of mandibular teeth are rarely affected.
  • 17. treatment modalitestreatment modalites
  • 18. ErosionErosion  Defined as the loss of tooth structure resulting from chemico-Defined as the loss of tooth structure resulting from chemico- mechanical acts in the absence of specific microorganism.mechanical acts in the absence of specific microorganism.  Popular theories of causes and pathogenesis:Popular theories of causes and pathogenesis: 1.1. Ingested acidIngested acid 2.2. Salivary citratesSalivary citrates 3.3. Secreted acids’Secreted acids’ 4.4. Mechanical abrasionMechanical abrasion 5.5. Chelating microbial metabolic productsChelating microbial metabolic products 6.6. Acid fumesAcid fumes 7.7. Excessive tensile stresses at the tooth clinical cervixExcessive tensile stresses at the tooth clinical cervix 8.8. Refused acids’Refused acids’ 9.9. Salivary flowSalivary flow
  • 19. Progressive erosion results in occlusal scooping or cupping of the exposed softer dentin in posterior teeth and grooving in anterior teeth Extensive erosion in teeth of wine tester Teeth showing acid erosion
  • 20. Treatment modalitiesTreatment modalities 1.1. Eliminate the causesEliminate the causes 2.2. Preoperative study models or photographsPreoperative study models or photographs 3.3. Give restorative modalities in extremelyGive restorative modalities in extremely symptomatic of disfiguring lesionssymptomatic of disfiguring lesions 4.4. Metallic restoration should be the material of choiceMetallic restoration should be the material of choice if restorations are indicatedif restorations are indicated
  • 21. Localized non hereditary enamelLocalized non hereditary enamel hypoplasiahypoplasia  During enamel formation if ameloblasts are irritated ,theirDuring enamel formation if ameloblasts are irritated ,their metabolic product,i.e the enamel matrix,will not be properlymetabolic product,i.e the enamel matrix,will not be properly formed ,causing certain interruptions and defects.formed ,causing certain interruptions and defects.  When the teeth erupt ,these defect are seen in crown portionWhen the teeth erupt ,these defect are seen in crown portion of tooth and is known as localized non hereditary enamelof tooth and is known as localized non hereditary enamel hypoplasiahypoplasia  Lesion range from isolated pits to widespread linear defectsLesion range from isolated pits to widespread linear defects ,depressions ,or loss of a segment in the enamel,depressions ,or loss of a segment in the enamel  Discoloration increases with ageDiscoloration increases with age
  • 22. Factors that can injure or destroy the ameloblast includesFactors that can injure or destroy the ameloblast includes i.i. Systemic disordersSystemic disorders ii.ii. Localized disordersLocalized disorders iii.iii. fluoridesfluorides
  • 23. Treatment modalitiesTreatment modalities  If defects are of minimum size : Selective odontotomyIf defects are of minimum size : Selective odontotomy  If defect is at occluding or contacting area go forIf defect is at occluding or contacting area go for metallic or cast restorationsmetallic or cast restorations  If lesions are discolured and veneering procedures areIf lesions are discolured and veneering procedures are not planned,vital bleaching can be attemptednot planned,vital bleaching can be attempted
  • 24. Localized non hereditary enamelLocalized non hereditary enamel hypocalcificationhypocalcification  Destruction of ameloblasts can interfere with the enamelDestruction of ameloblasts can interfere with the enamel matrix formation,it can also interfere with the mineralizationmatrix formation,it can also interfere with the mineralization of this matrix ,even it is formed this leads to Localized nonof this matrix ,even it is formed this leads to Localized non hereditary enamel hypocalcificationhereditary enamel hypocalcification  Signs and symptoms same as enamel hypoplasiaSigns and symptoms same as enamel hypoplasia  Affective areas appear chalky and soft to identation and willAffective areas appear chalky and soft to identation and will be very stainablebe very stainable  Enamel can be chipped if lesion involves entire surface of aEnamel can be chipped if lesion involves entire surface of a toothtooth
  • 25. Treatment modalitiesTreatment modalities 1.1. If diagnosis is made early, Mineralization of tooth enamelIf diagnosis is made early, Mineralization of tooth enamel is done using periodic fluoride application, fluorideis done using periodic fluoride application, fluoride ionophoresis and strict prevention of plaque accumulationionophoresis and strict prevention of plaque accumulation in these areasin these areas 2.2. Vital bleaching ,laminated veneering ,composite veneeringVital bleaching ,laminated veneering ,composite veneering and porcelain fused to metal and cast ceramic crownsand porcelain fused to metal and cast ceramic crowns Vital bleaching ,using H2O2 of the maxillary anterior teeth discolored by chromogenic bacteria staining and fluorosis mottling
