Causes of pulpal pathology

December 15, 2011 | By | Reply More

Causes of pulpal pathology

The causes of pulp inflammation, necrosis, and dystrophy are arranged below in logical sequence, beginning with the most frequent irritant, microorganisms:

I. Bacterial

A. Coronal ingress

1. Caries

2. Fracture

  •  Complete
  • Incomplete (cracks, infraction)

3. Nonfracture trauma

4. Anomalous tract

  • Dens invaginatus (aka dens in dente)
  • Dens evaginatus
  • Radicular lingual groove (aka palatogingival groove)

B. Radicular ingress

1. Caries

2. Retrogenic infection

  • a. Periodontal pocket
  • b. Periodontal abscess

3. Hematogenic

Figure :  Bacteria penetrating through dentinal tubules from carious lesion (top). Pulp inflammation is already established from toxins that precede bacteria (Orban collection).

II. Traumatic

A. Acute

1. Coronal fracture

2. Radicular fracture

3. Vascular stasis

4. Luxation

5. Avulsion

B. Chronic

1. Adolescent female bruxism

2. Traumatism

3. Attrition or abrasion

4. Erosion

III. Iatral

A. Cavity preparation

1. Heat of preparation

2. Depth of preparation

3. Dehydration

4. Pulp horn extensions

5. Pulp hemorrhage

6. Pulp exposure

7. Pin insertion

8. Impression taking

B. Restoration

1. Insertion

2. Fracture

  • a. Complete
  • b. Incomplete

3. Force of cementing

4. Heat of polishing

C. Intentional extirpation and root canal filling

D. Orthodontic movement

E. Periodontal curettage

F. Electrosurgery

G. Laser burn

H.Periradicular curettage

I. Rhinoplasty

J. Osteotomy

K. Intubation for general anesthesia

IV. Chemical

A. Restorative materials

1. Cements

2. Plastics

3. Etching agents

4. Cavity liners

5. Dentin bonding agents

6. Tubule blockage agents

B. Disinfectants

1. Silver nitrate

2. Phenol

3. Sodium fluoride

C. Desiccants

1. Alcohol

2. Ether

3. Others

V. Idiopathic

A. Aging

B. Internal resorption

C. External resorption

D.Hereditary hypophosphatemia

E. Sickle cell anemia

F. Herpes zoster infection

G.Human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS)

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Category: Dental, Endodontics

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