PULPITIS (PULP INFLAMMATION) - DENTISTRY
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Transcript of PULPITIS (PULP INFLAMMATION) - DENTISTRY
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PULPITISDr. Sarang Suresh Hotchandani
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Pulpitis is Most Common Cause of;
Dental Pain
Loss of tooth in
younger age
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Causes of Pulpitis
Dental Caries (Most Common)
Trauma
Cracked tooth syndrome
Thermal
Chemical
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If Pulpitis Not Treated this will happen!
Pulpitis
Pulp Necrosis
Periapical Periodontitis
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Clinical Features of Pulpitis
Patient unable to localize from which tooth
pain is originating.
Because pulps of individual teeth are not sensed
precisely on Sensory Cortex.
Sometimes pulpitis pain is referred;
E.g. mandibular molars to ear.
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Clinical Features of Pulpitis
There is no any pain on applying
pressure/palpation/percussion on tooth in
pulpitis.
If pain is present on pressure it is always periapical
periodontitis; inflammation of PDL.
But sometimes, when there is frank cavity in tooth, the
impacted food particles sometimes apply pressure
through soft & thin dentine.
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Clinical Classification of Pulpitis
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Acute Pulpitis (Early Stage Acute Pulpitis)
Tooth is hypersensitive
Very cold/hot stimuli cause stabbing
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Acute Pulpitis(Late Stage Acute Pulpitis)
Duration of pain increases & it is
persistent.
Pain starts spontaneously often
when patient try to sleep.
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Pain of Pulpitis Occurs due to;
Presence of inflammatory infiltrate in
closed pulp chamber on irritated nerve
endings.
Pain producing substances from
damaged pulp.
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Characteristics of Acute Pulpitis Pain
Sever
Sharp
Stabbing
Can’t relieved by simple analgesics.
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Clinical Classification of Acute Pulpitis
Acute Pulpitis
Irreversible Acute Pulpitis
Reversible Acute Pulpitis
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Characteristics of Irreversible Acute Pulpitis
Constant sever pain even after
removal of stimuli.
Treatment; Root Canal Therapy
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Outcome of untreated Acute Pulpitis!
Chronic Pulpitis
Pulp Necrosis
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Chronic Pulpitis
Spontaneous attack of dull pain for
hours or more
It may or may not be due to acute
pulpits.
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Acute Closed Pulpitis (Histologic Findings)
Pulp hyperemia
Infiltration of inflammatory exudate
Some areas of necrosis leading to micro
abscesses
If left untreated for long time can lead to
Pulp Necrosis
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Chronic Closed Pulpitis(Histologic Factors)
Mononuclear macrophage cell infiltrate
Vigorous connective tissue response
Small areas of pulp necrosis
Small areas of minute abscesses
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Factors Which Prevent Survival of Pulp
Pulp is enclosed within rigid walls of pulp
chamber
Only one small opening at apex for blood
supply to tooth
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Death of Pulp
Blood Supply Cut off to Tooth
Compression of Apical Vessels
Inflammation
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Open Pulpitis (Pulp Polyp)
Pulp grown through cavity opening.
This may be due to large open
apices & good blood flow.
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Clinical Features of Open Pulpitis (Pulp Polyp)
Dusky red/ pinkish soft tissue nodule protruding in
to cavity opening.
Painless
Bleed on probing
Tender to palpation
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Histological Features of Open Pulpitis (Pulp Polyp)
Few odontoblast present
Pulp tissue is replaced by granulation tissue
Proliferated mass of pulp polyp is covered by stratified
squamous epithelium
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Management of Pulpitis
If cause is fracture/ cracked tooth, stabilize & seal the pulp temporarily.
If cause is caries, pulp capping, caries removal.
Pulpotomy in deciduous teeth
Endodontic treatment
Extraction
Analgesic are ineffective against pulpitis pain
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THE END
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