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
Dental Caries

Symptoms of Reversible Pulpitis


Symptoms of Reversible Pulpitis
Pain is Short, Sharp and Lasting for a moment.
Pain is always Specific to stimulus
Pain is instantly relieved on removal of stimulus. (Doesn't Continue after the removal of stimulus)
Pain does not occur spontaneously
Pain often caused by Cold than Hot stimuli.
In some cases of deep restoration, patient may complains of mild sensitivity to temperature change, especially cold. This type of sensitivity may last for a week or longer but gradually it subsides. This is a typical symptom of Reversible Pulpitis.

Histopathology of Reversible Pulpitis

Histopathology of Reversible Pulpitis
Hyperemia to mild to moderate inflammatory changes
Disruption of Odontoblastic Layer
Formation of reparative dentin
Dilated blood vessels
Presence of inflammatory cells

Diagnosis of Reversible Pulpitis

Diagnosis of Reversible Pulpitis
Pain Sharp, Short duration and Ceases after the removal of Stimulus.
Visual Examination and History Caries, Recent restoration, Trauma and Fracture
Radiographic Examination Normal PDL and Lamina Dura, May be present of deep restoration and caries.
Percussion Test Normal to percussion and palpation, No mobility
Vitality Test Pulp is sensitive to Cold Stimuli.

Differential Diagnosis

Reversible Pulpitis Irreversible Pulpitis
Pain ceases after the removal of stimuli Pain stays longer even after the removal of stimuli
Pain doesn't occur spontaneously Pain occus spontaneously

Treatment of Reversible Pulpitis

Reversible Pulpitis Treatment
Prevention is the Best treatment
Use cavity varnish or cement base before permanent restotaion.
Periodic care, Desensitization of hypersentive teeth
Removal of noxious stimuli

Prognosis of Reversible Pulpitis

Prognosis is favourable if the irritant is removed otherwise the condition may develop into Irreversible Pulpitis

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