Powerpoint presentation | lecture slide | conservative dentistry
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The dental pulp is the loose C.T., containing blood vessels, lymphatic, nerves & undifferentiated C.T. cells.
Pulpitis: an inflammation of the pulpal tissue that may be reversible or irreversible.
Like any another C.T. is characterized by redness, swelling, fever, pain.
*However, is a unique one ,why
1-surrounded by hard tissue
2-small apical foramen
1-bacterial cause: caries, fracture, bacteremia, periodontal pocket
2-physical cause: sever thermal change (cavity preparation), large metallic restoration
3-trauma: from occlusion, like attrition or accident
4-chemical cause: filling (amalgam, composite), bases, disinfectant, eugenol
Classification of pulpitis
4-pulp polyp (chronic hyperplastic pulpitis)
1-sharp pain & respond to sudden changes in temperature
2-pain disappear as the stimuli removed
3-last less than 20 min.
4-easily localized & unaffected by body position
show dilatation of blood vessels(hyperemia)with RBC &WBC
protection of the pulp from further stimulation,& placing sedative dressing for several weeks
2*Acute pulpitis: may occur as asequel of focal reversible pulpitis or occur due to acute exacerbation of chronic pulpitis
1-occurs in a tooth with large carious lesion or defective margin of a restoration
2-pain is less intense than of reversible pulpitis
3-pain will be spontaneous &continous,even when stimuli removed
4-pain lasts for a prolonged period,longer than 20 min.
5-difficult to localized , & the pain initiated when the patient reclines (sleep) duo to increase blood pressure.
1-Show,vascular dilatation,edema&high amount of bacteria with
PML which lead to abscess formation by the macrophage action
2-odontoblast undergo degeneration at the area of inflammation
Treatment: pulpatomy, root canal, extraction
3*Chronic pulpitis: develop as a result of acute pulpitis, or develops as chronic once
1-spontaneous dull, itching pain
2-increased pain threshold (need strong stimuli) due to degeneration of the nerve fibers
3- the pain lasts for about 2 h.
1-infiltration of pulp by various amount of chronic inflam. Cells mainly lymphocytes & plasma cells
2-dilatation of capillaries & collagen fiber formation around the inflamed area.
Root canal or extraction
4*Chronic hyperplastic pulpitis: is a rare condition that is confined to the molars of children. It result from acute caries in young teeth that rapidly reaches the pulp before it becomes completely necrotic
1-polyp in the center of the tooth cavity
2-occurs in a tooth with large carious lesion
3-not sensitive to touch, due to little nerves in hyperplastic tissues
5-may confused with hypertrophic gingival polyp
1-the polyp is a mass of granulation tissue
2-sometimes,the polyp covered by a layer of stratified sq. Epith.
Root canal or extraction