AGE CHANGES IN ENAMEL

ENAMEL IS PROGRESSIVELY WORN AWAY WITH AGE, REFERRED TO TOOTH TO TOOTH CONTACT DURING OCCLUSION AND MASTICATION WITH ADVANCED AGE, IT HAS BEEN SUGGESTED THAT ENAMEL LOSES ITS PHYSICAL PROPERTIES. Eg. COLOUR, PERMEABILITY & LIGHT TRANSMISSION. LOSS OF PERMEABILITY OCCURS DUE TO BLOCKAGE OF ORGANIC CHANNELS BY FORMULATION OF ORGANIC BIOFILM ON TOOTH SURFACE. ENAMEL BECOMES MORE BRITTLE WITH AGE. DECREASE IN AMOUNT OF WATER CONTENT IN ENAMEL TISSUE. PROGRESSIVE INCREASE IN FLUORIDE CONTENT OF SURFACE ENAMEL DUE TO IONIC EXCHANGES WITH ORAL FLUID, WHICH CAUSES CONVERSION OF HYDROXYAPATITE CRYSTALS INTO FLUROAPATITE CRYSTALS. PROGRESSIVE DECREASE IN INCEDENCE OF CARIES.

AGE CHANGES IN DENTIN

GRADUAL ENLARGEMENT OF PERITUBULAR DENTIN AND FORMATION OF SECONDARY DENTIN. CONTINOUS FORMATION OF SECONDARY DENTIN CAUSING REDUCTION IN SIZE AND EVEN OBLITERATION OF PULP CHAMBER. ODONTOBLAST DECREASE IN SIZE AS TOOTH AGES.

JATIN PATEL, JIGAR PATEL, KALPESH PATEL<2006-07>

 DENTINAL TUBULES FORMED DURING SECONDARY DENTINOGENESIS SHOW REDUCED NO. OF DENTINAL TUBULES WITH IRREGULAR COURSE.

PREDENTIN WIDTH INCREASES WITH AGE. ROOTS OF TEETH BECOME MORE BRITTLE DUE TO DENTINAL SCLEROSIS. ROOT TRANSCLUCENCY STARTS AT THE APEX AND EXTENDS CORONALLY WITH AGE, THEREFORE THIS PHENOMENON CAN BE USED AS A GUIDELINE IN FORENSIC ODONTOLOGY AS METHOD OF AGE DETERMINATION OF PERSON.

DENTINAL SCLEROSIS

(TRANSPARENT DENTIN)

IT IS CONDITION CHARACTERIZED BY CALCIFICATION OF DENTINAL TUBULES OF THE TOOTH. FACTORS CAUSING IT: INJURY TO DENTIN BY CARIES AGEING PROCESS ABRASION OR EROSION OF TOOTH IN GROUND SECTIONS, WITH SHALLOW CARIOUS LESION OF TEETH DENTIN IS EXAMINED BY TRANSMITTED LIGHT, A TRANSLUSCENT ZONE CAN BE SEEN IN DENTIN UNDERLYING CAVITY. EXACT MECHANISM FOR DEPOSITION OF CALCIUM SALTS IN TUBULES IS THOUGHT TO BE SEEN IN UNDERLYING CAVITY. EXACT MECHANISM FOR DEPOSITION OF CALCIUM SALTS IN TUBULES IS THOUGHT TO BE BY SOURCE OF CALCIUM SALTS IN FLUID OR DENTAL LYMPH WITHIN THE TUBULES. INCREASED MINERALIZATION OF TOOTH DECREASES CONDUCTIVITY OF THE ODONTOBLASTIC PROCESSES. SCLEROTIC DENTIN UNDER CARIOUS LESION WAS SHOWN TO BE ACTUALLY HARDER THAN ADJACENT NORMAL DENTIN.

JATIN PATEL, JIGAR PATEL, KALPESH PATEL<2006-07>

DEAD TRACTS
DEAD TRACTS IN DENTIN ARE SEEN IN GROUND SECTIONS OF TEETH AND MANIFESTED AS BLACK ZONE BY TRANSMITTED LIGHT BUT AS WHITE ZONE BY REFLECTED LIGHT. OPTICAL PHENOMENON IS DUE TO DIFFERENCES IN REFRACTIVE INDICES OF AFFECTED TUBULES AND NORMAL DENTIN.

