PULPITIS

Dr. Shahzadi Tayyaba Hashmi

INTRODUCTON

Pulpitis is the most common cause of dental pain and loss of teeth in younger persons

The usual cause is caries penetrating the dentine, but there are other possibilities

Pulpitis if untreated, is followed by the death of pulp and spread of infection through the apical foramina into the Periapical tissues

DEFINITION

An inflammation of the pulpal tissue that may be acute or chronic, with or without symptoms, and reversible or irreversible

CAUSES OF PULPITIS

1. Dental caries is the most common cause of pulpitis

2. Trauma or injury that may open the pulp chamber & let bacteria enters

3. Mechanical trauma e.g. exposure during operative procedures allowing bacteria enter the pulp or scaling that lead to pulp exposure

4. Chemical sources e.g. teeth with gingival rescission & pulp exposure to acids

A)Bacterial: C) Iatrogenic:

Dental caries 1. pulp exposure Cracks in crown 2. filling

materials Periodontal pockets Malformed teeth

B)Traumatic: Crown fracture Root fracture Abrasion Bruxism

CAUSES OF PULPITIS

PATHOGENESIS

Any cause of

the above

Exposure of the pulp

Invasion by

bacteriaPulpitis

CLASSIFICATION

Reversible pulpitis Irreversible pulpitis

REVERSIBLE PULPITIS

Reversible pulpitis is a transient condition The diagnosis of reversible pulpitis implies that

the pulp is capable of full recovery if the irritating factors subside or are removed

Pain quality: Pain is usually sharp and intense Duration: Short duration (pain remains for 5-10

minutes). Quickly subsides after removal of the stimuli

Stimuli : reaction to hot, cold or sweet with immediate onset

Body position: Unaffected by changes in the position of the body

TREATMENT : remove any caries present, and place suitable pulp protection & then permanent restorations placed

IRREVERSIBLE PULPITIS

Usually occurs as a result of more severe insults of one of the causes

Typically, it may develop as a progression from a reversible state.

Symptoms: Pain quality: throbbing pain Duration: spontaneous pain which may lasts from

minutes to hours Body position: affected by body position Site & radiation: In the latter stages the periodontal

ligament becomes involved & the pain will be localized

Stimuli:.On the early stage –pain may develop spontaneously or from hot or cold stimuliLate stage – only to hot but relived by cold

Timing: the pain worsen at night

Irreversible pulpitis

Treatment:• Involves either root canal therapy or extraction of the tooth

Comparison of pain symptoms in reversible and irreversible pulpitis

REVERSIBLE PULPITIS IRREVERSIBLE PULPITISElicited Spontaneous

Sharp Dull

Less than 20 minutes duration More than 20 minutes duration

Unaffected by body position Affected by body position

Easily localized Often difficult to localize

Do not referred to nearby location radiate to nearby location such as l lateral aspect of face or other teeth in the arch