Dental Pulp Diseases | PPT | Download

December 17, 2012 | By | Reply More

Dental Pulp Diseases | PPT | Download

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PULP DISEASES

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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

*ETIOLOGY

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

Classified into

1-Reversible pulpitis(hyperemia)

2-Acute pulpitis

3-Chronic pulpitis

4-pulp polyp (chronic hyperplastic pulpitis)

 

1*Reversible pulpitis

Clinically

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

*Histopathology:
show dilatation of blood vessels(hyperemia)with RBC &WBC
extravasations &edema
*Treatment
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
clinically
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.

Histopathology

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

Clinically

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.

Histopathology:   show
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.

Treatment:

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

Clinically:

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

4-bleed easily

5-may confused with hypertrophic gingival polyp

Histopathology:
1-the polyp is a mass of granulation tissue
2-sometimes,the polyp covered by a layer of stratified sq. Epith.

Treatment:

Root canal or extraction

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