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    Endo - Pulp Diseases

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    Yassin Salah
    Reversible pulpitis is a reversible inflammation of the pulp that occurs when irritation increases pulp pressure but can return to normal if the cause is eliminated. Irreversible pulpitis begins as acute then progresses to moderate and advanced stages, causing initially mild then severe, sharp shooting pain. Pulpal necrosis results from continued inflammation that causes the entire pulp to become necrotic and non-vital, usually with no pain. Radiographs may show widening of the periodontal membrane space in advanced cases.

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    Endo - Pulp Diseases

    Uploaded by

    Yassin Salah
    166 views2 pages
    Reversible pulpitis is a reversible inflammation of the pulp that occurs when irritation increases pulp pressure but can return to normal if the cause is eliminated. Irreversible pulpitis begins as acute then progresses to moderate and advanced stages, causing initially mild then severe, sharp shooting pain. Pulpal necrosis results from continued inflammation that causes the entire pulp to become necrotic and non-vital, usually with no pain. Radiographs may show widening of the periodontal membrane space in advanced cases.

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    Reversible pulpitis is a reversible inflammation of the pulp that occurs when irritation increases pulp pressure but can return to normal if the cause is eliminated. Irreversible pulpitis begins as acute then progresses to moderate and advanced stages, causing initially mild then severe, sharp shooting pain. Pulpal necrosis results from continued inflammation that causes the entire pulp to become necrotic and non-vital, usually with no pain. Radiographs may show widening of the periodontal membrane space in advanced cases.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    166 views2 pages

    Endo - Pulp Diseases

    Uploaded by

    Yassin Salah
    Reversible pulpitis is a reversible inflammation of the pulp that occurs when irritation increases pulp pressure but can return to normal if the cause is eliminated. Irreversible pulpitis begins as acute then progresses to moderate and advanced stages, causing initially mild then severe, sharp shooting pain. Pulpal necrosis results from continued inflammation that causes the entire pulp to become necrotic and non-vital, usually with no pain. Radiographs may show widening of the periodontal membrane space in advanced cases.

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    Reversable pulpitis - hyperemia Irreversible pulpitis Pulpal necrosis

    D Acute pulpitis ( painful ) Chronic pulpitis (painless) Pulp undergo necrosis ass a sequel of
    e acute or chronic pulpitis , as the
    Occurs when the amount of irritation intensifies Chronic ulcerative pulpitis Chronic hyperplastic pulpitis ( pulp
    f inflammation progress tissue
    causing great increase in the interpulpal polyp)
    pressure beyond the threshold limits of the Chronic inflammation of cariously Chronic inflammation of cariously continue to disintegrate until entire
    sensory nerves causing variables degrees of exposed pulp characterized by exposed pulp characterized by ana pulp is necrotic .
    pain. formation of abcess at the point over growth of granulomatous
    of exposure leading to ulceration. tissue into the carious cavity
    forming a polyp.
    E - Incipient caries This response may arise at the end of acute phase or may develop from
    t - Cervical erosion onset in case where the irritant is of low grade.
    i - Occlusal attrition
    o Usually seen secondry to acute
    - Deep periodontal curettage pulpitis
    l
    o - Filling without insulation
    g - Leaking restoration
    y - Exposed dentinal tubules

    It’s a reversible inflammation , if Acute Irreversible , starts initial then moderate


    cause eliminated , inflammation & lastly advanced
    reverse pulp will return to normal
    S Nature of pain: Nature of pain: Nature of pain: Nature of pain: Nature of pain:
    i - Type of pain : Sharp transient - Type of pain : Initially :mild shooting - Pain : usually abscent as no - Pain : usually polyp not - Pain:very mild & mostly
    g pain By time: sharp shooting ( ↑by lying down) accumulation of fluids occur painful , it bleeds easily on abscent
    n iside pulp & intra-pulpal probing ( open apex)
    s - Stimulus: initially : cold (last 4 few min’s) pressure does not rise
    & - Stimulus : cold (↓ immediately By time: spontaneous without stimulus - Stimulus: heat sometimes
    after removal of stimulus)
    s - Course of pain :transient - Course of pain : initially : intermittent
    y By time: continues
    m
    p - Vitality testing : normal - Vitality testing : normal
    t - Vitality testing : respond at - Vitality testing : pulp responds - Vitality testing : negative
    o higher stimulation
    m - Palpitation & percussion : -ve - Palpitation & percussion test : -ve
    s - Palpitation & percussion : -ve - Palpitation & percussion : -ve
    - Palpitation & percussion : -ve
    - Stimulus : initially : cold
    Followed by a stage : cold & hot - Visual examination reveals - This form seen in young
    Advanced stage : heat causes sever the presence of long patients where this polyp
    pain( relieved 4 few sec.’s by cold standing carious cavity appears as pinkish red globule
    application ‘’Hot tooth ‘’) of tissue protruding from the
    - Pain referred → neighboring teeth , pulp chamber.
    opposing dentition & temporal area & ear
    - Distribution of pain: always diffuse , cannot
    localize correctly offended tooth .
    - Pain control : initially : by analgesics
    Advanced stage : nothing can stop pain
    h Local vasodilatation & ↑ in ↑ pulpal pressure , tissue damage & bacterial
    i permeability of blood vessels can toxins lead to formation of micro-abcesses at A zone of necrosis is seen at the The polyp is a complex of new
    s cause slight ↑ in local pulpal the site of the carious exposure. The neutrophils surface of the pulp followed by a capillaries, proliferating fibroblasts
    t pressure. Infiltration for few are the primary cells present. Surrounding the zone of leukocytic infiltration. & inflammatory cells.
    o numbers of inflammatory cells . if abcess , a dense infiltration of lymphocytes, Beyond this zone, a zone of
    irritation of pulp continues or ↑ , plasma cells & macrophages is seen. proliferating fibroblasts is seen.
    case changesto irreversible pulpitis
    & eventually necrosis.

    R
    a Normal No radiographic changes except No changes seen, except in some No changes seen, except in some No changes seen, except some cases
    d Advanced stage :some widening in the cases there can be some widening cases there can be some widening there can be some widening in the
    i periodontal membrane space in the periodontal membrane in the periodontal membrane periodontal membrane space.
    o space. space.
    g
    r
    a
    p
    h
    i
    c

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