Widespread prevalence of Equine Odontoclastic Tooth Resorption and Hypercementosis detected in German Icelandic horse population: impact of anamnestic factors on etiology.

OBJECTIVE: To compare anamnestic factors in Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH) in affected and nonaffected horses to detect risk factors for horses developing EOTRH. ANIMALS: A total of 154 Icelandic horses, aged 15 years and older, examined at 22 locations in Lower Saxony, Germany. The investigations took place from October 2020 to December 2021. METHODS: Anamnestic data were collected using an owner-completed questionnaire. Horses underwent a thorough physical examination and CBC. The rostral oral cavity was clinically examined, and intraoral radiographs of the incisors were taken. Clinical and radiographic findings were scored. Based on the results, the study population was separated into "EOTRH-affected" and "EOTRH-healthy" horses. Both groups were compared to identify differences within the anamnestic factors. In case of inconclusive findings, some horses were classified as "suspicious". RESULTS: The diagnosis of EOTRH was made in 72.2% (109/151) of horses. The risk of contracting the disease increased with the age of the horse (P = .004). In addition, there was a predisposition for male animals (P = .032). Feeding, keeping, and dental treatments showed no significant influence, while place of birth seemed to influence horses developing EOTRH (P = .017). CLINICAL RELEVANCE: The results highlight how widespread EOTRH is among the German Icelandic horse population and the need for raising awareness of EOTRH, as many horses were not suspected of having EOTRH beforehand. Moreover, numerous etiological propositions exist, but, to date, no studies have investigated their relevance.

Dental Pain in Cats: A Prospective 6-Month Study.

Dental pathology is among the most ubiquitous diseases in cats of all ages. Dental pain is yet to be fully understood in cats and therefore its presence is often missed. To better understand feline dental disease as a pain trigger during routine examination and whether disease severity correlates to the degree of pain, a 6-month prospective study in a cats' only veterinary hospital in Portugal was conducted. Sixty-four cats that randomly presented for different clinical procedures were evaluated. Dental and periodontal abnormalities (primary dental parameters, PDP), as well as clinical signs related to dental pain (secondary dental parameters, SDP), were assessed. All cats underwent an oral cavity examination, upon which, the Feline Acute Pain Scale from Colorado State University Veterinary Teaching Hospital (CPS), was used in order to assess pain. Six PDP (periodontal disease, gingival index, calculus index, tooth resorption, tooth fracture and missing teeth) and five SDP (mouth discomfort, halitosis, hypersalivation, difficulty in holding food and several attempts at prehension of food), were compared with CPS pain scores. All SDP were significantly associated to higher CPS pain scores (p < 0.05). The number of missing teeth was significantly associated to higher CPS pain scores (p < 0.0001). A trend was observed between higher CPS pain scores and tooth resorption (p = 0.08). This study concluded that cats with dental disease feel pain during clinical examination and the pain increases as the severity of the disease progresses.

Internal Resorption of Multiple Posterior Teeth in a Patient Diagnosed with Hyperparathyroidism: A Case Report.

This case reports a 46-year-old man with end-stage renal disease and internal resorption (IR) affecting multiple posterior teeth. IR involves odontoclast's removal of dentin within pulp chambers and root canal space. Typically, asymptomatic until detected on radiographs, IR is relatively rare, so the etiology and pathogenesis are poorly understood. Patients' radiographs with cone-beam computed tomography revealed extensive IR in multiple premolars and all remaining molar teeth. Blood tests and hormonal assay measured elevated phosphorus and parathyroid hormone levels consistent with secondary hyperparathyroidism. Histopathology showed highly vascularized and inflamed pulp tissues with numerous odontoclast-like multinucleated giant cells along dentinal walls and in resorption lacunae. Immunohistochemistry showed that multinucleated giant cells and adjacent mononuclear precursors stained strongly for tartrate-resistant acid phosphatase like osteoclasts. Extraction of crown-root fractures and endodontic treatment with crown restorations for all IR teeth effectively arrested disease progression at 9 months' follow-up. Elevated parathyroid hormone from secondary hyperparathyroidism that promotes bone osteoclast activity may also stimulate odontoclasts causing IR.

Dental Pathology of the Domestic Pig (Sus Scrofa Domesticus).

