Necrosis Pulp and Periapical Disease

Pulp necrosis refers to when the pulp is dead, that is the result of an irreversible pulpitis that was untreated or is the result of trauma which caused the interruption of blood supply to the pulp.

The necrosis may be partial or complete, total necrosis is asymptomatic before affecting the periodontal ligament, this is because the nerve tissue is no longer working properly.

The pulp necrosis is accompanied by color change in the anterior teeth, but this should not be given for a definitive diagnosis but a warning.

Bacterial toxins and sometimes the same bacteria that caused pulp necrosis, follow the path of the slurry to the apical foramen, to the periodontal ligament that triggers an inflammatory reaction, this inflammation will cause the widening of tissue and It will manifest as sensitivity to percussion and chewing, if these irritants continue, it may cause periapical disease which symptoms may be absent, with the presence of a fistula or having severe pain.

In an X-ray the ligament can be seen within normal limits but slightly enlarged or show a dark spot at the end of the root.