Tooth wear and fractures
Teeth that make contact with other teeth become worn by the constant contact and this is defined as attrition. The pulp chamber may become exposed, in which case root canal therapy will be required. Teeth with “near exposure” will require placement of a restoration and odontoplasty of the tooth causing attrition and that tooth or teeth may also require placement of a restoration.
Abrasion of the teeth occurs when the teeth wear due to play with balls, sticks, stones and other abrasive items. If the teeth wear slowly, the body reacts to the stimulus by laying down additional secondary or reparative dentine (also called tertiary dentine) in the pulp chamber to protect the pulp. Where the teeth are worn faster than tertiary dentine can be laid down, the pulp chamber will become exposed, exposing the pulp and leading to inflammation. In rare situations, the pulp will form a granuloma to protect itself but these teeth often have bone loss around the root tip, when radiographed. Root canal therapy is the treatment of choice when the pulp has become exposed. The only other option is extraction of the tooth.
Uncomplicated crown fractures are defined as fractures of the crown that affect the enamel and dentine only.
Complicated crown fractures are defined as fractures that affect the enamel and dentine and expose the pulp chamber.
Uncomplicated crown-root fractures are define as fractures that involve the enamel and dentine and extend below the gum margin.
Complicated crown root fractures are defined as those fractures that involve the enamel and dentine, expose the pulp canal and extend below the gingival margin.