Antemortem domestic pig (Sus scrofa domesticus) dental pathology literature is sparse. This observational descriptive study evaluated 23 client-owned pigs that while sedated/anesthetized for routine annual care had intraoral dental radiographs and an oral examination performed. Age, gender, weight, and breed for each pig were recorded. Oral examination and radiographic findings were reviewed to create a comprehensive list of dental abnormalities identified. Descriptive statistics were performed to summarize the data. The study population included 14 castrated males and 20 Vietnamese pot-bellied mini-pigs. The median age was 3 years (range 2-12 years), and the median weight was 39 kg (range 11-140 kg). The most common finding was missing teeth (21/23 pigs); the first premolar tooth was the most likely to be absent (64/106 missing teeth). Periodontal disease was common (20/23 pigs). Advanced stages primarily affected the first molar teeth frequently in the form of a mucogingival defect. Supernumerary roots were discovered on the maxillary canine teeth in female pigs only (10/25 teeth with supernumerary roots). The most common persistent deciduous tooth was the maxillary second incisor (15/19 persistent deciduous teeth). Non-age or gender related open apices were most likely associated with mandibular first and second incisor teeth (26/96 teeth with open apices). Tooth resorption was also identified (7/23 pigs). The study findings prove that pet pigs commonly have dental pathology; therefore, thorough oral examinations with intraoral radiographs should be included in porcine routine health care regimens.

Primary molar pulpotomies with different hemorrhage control agents and base materials: A randomized clinical trial.

OBJECTIVE: To evaluate the clinical and radiographical success of primary molar pulpotomies which used 15.5% ferric sulfate (FS) or 1.25% sodium hypochlorite (NaOCl) for hemostasis and zinc oxide-eugenol (ZOE) and calcium hydroxide (CH) pastes as base materials. METHODS: In 29 healthy children, 80 primary molars were randomly allocated to one of the study groups: Group 1: FS-ZOE, Group 2: FS-CH, Group 3: NaOCl-ZOE, and Group 4: NaOCl-CH. After hemostasis with the respective solutions, pulp stumps and floor of the pulp chambers were covered with either ZOE or CH pastes. All teeth were restored with stainless steel crowns. Follow-up examinations were carried out at 1, 3, 6, and 12 months. RESULTS: One tooth in Group 1 and two teeth in Group 4 were extracted because of pain and periapial pathosis at sixth month. After 12 months, clinical success rates of pulpotomies in Groups 1-4 were 95%, 100%, 100%, and 89.5%, respectively. The differences were not significant (P = 0.548). Radiographic success rates for Groups 1-4 were 80%, 88.9%, 78.9%, and 84.2%, respectively. No statistically significant difference was found (P = 0.968). Pain on percussion was the most observed clinical finding. However, internal root resorption was the most common radiological finding and it was observed significantly more in mandibular primary molars (P < 0.05). CONCLUSION: Both ZOE and CH can be preferred as base materials after hemostasis achieved by the use of 15.5% FS or 1.25% NaOCl in primary tooth pulpotomy.

Multiple Idiopathic Cervical Root Resorptions in Patients with Hepatitis B Virus Infection.

Multiple idiopathic cervical root resorptions are a rare finding. The diagnosis is perplexing, and treatment is a challenge. It is a debilitating condition that often leads to extraction of all the involved teeth. Various theories have been given for explanation of the disease entity; however, the etiology remains elusive. This report describes a case of an 18-year-old man with idiopathic cervical resorption that progressed aggressively and involved 20 teeth. The medical history of hepatitis B virus infection made this case unique in the literature. The mechanism of increased osteoclastic activity in patients with hepatitis B virus infection is discussed as a predisposing factor for the development of root resorption.

[Dental complications during orthodontic preparation and orthognathic surgery]. / Complications dentaires de la préparation orthodontique et de la chirurgie orthognathique.

INTRODUCTION: Orthodontic-surgical treatment can present risks to the dental organ and the periodontium. Despite the low incidence of such cases, these complications can compromise a treatment plan. Practitioners should be aware of these potential complications, take them into account during treatment in order to reduce their negative impact and, if necessary, manage them by orthodontic-surgical collaboration. MATERIALS AND METHODS: In this article, the authors present several potential complications that can occur during treatment. CONCLUSION: The information given to the patient about the risks inherent in the implementation of an orthodontic-surgical protocol must necessarily include the risks of lesion to the dental organ and the periodontium.

Use of cone beam computed tomography to assess significant imaging findings related to mandibular third molar impaction.

