Secondary and Tertiary Dentin
Secondary dentin is that which is deposited in the pulp structures. This process occurs after the primary dentin has fully formed, usually as part of aging.9 Dentinal deposition can be a response to a variety of conditions such as moderate carious lesions, prolonged tooth trauma, deep restorative treatments, and tooth-wearing processes like attrition (Figure 52), abrasion, and erosion.7,9 In such instances, the term tertiary dentin may be applied, suggesting that the additional dentin is deposited in response to conditions unrelated to aging.7,9
Age-related secondary dentin deposition diminishes the size of the pulp chamber, especially the pulp horns early in the process, and the pulp canals.9 These changes can be visualized radiographically. This process may eventually result in obliteration of all pulp structures.7,9 Tertiary dentinal deposition tends to be a more rapid, localized process by comparison.7
Several other types of calcifications can affect the pulpal structures of the teeth including pulp stones and pulpal sclerosis. The stones tend to be more localized while pulpal sclerosis is more generalized.
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