Pulpal pathology in relation to discoloration of primary anterior teeth

Discoloration is the most common sequela to trauma in the primary dentition (Hargreaves, et al, 1981). The significance of this phenomenon has not been properly investigated. The purpose of this study is to investigate histologically pulpal changes in discolored primary anterior teeth following trauma. Twenty-three healthy children ranging in age from one year, eleven months to six years, seven months were included. The sample included teeth with no evidence of abscess formation clinically or radiographically, no history of pain, and no mobility. All teeth had a minimum of three-quarter root length. Shade matching was determined by the same operator, utilizing a Vita Lumin shade guide. Each tooth was anesthetized, isolated, disinfected, then opened. Pulp tissues were extirpated and placed in formalin. Histologic evaluation was performed maintaining a double-blind system of identification. Three major problem areas were evaluated: necrosis, acute inflammation, and chronic inflammation. Each was graded on a four-point scale. Total pulpal necrosis occurred in eleven of the twenty-three specimens. Seven specimens showed complete autolysis. Eight specimens showed dystrophic calcification with associated partial necrosis and inflammation. No healthy specimens were found. There was no apparent correlation between the shade of discoloration and the histologic status of the pulps examined. All discolored teeth showed significant histopathological changes.