OBJECTIVE: The aim of the study was to identify risk factors for pathoses related to mandibular third molars observed in cone beam computed tomography. STUDY DESIGN: Cone beam computed tomography volumes of 410 mandibular third molars were assessed by 3 observers, according to the angulation and position of the third molar in relation to the second molar. In addition, pathoses (marginal bone loss, resorption of the second molar, increased follicular space and lingual bone perforation) were assessed. Logistic regression analyses were used to test whether the angulation and position of the third molar were risk factors for pathoses. RESULTS: On average, 41% of second molars had resorption; mesioangulated (odds ratio [OR] 11-107; P < .001) and horizontally positioned (OR 13-120; P < .001) third molars located cervically at the second molar (OR 2-3; P < .027) significantly increased the risk. On average, 49% of second molars had marginal bone loss; mesioangulated (OR 16-85; P < .001) and horizontally positioned (OR 61-573; P < .001) third molars increased the risk. For the third molar, an increased follicular space was seen in 25% of cases; distal (OR 5-9; P < .001) and vertical positions (OR 5; P < .002) increased the risk. Lingual bone perforation was not related to a specific angulation. CONCLUSIONS: Specific angulations of the mandibular third molar are risk factors for marginal bone loss and resorption of the second molar.

Descriptive Analysis of Factors Associated with External Cervical Resorption.

INTRODUCTION: The aim of this study was to perform a descriptive analysis of the occurrence of external cervical resorption (ECR) in relation to the patients' characteristics (sex, age, and tooth type) and the potentially involved predisposing factors. METHODS: This study includes data on 284 patients (337 teeth with evidence of ECR) referred to the University Hospital Leuven (Leuven, Belgium) and Endo Rotterdam (Rotterdam, the Netherlands) for diagnosis and treatment from 2010 to 2015. The medical history, existing radiographs, and dental records were available for evaluation. Each patient was then interviewed followed by a thorough clinical and radiographic examination. Intraoral pictures using a dental operating microscope and digital camera were taken during clinical examination. The radiographic examination consisted of digital periapical radiography and/or cone-beam computed tomographic imaging. A review of existing literature provided a potential predisposing factor checklist for ECR. The clinical data were correlated with the dental and medical history of each patient in an attempt to identify some potential predisposing factor(s) that could contribute to ECR. The frequency of the occurrence of ECR was correlated with tooth type, sex and age of the patient, and each 1 of the recorded potential predisposing factor(s). RESULTS: From the examined teeth (337) with ECR, 175 (54%) were found in male patients and 162 (46%) were found in female patients. In 59% of the cases, more than 1 potential predisposing factor was identified. Most ECR cases were observed on maxillary central incisors (29%) followed by maxillary canines (14%), mandibular molars (14%), and maxillary premolars (11%). In addition, most ECR cases were observed on maxillary teeth (72%). The most frequently appearing factor was orthodontics (45.7%). Other frequently observed factors were trauma (28.5%), parafunctional habits (23.2%), poor oral health (22.9%), malocclusion (17.5%), and extraction of a neighboring tooth (14%). CONCLUSIONS: The data indicate that ECR is not related to patient sex. ECR occurs most often in the maxillary central incisor. In the majority of the cases, more than 1 potential predisposing factor was identified, indicating that ECR may be mainly multifactorial. The most frequently appearing factors were orthodontics, iatrogenic or accidental trauma, and poor oral health. This information may be helpful in diagnosing ECR at an early stage when screening patients presenting with these predisposing factors.

Hematologic, Biochemical, and Endocrine Parameters in Horses With Tooth Resorption and Hypercementosis.

