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 chamber or even extending beyond the confines of the tooth. 

  • Cutting of this tissue produces no pain. 
  • Does not respond to thermal tests 
  • Electric pulp tester – more current is required Bleeds easily
  • Polypoid tissue is less sensitive tha pulp and more sensitive than gingival tissue.

Radiographically

A large open cavity with direct access to pulp chamber.

Differential Diagnosis

To differentiate it from gingival tissue proliferation raise and trace the stalk of tissue back to its origin which is pulp chamber in case of Pulp Polyp.

Treatment

Elimination of polypoid tissue followed by extirpation of the pulp then pulpectomy is done.

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