NATURE OF CHANGE IN AFFECTED TUBULES IS NOT KNOWN, ALTHOUGH THESE TUBULES ARE NOT CALCIFIED AND ARE PERMEABLE TO PENETRATION OF DYES.

AGE CHANGES IN CEMENTUM

CEMENTUM CONTINUES TO FORM IN APICAL THIRD OF ROOT THROUGHOUT LIFE. INCREASE IN THICKNESS OF CEMENTUM AT ROOT END HELPS TO COMPENSATE FOR OCCLUSAL AND INTERPROXIMAL ATTRITION OF TOOTH. AMOUNT OF SECONDARY CEMENTUM APPOSITION INCREASES WITH AGE AND CAN BE AN IMPORTANT FACTOR IN AGE DETERMINATION IN FORENSIC DENTISTRY. BESIDES CEMENTAL APPOSITION, THERE MAY BE AREAS OF CEMENTAL RESORPTIONS WITH INCREASING AGE.

HYPERCEMENTOSIS

JATIN PATEL, JIGAR PATEL, KALPESH PATEL<2006-07>

 IT IS AN ABNORMAL THICKENING OF THE CEMENTUM. HYPERCEMENTOSIS IS OF UNKNOWN EITOLOGY, MAY OCCUR IN GENERALIZED FORM, INVOLVING ALL TEETH, OR IN LOCALISED FORM INVOVING ONE TOOTH. EITOLOGY: ACCERATED ELONGATION OF TOOTH. INFLAMMATION ABOUT A TOOTH TOOTH REPAIR PAGETS DISEASE OF BONE. CLINICAL FEATURES: NO SIGNIFICANT CLINICAL FEATURES WHEN TOOTH WITH HYPERCEMENTOSIS IS EXTRACTED, ROOT APPEAR LARGER IN DIAMETER THAN NORMAL AND PRESENT ROUNDED APICES ROENTGENOGRAPHICALLY: ON PERIAPICAL , THICKENING AND BLUNTING OF ROOTS SEEN. THE ROOTS LOSE THEIR TYPICAL SHARPENED OR SPIKED APPEARANCE AND EXHIBIT ROUNDING OF APEX. TREATMENT:NO TREATMENT IS INDICATED SINCE CONDITION IS INNOCUOUS.

AGE CHANGES IN PULP

FOLLOWING CHANGES OCCUR IN PULP TISSUE WITH AGE: DECREASED CELLULARITY INCREASED FIBROSIS DUE TO CONTINUED FORMATION OF COLLAGEN FIBRES. NO. OF BLOOD VESSELS ENTERING PULP THROUGH APICAL FORAMEN ARE CONSIDERABLY DECREASED. THIS LEADS TO DECREASED RESPONSE OF PULP TO ANY TRAUMATIC INSULT. DECREASE IN PULP CELL DENSITY HAS BEEN REPORTED TO REDUCE PULP REPAIR ACTIVITY Eg. AFTER RESTORATIVE TREATMENT. SOME STUDIES SHOWED LOSS AND DEGENERATION OF BOTH MYELINATED AND NON-MYELINATED NERVES.

JATIN PATEL, JIGAR PATEL, KALPESH PATEL<2006-07>

 THERE IS OVERALL REDUCTION IN SENSITIVITY TO PULPAL STIMULATION IN AGED PULPS. PULP VOLUME GRADUALLY DECREASE WITH CONTINUED PRODUCTION OF SECONDARY DENTIN INCIDENCE OF PULP CALCIFICATION WILL BE HIGHER WITH AGE.

PULP CALCIFICATION
DEPOSITION OF CALCIFIED MASSES WITHIN THE DENTAL PULP FOR NO APPARENT REASON IS CALLED AS PULP CALCIFICATION. EITILOGY:EITIOLOGY IS UNKNOWN AND IT APPEARS TO BE RELATED TO INFLAMMATION, TRAUMA OR ANY SYSTEMIC DISEASE. TWO CHIEF MORPHOLOGICAL PULP CALCIFICATION: PULP STONES o TRUE DENTICLES o FALSE DENTICLES DIFFUSE CALCIFICATIONS

TRUE DENTICLES
IT IS MADE UP OF LOCALISED MASS O FCALCIFIED TISSUE THAT RESEMBLE DENTIN BECAUSE OF THEIR TUBULAR STRUCTURE. CONSIDERABLY MORE COMMON IN PULP CHAMBER THAN IN ROOT CANAL. A THEORY SAYS TRUE DENTICLE IS CAUSED BY INCLUSION OF REMNANTS OF EPITHELIAL ROOT SHEATH WITHIN THE PULP. THESE NODULES BEAR GREATER RESEMBLANCE TO SECONDARY DENTIN THAN TO PRIMARY DENTIN.