BACKGROUND: Equine odontoclastic tooth resorption and hypercementosis (EOTRH) is a frequently diagnosed condition in adult horses. The underlying etiology is still unknown. Hematologic, biochemical, and endocrine values have not been reported in EOTRH-affected horses. OBJECTIVES: The main objective of the study was to describe the hematologic, biochemical, and endocrine parameters in horses with EOTRH. STUDY DESIGN: Descriptive cross-sectional study of client-owned animals with EOTRH. METHODS: A complete blood count, biochemistry panel, and endocrine profile were performed in horses diagnosed with EOTRH. Diagnosis was based on oral and radiographic examination findings and confirmed with histopathology. RESULTS: Eighteen horses with EOTRH aged 10 to 32 years from various regions of the United States were sampled. The only consistent abnormality on the complete blood cell count and chemistry panel was hypoalbuminemia (88%). Endocrine parameters demonstrated no major abnormalities in the functioning of the thyroid and pituitary pars intermedia. The parathyroid hormone concentration was increased in 7 (47%) of 15 horses with an elevated 25-hydroxy vitamin D in 3 (17%) of 17 horses. Main Limitations: The main limitations of this study are the small sample size and lack of age-matched and management-matched control horses. CONCLUSIONS: The relevance of elevated parathyroid hormone in this study cannot be determined due to the lack of age-based controls and large population studies. With the small population evaluated in this study, there are no obvious hematological, biochemical, and endocrine changes evident. Further evaluation with signalment-matched controls will be necessary to evaluate some trends noted in the laboratory values.

External tooth resorption associated with a peripheral odontogenic fibroma: review and case report.

The purpose of the study is to document a rare case of a peripheral odontogenic fibroma with associated cervical and coronal tooth resorption in a 38 year old woman. Histopathological features are described, the clinical management outlined and follow-up observations over 27 years detailed. The exophytic firm lesion, coral pink in appearance, located on the labial aspect of a maxillary right lateral incisor was excised, fixed in formalin and prepared for histological evaluation. The resorption cavity and adjacent soft tissue were treated by the topical application of trichloroacetic acid prior to restoration with a glass-ionomer cement and subsequent root canal treatment. Histologically, the body of the lesion was characterized by the presence of odontogenic epithelium embedded in a mature fibrous stroma. Areas of dystrophic calcification could also be identified. The features were consistent with a diagnosis of a peripheral odontogenic fibroma. The clinical result of treatment assessed 27 years postoperatively showed no evidence of recurrence of the peripheral odontogenic fibroma. External cervical and coronal tooth resorption can, on rare occasions, prove to be a clinical feature associated with peripheral odontogenic fibroma. Treatment of the tumour mass and the resorptive lesion can provide a successful outcome.

External Cervical Resorption: A New Oral Manifestation of Systemic Sclerosis.

Systemic sclerosis (SSc) is a complex, chronic, and progressive autoimmune disease. SSc causes bone resorption of mandible and distal phalanges of fingers through a known mechanism, and it has also been pointed out as a possible cause of apical root resorption of teeth, because tooth resorption is regulated by similar mechanisms to those controlling bone resorption. The objective of this article was to report the first case in the literature of external cervical resorption (ECR) as an oral manifestation of SSc. A 66-year-old female patient with a 35-year history of SSc was diagnosed with multiple ECRs through a computerized axial tomography and clinical examination. All known causes of ECR were discarded after a detailed anamnesis and clinical examination. This report details SSc as a possible cause of ECR and discusses the pathogenesis of ECR in relation with SSc. The systemic alterations provoked by SSc can be related to the etiopathogenesis of cervical root resorption. It is extremely relevant that dental care providers be aware that external cervical resorptions could be present in patients suffering from SSc, consciously look for these lesions, treat them early in case they are present, and advise the patient with SSc of the importance of continuous dental controls.

Fibroma odontogénico periférico: reporte de un caso / Peripheral odontogenic fibroma: case report

El Fibroma Odontogénico Periférico fue definido por la OMS en el año 2005 como una neoplasia benigna rara constituida por tejido fibroso maduro y una cantidad variable de epitelio odontogénico inactivo. Dada su presentación clínica, localización y baja prevalencia suele ser mal diagnosticado como una lesión reaccional. Se presenta un caso clínico de fibroma odontogénico periférico tratado mediante remoción quirúrgica y se realiza una revisión de la bibliografía respecto a la patología con el propósito de esclarecer algunos aspectos de esta lesión, además de incluirla dentro de los posibles diagnósticos diferenciales de lesiones reaccionales gingivales. El objetivo del siguiente artículo es presentar un caso clínico de FOP tratado mediante remoción quirúrgica y aportar en el diagnóstico diferencial de las lesiones reaccionales gingivales.

Peripheral odontogenic fibroma was described by the World Health Organization (WHO) in 2005, as a rare benign tumor containing mature fibrous connective tissue with a varying amount of inactive odontogenic epithelium. Though its clinical presentation, localization and low prevalence, it tends to be misdiagnosed as a reactive lesion. We present a case report of a Peripheral Odontogenic Fibroma treated by surgical resection and a narrative review of the literature with the purpose of clarifying different aspects of this lesion besides considering it as a possible differential diagnosis of reactive gingival lesions. The purpose of this article is to present a case report of peripheral odontogenic fibroma treated by surgical resection. Also to contribute to the differential diagnosis of gingival reactive lesions.

