Chronic Perforating Hyperplasia of the Pulp
The above 2 are also the names assigned to the clinical condition called Internal Resorption or Pink Tooth of Mummery.
Intrinsic staining – Pink Tooth of Mummery Characterized by Internal Resorption and increase in blood flow due to inflammatory response .
How does it happen ?
* It is an unusual form of tooth resorption that begins centrally within the tooth in many cases by the inflammatory hyperplasia of the pulp.
* Most obvious reason seems to be carious exposure and accompanying pulp infection.
* It has also been proposed that it is the result of resorption of the tooth and invasion of the pulp by granulation tissue arising in the periodontium.
* The cause of this condition is not clearly known, except of few patients complaining about trauma to the teeth. Also, persistant chronic pulpitis may sometimes cause the internal resorption. This is another asymptomatic condition, and a type of Chronic irreversible pulpitis (other types include Pulp Polyp).
1. In most cases resorption presents no early clinical symptom.
2. First appearance of pink colored hue on the crown that represents the hyper plastic vascular tissue filling the resorbed area and showing through the remaining overlying tooth structure.
3. Multiple tooth cases have been recorded without any predilection to any particular tooth.
4. The crown of the tooth clearly shows a reddish spot, called as Pink Spot which represents the granulation tissue, showing the resorbed area of the tooth. The resorption can be confined to just the crown or the root, or sometimes both. The duration can also vary, with slow progression for 1-2 years or rapid progression within a few months. There is pain seen if there is severe resorption, leading to perforation of the crown.
Radiolucent enlargement of pulp canal
Original root canal outline is distorted
Changes in the bone not usually seen, but visible only when the root perforation occurs.
Variable degree of resorption of the inner surface of the dentin
Accumulation of Odontoclasts
A state of chronic inflammation
In few samples there are also the zones of alternating resorption and repair
In case the resorption spreads in to the root portion then the dentin and cementum undergo resorption .
Treatment & Prognosis
If the condition is discovered before the perforation of the crown or root RCT can be carried out.
Once the perforation has occurred the tooth must usually be extracted .
Heres a article research piece describing about internal resorption in the root portion.
Internal Root Resorption- A Review