  • 26. Localized non-hereditaryLocalized non-hereditary dentin hypocalcificationdentin hypocalcification  Same causes as hypoplasiaSame causes as hypoplasia  Dentin will be present in substance ,it will be softer,Dentin will be present in substance ,it will be softer, more penetrable and less resilent.eg:interglobularmore penetrable and less resilent.eg:interglobular dentindentin Treatment: intermediary basingTreatment: intermediary basing
  • 27. DiscolorationDiscoloration  Classified from etiologic aspect asClassified from etiologic aspect as 1.1. Extrinsic : due to surface staining , calculus or anyExtrinsic : due to surface staining , calculus or any other surface depositsother surface deposits 2.2. Intrinsic : created from changes in one or more ofIntrinsic : created from changes in one or more of the tooth tissuesthe tooth tissues  Discoloring changes in enamel include hypoplasiaDiscoloring changes in enamel include hypoplasia and hypocalcificationand hypocalcification
  • 28.  Discoloring changes in dentin may result from non –Discoloring changes in dentin may result from non – vitality resulting in disintegration of the dentinalvitality resulting in disintegration of the dentinal tubules contents or from pigmentation and stainingtubules contents or from pigmentation and staining which is due to external sources e.g. corrosion productswhich is due to external sources e.g. corrosion products of metallic restorations,medications,microbialof metallic restorations,medications,microbial metabolites,etcmetabolites,etc  Tetracycline colorationTetracycline coloration  Discoloring changes in the pulp root canal system canDiscoloring changes in the pulp root canal system can result from pulpal necrosisresult from pulpal necrosis
  • 29. Treatment modalitiesTreatment modalities  By scaling and polishing with abrasivesBy scaling and polishing with abrasives  Intrinsic discoloration in enamel and dentin can beIntrinsic discoloration in enamel and dentin can be treated by Vital bleaching ,laminated veneeringtreated by Vital bleaching ,laminated veneering ,composite veneering and porcelain fused to metal,composite veneering and porcelain fused to metal and cast ceramic crowns as in localized nonand cast ceramic crowns as in localized non hereditary enamel hypoplasia and hypocalcification.hereditary enamel hypoplasia and hypocalcification.
  • 30.  In intrinsic discoloration due to discoloring changes inIn intrinsic discoloration due to discoloring changes in pulp-root canal system first endodontic therapypulp-root canal system first endodontic therapy should be instituted and then proceed with followingshould be instituted and then proceed with following treatment sequencetreatment sequence a.a. non-vital bleachingnon-vital bleaching b.b. If no pleasant result are there it may be necessary toIf no pleasant result are there it may be necessary to to resort laminated veneer or porcelain fused to metalto resort laminated veneer or porcelain fused to metal or cast ceramic veneering restorationsor cast ceramic veneering restorations
  • 31. MalformationMalformation  Can be either in micro- or macroforms and usually ofCan be either in micro- or macroforms and usually of hereditary origin.hereditary origin.  One or two teeth (usually upper lateral) that areOne or two teeth (usually upper lateral) that are noticebly smaller in size than surrounding ones ,withnoticebly smaller in size than surrounding ones ,with pointed incisal edges(peg teeth)- most commonpointed incisal edges(peg teeth)- most common malformationmalformation
  • 32. Treatment modalitiesTreatment modalities 1.1. If the affected tooth is properly aligned in the arch and hasIf the affected tooth is properly aligned in the arch and has intact enamel and is not subjected to extensive occludingintact enamel and is not subjected to extensive occluding forces,then conditioning of the enamel & building the toothforces,then conditioning of the enamel & building the tooth up with a direct tooth-colored resinous material is done.up with a direct tooth-colored resinous material is done. 2.2. If the affected tooth is malaligned ,repositioning should beIf the affected tooth is malaligned ,repositioning should be performed before restorationperformed before restoration 3.3. If excessive occluding forces are present select porcelainIf excessive occluding forces are present select porcelain fused to metal or cast ceramic veneering restorations.fused to metal or cast ceramic veneering restorations.