Predictive factors for resorption of teeth adjacent to impacted maxillary canines.

PURPOSE: The aim of this study was to assess the link between the degree of resorption of teeth adjacent to an impacted maxillary canine and the situation of the latter so as to identify factors predictive of resorption. MATERIAL AND METHODS: This was a retrospective study concerning all patients with impacted maxillary canines who consulted the orthodontics department at the Center for dental care, teaching and research (CSERD) in Montpellier between 2010 and 2015, with a full radiological file including panorex, periapical long-cone and cone-beam images. In all, 25 patients with 31 impacted maxillary canines were analyzed. Measurements were made by a single operator using 2D images and 3D analysis; they concerned the quantitative and qualitative aspects of resorption of teeth adjacent to the impacted canines and also evaluation of the position of the maxillary canine and its follicular sac. The X2 test was used to compare percentage resorption in men and women. Analysis of variance (ANOVA) was applied to compare the average degree of resorption of the adjacent teeth depending on the sagittal or vertical position of the impacted maxillary canine. Covariance analysis (ANCOVA) was used to study the average degree of resorption taking jointly into account the sagittal, vertical and transverse positions and adjusting for age and sex. Calculations were performed with a significance threshold of 5% using MyStat® software. RESULTS: Women made up 60.6% of the study population, with no significant age differences between the two sexes (21±5 years). The risk of adjacent resorption was not linked to age but was significantly greater (P-value=0.03) for women (60%) than for men (23%). The average degree of resorption is explained jointly by sagittal position (P-value=0.0001) and transverse position (P-value=0.01), after adjustment for age and sex. On the other hand, the average degree of resorption was not linked to vertical position, nor to the shape or size of the follicular sac. CONCLUSION: This study leads to the conclusion that the risk of resorption of the lateral incisor is not linked to the buccal or palatal situation of the canine. The risk is greater when the canine is vertically above the lateral incisor root and close to the median palatine suture, suggesting a mechanical blockage by the apex of the lateral incisor.

Occurrence of invasive cervical resorption after the completion of orthodontic treatment.

The invasive cervical resorption (ICR) is an irreversible and progressive loss of tooth hard tissues involving coronal and root dentine that usually affects single permanent teeth. The aim of this study was to present the pattern of ICR lesions detected in three patients with no contributory medical and dental anamnesis, at different time periods after orthodontic tooth movements. Conventional radiographs and cone-beam computed tomography (CBCT) images were obtained by X-Mind™ (Satelec), respective 3D Accuitomo (Morita). The present clinical study confirmed that orthodontic forces might be a key factor for generating an ICR and the risk of lesion occurrence is increased in long movements of the teeth because the orthodontic forces act continuously an extended time. However, it should not be overlooked the synergistic effect of additional factors such as traumatic injuries, periodontal inflammation, clenching, and grinding. The more advanced ICR lesions found in our study, described as Heithersay Class 3 and Class 4, appeared on conventional radiographs as irregular, diffuse, mottled radiolucencies extended both to the crown and deeply into the tooth root. CBCT proved to have a superior accuracy in detection and assessing the severity of ICR, since the conventional intraoral radiographs cannot afford an early and proper identification of the resorptive defect. Moreover, the CBCT image allows an accurate inspection of all surfaces of tooth due to the slices in sagittal, axial and coronal planes, and to avoid erroneous diagnostic conclusions. Currently, due to CBCT scan, the nature and extension of ICR lesion into the tooth structures can be exactly evaluated.

External cervical resorption: diagnostic and treatment tips.

External cervical resorption is caused, almost exclusively, by dental trauma - especially those characterized by concussion - and is a dental disease to be diagnosed and treated accurately by endodontists. However, the vast majority of the cases is initially diagnosed by an orthodontist, due to the imaging possibilities in standardized documentations. Among the causes of external cervical resorption, it is common to mistakenly attribute it to orthodontic treatment, traumatic occlusion or even to chronic inflammatory periodontal disease. External cervical resorption is associated to dental trauma in several situations mentioned in this paper. In old cases, and eventually still nowadays, it may have been induced by internal tooth bleaching, which is increasingly less frequent in endodontically treated teeth. There are some tips to be followed and some care that must be taken during the diagnosis and treatment of external cervical resorption clinical cases. The present study lists foundations that will allow the professional to perform safely and accurately in each specific case. Some of these tips and care measures are of orthodontic nature.

