Ischemic necrosis

Sometimes physical trauma on the tooth causes damage to the blood vessels entering the pulp so that the whole intrapulpal circulation is permanently stopped. This will rapidly result in pulp necrosis. Ischemic necrosis is typically aseptic and is not followed by apical periodontitis as long as bacteria do not invade the necrotic root canal.

Experimental studies have tried to establish the time required for the oral microbes to penetrate into the necrotic pulp. These studies have indicated that infection may take place within days, but may in some teeth never happen. The nature of the trauma together with several anatomical and other local factors determine the probability of infection.

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