  • 33. Amelogenesis imperfectaAmelogenesis imperfecta  Results from genetically determined abnormalities in theResults from genetically determined abnormalities in the formative stage of enamel unassociated with evidence offormative stage of enamel unassociated with evidence of biochemical or systemic diseases.biochemical or systemic diseases.  Can be autosomal dominantCan be autosomal dominant traits(hypocalcification,hereditary generalized and localizedtraits(hypocalcification,hereditary generalized and localized hypoplasia) or they can be X-linked trait (hypomaturation) orhypoplasia) or they can be X-linked trait (hypomaturation) or a recessive trait (pigmented hypomaturation)a recessive trait (pigmented hypomaturation)  The abnormality could be in the matrix formation leading toThe abnormality could be in the matrix formation leading to hypoplasia or it could be in the mineralization leading tohypoplasia or it could be in the mineralization leading to hypomineralization.hypomineralization.  Affects one type of dentition,and only enamelAffects one type of dentition,and only enamel
  • 34. Classes of hypoplasia show following featuresClasses of hypoplasia show following features 1.1. Thin enamelThin enamel 2.2. Open contactOpen contact 3.3. Small teeth ,with short roots ,very limited pulp chambers and root canal dimensionsSmall teeth ,with short roots ,very limited pulp chambers and root canal dimensions 4.4. Delay in eruptionDelay in eruption 5.5. Sometimes the enamel is glassy(prismless)Sometimes the enamel is glassy(prismless) 6.6. There may be some discoloration ,usually yellowThere may be some discoloration ,usually yellow 7.7. The enamel could look wrinkledThe enamel could look wrinkled 8.8. All signs of severe occlusal wearAll signs of severe occlusal wear
  • 35. Class of hypomineralization imperfectas shows:Class of hypomineralization imperfectas shows: 1.1. Enamel is usually stained (yellow or black).it may be chalky at early stages of life.Enamel is usually stained (yellow or black).it may be chalky at early stages of life. 2.2. The enamel chips easilyThe enamel chips easily 3.3. enamel can be very soft in consistency (cheesy)enamel can be very soft in consistency (cheesy) 4.4. Teeth are normally erupted but have dull surfaces readily stainable by ageTeeth are normally erupted but have dull surfaces readily stainable by age 5.5. Enamel is worn away very easily in life with all signs and symptoms of severeEnamel is worn away very easily in life with all signs and symptoms of severe attrition .attrition .
  • 36. Treatment modalitiesTreatment modalities  Selective odontotomySelective odontotomy  Full veneering includes procedures with metallic ,Full veneering includes procedures with metallic , metallic based or cast ceramic restorations.metallic based or cast ceramic restorations.
  • 37. Dentinogenesis imperfectaDentinogenesis imperfecta  Genetically dictated classes of diseases affecting theGenetically dictated classes of diseases affecting the formation and/or maturation of the dentin matrix information and/or maturation of the dentin matrix in the absence of any obvious systemic or biochemicalthe absence of any obvious systemic or biochemical changes.changes.  Clinical featuresClinical features 1.1. Color may be from grey,brown ,yellow brown to violetColor may be from grey,brown ,yellow brown to violet 2.2. Most of them exhibit a translucent hue.Most of them exhibit a translucent hue. 3.3. The enamel ,although intact ,is easily chipped becauseThe enamel ,although intact ,is easily chipped because of defective dentino -enamel junctionof defective dentino -enamel junction
  • 38. 4.4. The crowns are overcontoured.The crowns are overcontoured. 5.5. The roots are short and slenderThe roots are short and slender 6.6. There are signs and symptoms of extensive attritionThere are signs and symptoms of extensive attrition 7.7. The dentin is devoid of tubulesThe dentin is devoid of tubules 8.8. The dentin contains a lot of interglobular dentin.The dentin contains a lot of interglobular dentin. 9.9. The decay process ,if initiated ,will spread laterally.The decay process ,if initiated ,will spread laterally. 10.10. Root canal and pulp chamber space is obliterated.Root canal and pulp chamber space is obliterated. 11.11. Dentin hardness and resilience is almost half that ofDentin hardness and resilience is almost half that of normal dentinnormal dentin
  • 39. Treatment modalitiesTreatment modalities 1.1. Selective odontotomySelective odontotomy 2.2. Permanent full veneeringPermanent full veneering
  • 40. TraumaTrauma  Separation and/or loss of tooth structure as a result of traumaSeparation and/or loss of tooth structure as a result of trauma frequently occurs necessitating dental treatmentfrequently occurs necessitating dental treatment  According to Ellis classification ,injury to natural teeth can beAccording to Ellis classification ,injury to natural teeth can be classified into:classified into: Class IClass I : simple fracture of tooth crown involving little or no dentin: simple fracture of tooth crown involving little or no dentin  TreatmentTreatment Smoothing of edges and peripheriesSmoothing of edges and peripheries esthetic reshapingesthetic reshaping If relatively large surface areas are involved ,in anterior GIC restorationIf relatively large surface areas are involved ,in anterior GIC restoration and in posterior metallic restorationand in posterior metallic restoration