FALSE DENTICLES
THEY ARE COMPOSED OF LOCALISED MASSES OF CALCIFIED MATERIAL, AND UNLIKE TRUE DENTICLES DO NOT EXHIBIT JATIN PATEL, JIGAR PATEL, KALPESH PATEL<2006-07>

DENTINAL TUBULES BUT APPEAR TO MADE UP OF CONCENTRIC LAYERS OR LAMELLA DEPOSITED AROUND A CENTRAL NIDUS. IN CENTRE OF THESE NECROTIC LAYERS OF CALCIFIED TISSUES MAY BE REMNANTS OF NECROTIC AND CALCIFIED TISSUES.

CALCIFICATIONS OF THROMBI IN BLOOD VESSELS, CALLED PHLEBOLITHS, ALSO SERVE AS NIDI FOR FALSE CALCIFICATION. ALL DENTICLES BEGIN AS SMALL NODULES BUT INCREASE IN SIZE BY INCREMENTAL GROWTH ON THEIR SURFACE. PULP STONES FREE ATTACHED OR EMBEDDED DEPENDING ON THEIR RELATION TO THE DENTIN OF TOOTH. FREE DENTICLES ARE ENTIRELY SURROUNDED BY PULP TISSUE, ATTACHED DENTICLES ARE PARTLY FUSED WITH DENTIN AND EMBEDDED DENTICLES ARE ENTIRELY SURROUNDED BY DENTIN. ALL ABOVE ARE FORMED FREE IN PULP AND LATER TO BECOME ATTACHED OR EMBEDDED AS DENTIN FORMATION PROGRESSES.

DIFFUSE CALCIFICATION
IT IS AN AMORPHOUS, UNORGANISED LINEAR STRANDS OR COLUMNS PARALLELING BLOOD VESSEL AND NERVES OF PULP. FOUND IN ROOT CANAL AND LESS IN CORONAL AREA, WHEREAS DENTICLES MORE FREQUENTLY IN CORONAL PULP. ALSO CLASSIFIED AS DYSTROPHIC CALCIFICATION.

CLINICAL FEATURES: ON OCCASIONS PULP STONES ARE CAUSE OF PAIN VARYING FROM MILD NEURALGIA TO SEVERE PAIN. THE CONSENSUS IS THAT THOUGH DENTICLES MAY SEEN TO IMPINGE ON NERVES OF PULP, THEY PROBABLY DO NOT.

JATIN PATEL, JIGAR PATEL, KALPESH PATEL<2006-07>

 DIFFICULTY MAY BE ENCOUNTERED IN EXTIRPATING THE PULP DURING ROOT CANAL THERAPY IF CALCIFICATIONS ARE PRESENT.

CEMENTICLES
THESE ARE SMALL FOCI OF CALCIFIED TISSUE, NOT NECESSARILY TRUE CEMENTUM WHICH LIE FREE IN PERIODONTAL LIGAMENT OF LATERAL AND APICAL ROOT AREAS. IT DEVELOPS BY CALCIFICATIONS OF EPITHELIAL RESTS, IN PERIODONTAL LIGAMENT AS A RESULT OF DEGENERATIVE CHANGE. ALTHOUGH ALL CEMENTICLES ARE COMPOSED OF CALCIFIED MATERIAL , ARE TOO SMALL TO BE SEEN ON IOPA. AS CEMENTUM THICKENS WITH ADVANCING AGE, IT MAY ENVELOPE THESE CEMENTICLES, WHEN THEY ARE ADHERENT TO CEMENTUM THEY FORM EXCEMENTOSIS. CEMENTICLES ARE OF NO CLINICAL SIGNIFICANCE AND AS FAR ARE NOT DETRIMENTAL TO TOOTH FUNCTION

JATIN PATEL, JIGAR PATEL, KALPESH PATEL<2006-07>