Etiology of PULP & PERIAPICAL diseases

2. CAUSE OF PULP DISEASE
According to Grossman,
 1) PHYSICAL
 A) Mechanical
 1) Trauma
a) Accidental
b) Iatrogenic dental procedures
 2) Pathologic wear
 3) Crack through the body of the tooth
 4) Barometric changes

3. B) Thermal
 1. Heat during cavity preparation
 2. Exothermic heat during setting of cement
 3. Conduction of heat and cold through deep restoration
with out a protective base
 4. Frictional heat during the polishing of restoration
c) Electrical
Galvanic shock

4.  II) CHEMICAL
 A) Phosphoric acid, acrylic monomer
 B) Erosion
 III) BACTERIAL
 A) Toxins associated with caries
 B) Direct invasion of pulp from caries or trauma
 C) Anachoresis

5. Dental Caries:
Most cases of pulpitis are primarily a result
of dental caries in which bacteria or
their products invade the dentin and pulp tissue.
Bacteria circulating in the blood stream tend to settle out
or accumulate at sites of Pulpal inflammation, such as
that which might follow some chemical or mechanical
injury to the pulp --‘anachoretic pulpitis’.

6.  Anachoresis is a phenomenon by which blood
borne bacteria, dyes, pigments, metallic
substances, foreign proteins, and other
materials are attracted to the site of
inflammation.
 One probable cause of this phenomenon is
increased capillary permeability in the
particular area.

8.  In cracked tooth syndrome, a tooth, may split under
masticatory stress.
 These cracks are often minute and invisible clinically,
and they allow the bacteria to enter into the pulp.

9. chemical irritation
use of acidic restorative materials
This may occur not only in an exposed pulp
to which some irritating medicament is
applied but also in intact pulps beneath deep
or moderately deep cavities into which some
irritating filling material is inserted.
This is undoubtedly a result of penetration of
the irritating substances into the pulp via the
dentinal tubules.

10.  Heat produced by over-rapid tooth preparation or without
sufficient coolant
 Polishing procedures, tooth restored with exothermic
restorative materials or large metallic restorations,
particularly, in which there is inadequate insulation between
the restoration and the pulp

11.  When 2 dissimilar metallic restorations are present, the
saliva acts as an electrolyte and there will be formation of a
galvanic current.

12. AERODONTALGIA/ BARODONTALGIA
 Toothache occuring at low atmospheric pressure
 experienced either during flight or during a test run in a
decompression chamber
 Observed in higher altitudes over 5000 feet
 Tooth with chronic pulpitis can be symptomless at ground
level, but it may cause pain at high altitudes because of
reduced pressure