Short Presentation on Pulpitis

1. z
PULPITIS
Dr. Sarang Suresh Hotchandani

2. z
Pulpitis is Most Common Cause of;
Dental Pain
Loss of tooth in
younger age
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Causes of Pulpitis
 Dental Caries (Most Common)
 Trauma
 Cracked tooth syndrome
 Thermal
 Chemical
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4. z
If Pulpitis Not Treated this will happen!
Pulpitis
Pulp Necrosis
Periapical
Periodontitis
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Clinical Features of Pulpitis
 Patient unable to localize from which tooth
pain is originating.
 Because pulps of individual teeth are not sensed
precisely on Sensory Cortex.
 Sometimes pulpitis pain is referred;
 E.g. mandibular molars to ear.
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Clinical Features of Pulpitis
 There is no any pain on applying
pressure/palpation/percussion on tooth in
pulpitis.
 If pain is present on pressure it is always periapical
periodontitis; inflammation of PDL.
 But sometimes, when there is frank cavity in tooth, the
impacted food particles sometimes apply pressure
through soft & thin dentine.
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Clinical Classification of Pulpitis
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Acute Pulpitis
(Early Stage Acute Pulpitis)
 Tooth is hypersensitive
 Very cold/hot stimuli cause stabbing
pain, relieved by removing stimuli.
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Acute Pulpitis
(Late Stage Acute Pulpitis)
 Duration of pain increases & it is
persistent.
 Pain starts spontaneously often
when patient try to sleep.
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10. z
Pain of Pulpitis Occurs due to;
 Presence of inflammatory infiltrate in
closed pulp chamber on irritated nerve
endings.
 Pain producing substances from
damaged pulp.
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Characteristics of Acute Pulpitis Pain
 Sever
 Sharp
 Stabbing
 Can’t relieved by simple analgesics.
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Clinical Classification of Acute Pulpitis
Acute Pulpitis
Irreversible
Acute Pulpitis
Reversible
Acute Pulpitis
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Characteristics of Irreversible
Acute Pulpitis
 Constant sever pain even after
removal of stimuli.
 Treatment; Root Canal Therapy
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Outcome of untreated Acute Pulpitis!
 Chronic Pulpitis
 Pulp Necrosis
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Chronic Pulpitis
 Spontaneous attack of dull pain for
hours or more
 It may or may not be due to acute
pulpits.
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Acute Closed Pulpitis
(Histologic Findings)
 Pulp hyperemia
 Infiltration of inflammatory exudate
 Some areas of necrosis leading to micro
abscesses
 If left untreated for long time can lead to
Pulp Necrosis
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Chronic Closed Pulpitis
(Histologic Factors)
 Mononuclear macrophage cell infiltrate
 Vigorous connective tissue response
 Small areas of pulp necrosis
 Small areas of minute abscesses
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Factors Which Prevent Survival of Pulp
 Pulp is enclosed within rigid walls of pulp
chamber
 Only one small opening at apex for blood
supply to tooth
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19. Death of Pulp
Blood Supply Cut off to Tooth
Compression of Apical Vessels
Inflammation
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Open Pulpitis
(Pulp Polyp)
 Pulp grown through cavity opening.
 This may be due to large open
apices & good blood flow.
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Clinical Features of Open Pulpitis
(Pulp Polyp)
 Dusky red/ pinkish soft tissue nodule protruding in
to cavity opening.
 Painless
 Bleed on probing
 Tender to palpation
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Histological Features of Open Pulpitis
(Pulp Polyp)
 Few odontoblast present
 Pulp tissue is replaced by granulation tissue
 Proliferated mass of pulp polyp is covered by stratified
squamous epithelium
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23. z
Management of Pulpitis
 If cause is fracture/ cracked tooth, stabilize & seal the pulp temporarily.
 If cause is caries, pulp capping, caries removal.
 Pulpotomy in deciduous teeth
 Endodontic treatment
 Extraction
 Analgesic are ineffective against pulpitis pain
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THE END
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