External cervical resorption: diagnostic and treatment tips

ABSTRACT External cervical resorption is caused, almost exclusively, by dental trauma - especially those characterized by concussion - and is a dental disease to be diagnosed and treated accurately by endodontists. However, the vast majority of the cases is initially diagnosed by an orthodontist, due to the imaging possibilities in standardized documentations. Among the causes of external cervical resorption, it is common to mistakenly attribute it to orthodontic treatment, traumatic occlusion or even to chronic inflammatory periodontal disease. External cervical resorption is associated to dental trauma in several situations mentioned in this paper. In old cases, and eventually still nowadays, it may have been induced by internal tooth bleaching, which is increasingly less frequent in endodontically treated teeth. There are some tips to be followed and some care that must be taken during the diagnosis and treatment of external cervical resorption clinical cases. The present study lists foundations that will allow the professional to perform safely and accurately in each specific case. Some of these tips and care measures are of orthodontic nature.

RESUMO A reabsorção cervical externa é provocada, quase exclusivamente, pelo traumatismo dentário, especialmente os do tipo concussão. Ela constitui uma doença dentária a ser diagnosticada e tratada com precisão pelo endodontista, mas a grande maioria dos casos é inicialmente diagnosticada pelo ortodontista, em função das oportunidades imagiológicas nas documentações padronizadas. Entre as causas da reabsorção cervical externa, é comum atribuí-la equivocamente ao tratamento ortodôntico, à oclusão traumática ou, ainda, à doença periodontal inflamatória crônica. A reabsorção cervical externa está associada ao traumatismo dentário em várias situações mencionadas neste trabalho. Em casos mais antigos - e ainda hoje, eventualmente -, pode ter sido induzida pelo clareamento dentário interno, cada vez menos realizado em dentes endodonticamente tratados. Algumas dicas e cuidados devem ser tomados no diagnóstico e no tratamento dos casos clínicos de reabsorção cervical externa. No presente trabalho, são listados fundamentos para que o clínico possa atuar com segurança e precisão em cada caso, especificamente. Nessas dicas e cuidados, encontram-se alguns de natureza ortodôntica.

Reabsorções externas inflamatórias por movimentação ortodôntica / External inflammatory resorption by orthodontic movement

A reabsorção radicular é um dos problemas clínicos de maior complexidade para o dentista no tocante ao diagnóstico e ao tratamento, pela dificuldade de detecção e por ser assintomática. Este trabalho teve comoobjetivo revisar a literatura sobre a reabsorção radicular oriunda da movimentação ortodôntica, os fatores que contribuem para o seu aparecimento, bem como as consequências e o melhor tratamento a ser proposto para esse tipo de patologia

The root resorption is one of the medical problems of greater complexity to the dentist with regard todiagnosis and treatment, the difficulty of detection and be asymptomatic. This paper aimed to review theliterature on deriving root resorption of orthodontic movement, the factors that contribute to your appearanceas well as the consequences and the best treatment to be proposed for this type of pathology

Responses of the pulp, periradicular and soft tissues following trauma to the permanent teeth.

Trauma to the permanent teeth involves not only the teeth but also the pulp, the periodontal ligament, alveolar bone, gingiva and other associated structures. There are many variations in the types of injuries with varying severity and often a tooth may sustain more than one injury at the same time. In more severe trauma cases, there are many different cellular systems of mineralized hard and unmineralized soft tissues involved, each with varying potential for healing. Furthermore, the responses of the different tissues may be interrelated and dependent on each other. Hence, healing subsequent to dental trauma has long been known to be very complex. Because of this complexity, tissue responses and the consequences following dental trauma have been confusing and puzzling for many clinicians. In this review, the tissue responses are described under the tissue compartments typically involved following dental trauma: the pulp, periradicular and associated soft tissues. The factors involved in the mechanisms of trauma are analysed for their effects on the tissue responses. A thorough understanding of the possible tissue responses is imperative for clinicians to overcome the confusion and manage dental trauma adequately and conservatively in order to minimize the consequences following trauma.