12.6 SEQUELAE OF INJURIES TO THE PRIMARY DENTITION
12.6.1 Pulpal necrosis
Necrosis is the commonest complication of primary trauma. Evaluation is based upon
colour and radiography. Teeth of a normal colour rarely develop periapical
inflammation but conversely mildly discoloured teeth may be vital. A mild grey
colour occurring soon after trauma may represent intrapulpal bleeding with a pulp that
is still vital. This colour may recede, but if it persists then necrosis should be
suspected. Radiographic examination should be 3 monthly to check for periapical
inflammation (677HFig. 12.10 (a) and (b)). Failure of the pulp cavity to reduce in size is an
indicator of pulpal death. Teeth should be extracted whenever there is evidence of
periapical inflammation, to prevent possible damage to the permanent successor.