Pulpal Inflammation

By Dr. Vishaal Bhat on Tuesday 10 June 2008 with 0 comments



Pulpal inflammation: microbial, traumatic, iatrogenic (dentist caused) idiopathic (don’t know why it happened).


Juveniles, teeth develop from outside to inside, start with thin walls and large pulp, no root tip, then slowly the walls become thicker and the pulp becomes narrower.


Prevention of pulpitis

First stage is reversible pulpitis, pulp can still go to healthy state if you remove caries. Prophylaxis, hygiene, fluoride application. Trauma prophylaxes in sports (mouth guard). If pulpitis occurs for longer period of time, stimulant is not removed, it becomes irreversible.

Early stage of irreversible pulpitis, means still vital and sterile tissue in root canal, but some infection in coronal portion of pulp, in pulp chamber. Strategies to keep tooth vital is pulpotomy, cutting off healthy tissue at orifice of root canal. Later stage continuously bacterial front advances into root canals and the only way to treat the tooth is total pulpectomy.

If no treatment is done, the tooth becomes totally infected and we have apical radiolucency, dark area around root tip on radiograph, body has removed bone, a vulnerable tissue, body removes it and replaces bone by granulation tissue. We don’t have a lot of bacteria in apical granuloma, thick wall of immune competent cells that wall off the body against the exit out of the root canal system.


Category: Endodontics Notes

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