Pulp necrosis

Pulp necrosis (Latin necrosis pulpae) is a condition of irreversible death of the tooth’s soft tissues, accompanied by cessation of blood flow and nerve activity. Pulp necrosis can develop due to infections or the influence of thermal, chemical, or mechanical factors.

Etiology and Pathophysiology

In necrosis, the pulp tissue breaks down under the influence of bacterial enzymes. In the closed cavity of the tooth, this process leads to the accumulation of toxic decay products. Since protective blood cells no longer enter the cavity, bacteria multiply unhindered within the tooth, turning it into a permanent source of infection for the entire body.

Clinical significance

A tooth with necrotized pulp often does not cause pain when subjected to temperature stimuli, which can create a false sense of recovery. However, infection from the nonviable pulp inevitably spreads to the periapical tissues, causing their inflammation. Often a sign of necrosis is the discoloration of the tooth’s crown, which becomes grayish or dull.