  • 41. Class II :Class II :Extensive fracture of tooth crown involving considerable dentin but no pulp.Extensive fracture of tooth crown involving considerable dentin but no pulp.  TreatmentTreatment  In anterior, provisional restoration can be Class IV and in posterior amalgamIn anterior, provisional restoration can be Class IV and in posterior amalgam restorationrestoration Class III : extensive fracture of crown , involving considerable dentin and exposing theClass III : extensive fracture of crown , involving considerable dentin and exposing the pulppulp  TreatmentTreatment  Pulp and root canal treatmentPulp and root canal treatment
  • 42. Class IV :Class IV : A traumatized tooth which becomes non vital with/without lossA traumatized tooth which becomes non vital with/without loss of crown structureof crown structure  TreatmentTreatment  If tooth crown is intact - Endodontic therapyIf tooth crown is intact - Endodontic therapy a.a. If tooth crown is fracture-pulp or root canal therapyIf tooth crown is fracture-pulp or root canal therapy b.b. If tooth crown is discolored – non vital bleaching orIf tooth crown is discolored – non vital bleaching or laminated veneeringlaminated veneering c.c. If toth is discolored beyond any bleaching then should beIf toth is discolored beyond any bleaching then should be veneered with cast alloy based or cast ceramic restorationveneered with cast alloy based or cast ceramic restoration
  • 43. Class V :Class V : Tooth lost as a result of traumaTooth lost as a result of trauma  TreatmentTreatment  Accidental tooth loss or fracture beyond any restorative capabilityAccidental tooth loss or fracture beyond any restorative capability should be replaced with a prosthesis likeshould be replaced with a prosthesis like o Provisional fixed bridgeProvisional fixed bridge o PonticPontic o Electrochemically etched ,non noble alloy based bridgeElectrochemically etched ,non noble alloy based bridge
  • 44. Class VI :Class VI : Fracture of tooth root with or without loss of tooth structureFracture of tooth root with or without loss of tooth structure Root fracture can beRoot fracture can be a.a. Cervically horizontal :Cervically horizontal : Treatment –endodontic therapyTreatment –endodontic therapy b.b. midradicularally horizontal :midradicularally horizontal : Treatment –endodontic treatment and/or splintingTreatment –endodontic treatment and/or splinting c.c. Apically horizontal:Apically horizontal: Treatment-Treatment- vital tooth –should be left without interferencevital tooth –should be left without interference non vital tooth-endodontic therapy and splint, when surgery is not feasiblenon vital tooth-endodontic therapy and splint, when surgery is not feasible d.d. Vertical root fractureVertical root fracture Treatment-unfavorable prognosisTreatment-unfavorable prognosis Single rooted teeh-extractionSingle rooted teeh-extraction Multirooted teeth -hemisectioningMultirooted teeth -hemisectioning
  • 45. Class VII :Class VII : Displacement (dislocation) of tooth(teeth) without fracture of crown or rootDisplacement (dislocation) of tooth(teeth) without fracture of crown or root  TreatmentTreatment After proper reduction of tooth and/or replacing in its socket should be splintedAfter proper reduction of tooth and/or replacing in its socket should be splinted Class VIII : fracture of crown en masse with broken crown piecesClass VIII : fracture of crown en masse with broken crown pieces TreatmentTreatment Endodontic treatment pulpchamber shold be filled with resin and two pieces should beEndodontic treatment pulpchamber shold be filled with resin and two pieces should be brought together and kept under pressure until primer and composite resin setsbrought together and kept under pressure until primer and composite resin sets
  • 46. Amelogenesis imperfecta
  • 47. Class IX :Class IX : Incomplete fracture of tooth cracked toothIncomplete fracture of tooth cracked tooth Treatment:Treatment: Relieve tooth from eccentric occluding contacts.Relieve tooth from eccentric occluding contacts. Orthodontic bandOrthodontic band If any sign of pulpitis-endodontic therapyIf any sign of pulpitis-endodontic therapy
  • 48. ConclusionConclusion  Firstly, endodontic therapies should be considered to treat theFirstly, endodontic therapies should be considered to treat the deformities likedeformities like Attrition-Composite resinAttrition-Composite resin Abrasion-glass ionomer cementAbrasion-glass ionomer cement Erosion –metallic restorationsErosion –metallic restorations Abfraction-composite resinsAbfraction-composite resins Enamel hypoplasia and calcifications-vital bleaching,selectiveEnamel hypoplasia and calcifications-vital bleaching,selective odontomy,flouride applicationodontomy,flouride application Dentin hypoplasia and calcificatons-intermediary basingDentin hypoplasia and calcificatons-intermediary basing Amelogenesis and dentinogenesis imperfecta-Odontomy and fullAmelogenesis and dentinogenesis imperfecta-Odontomy and full veneerveneer Discolouration –abrasivesDiscolouration –abrasives Trauma-splintingTrauma-splinting