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Reversible Pulpitis- Symptoms, Diagnosis and Treatment

  Introduction This is the first stage of pulpitis giving sharp hypersensitivity response to cold, but pain subsides on the removal of stimulus. Definition Reversible pulpitis: it is a mild to moderate inflammatory condition of the pulp caused by noxious stimuli in which the pulp is capable of returning to uninflamed condition following removal of stimuli. Types of Reversible Pulpitis There are two types of Reversible Pulpitis- Acute Reversible Pulpitis Pain occurs for short period of time (few hours and day) however pain immediately ceases when the stimulus is removed. Chronic Reversible Pulpitis Pain present for Long time (months) however pain immediately ceases on the removal of stimulus. Causes/Etiology of Reversible Pulpitis Causes/Etiology of Reversible Pulpitis Trauma to Tooth Heat produced when preparing a cavity with dull bur or without coolant Excessive dehydration of cavity Galvanic shock Chemical stimulus as from sweets and sour
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Infections in Immunocompromised Patients

  ·   Gingivitis normally has a slow progression toward periodontal disease with increasingly obvious symptoms as the disease worsens. However, people with immune system impairments have more rapid development of periodontal disease. ·   Causes of Periodontal Disease The microbial causes of periodontal disease in immunocompromised patients are the same as in individuals with normal immune systems (Tyring, 2006).   In individuals infected with HIV, if the level of T-helper cells falls too low and AIDS develops, the likelihood of infection from even normally benign microorganisms increases (Prevention, 2017). Effects of Periodontal Disease ·          Gingival tissues specifically are likely targets for opportunistic infections due to the diverse population of bacteria, fungi, and viral particles normally in their environment. In these patients an infection can take root quickly, resulting in significant destruction of gingival tissue and neighboring alveola
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Internal Resorption (Pink Tooth of Mummery)

  Definition it is an idiopathic slow or fast progressive resorptive process occurring in dentin of the pulp chamber or root canals of teeth.  It is known as pink tooth of mummery due to its pinking discoloration of crown and named after anatomist Mummery.  First Reported by Bell in 1830. Causes/ Etiology Not Known, but generally patients have history of trauma. Histopathology It is a result of the osteoclastic activity. Resorptive process is characterised by lacunae which may be filled by osteoid tissue Osteoid tissue may be regarded as attempt of repair. Symptoms Asymptomatic  Pain occurs if resorption perforates the root.  Pink tooth is pathognomonic feature.  Pulp shows either partial or complete necrosis.  In crown may be manifested as a reddish area called “Pink Spot” which is due to granulation tisue showing throgh resorbed area.  Diagnosis Clinically - Pink Tooth appearance. Radiographic Changes- -Well defined radiolucency of uniform density which balloons out of root canal-
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Chronic Hyperplastic Pulpitis ( Pulp Polyp)

  It is a productive pulpal inflammation due to an extensive carious exposure of a young pulp.  It is characterised by development of granulation tissue covered at times with epithelium and reulting from long standing low grade irritation. Causes/ Etiology Slow progressive carious exposure of the pulp.  For pulp polyp development, a large open cavity a young resistant pulp and a chronic low grade stimulus is necessary. Histopathology Surface is covered by stratified squamous epithelium.  The tissue in chamber is often transformed into granulation tissue, which projects from pulp to carious lesion.  Granulation tissue is young, vascular connective tissue containing PMN’s, lymphocytes and plasma cells. Symptoms Symptomless except during mastication when pressure of food bolus may cause some discomfort. Diagnosis Generally seen in teeth of children and young adults.  Appearance of polypoid tissue is clinically characteristic: a fleshy reddish pulpal mass filling most of pulp ch
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Irreversible Pulpitis- Symptoms, Diagnosis and Treatment

  Definition Irreversible pulpitis is a persistent inflammatory condition of the pulp, symptomatic or asymptomatic in nature with the pulp becoming incapable of healing. Types There are two types of Irreversible Pulpitis 1) Asymptomatic Irreversible Pulpitis 2) Symptomatic Irreversible Pulpitis Causes/Etiology CAUSES/ETIOLOGY  Most common is Dental Caries Chemical, Mechanical and Thermal injuries to pulp Untreated reversible pulpitis Symptoms SYMPTOMS Pain is caused by sudden change in temperature specially cold, sweet or acidic food items and pressure from food entrapped in tooth cavity Pain remains even after the removal of stimulus. Pain can be spontaneous which can be Sharp, Piercing, Intermittent or Continuous in nature Pain exacerbated by lying down or on bending due to increase in intra-pulpal
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