Pulp necrosis

Necrosis of the pulp (Latin: necrosis pulpae) is a state of irreversible death of the soft tissues of the tooth, accompanied by cessation of blood flow and nerve activity. Pulp necrosis can occur due to infection, thermal, chemical or mechanical factors.

Etiology and pathophysiology

In necrosis, the pulp tissue is broken down by bacterial enzymes. In the confined cavity of the tooth, this process leads to the accumulation of toxic decay products. Since the protective blood cells no longer enter the cavity, the bacteria are free to multiply inside the tooth, making it a constant source of infection for the entire body.

Clinical significance

A tooth with necrotic pulp often does not cause pain with thermal stimuli, which can create a false sense of recovery. However, infection from the non-viable pulp inevitably escapes into the periapical tissues, causing them to become inflamed. A frequent sign of necrosis is a discoloration of the tooth crown, which becomes grayish or dull.