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Pulpitis

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Oral Pathology I
Third Year

Pulpitis

  1. 1. Inflammatory Jaw lesions I Aiman A. Ali, DDS, PhD.
  2. 2. Pulpitis Definition: Inflammation of the dental pulp, which can be acute or chronic. Aiman A. Ali, DDS, PhD.
  3. 3. Etiology  Dental Caries.  Traumatic exposure.  Fracture of the crown.  Thermal changes.  Chemical irritation.  Cracked tooth syndrome. Aiman A. Ali, DDS, PhD.
  4. 4. Types of pulpitis Acute Chronic  Reversible.  Closed.  Irreversible.  Opened (Hyperplastic) Aiman A. Ali, DDS, PhD.
  5. 5. Acute Reversible Pulpitis Etiology: Dental Caries.  Cavity preparation.  Thermal changes in large metallic fillings.  Aiman A. Ali, DDS, PhD.
  6. 6. Acute Reversible Pulpitis Clinical Features: Pain: mild to moderate and stimulated.  The etiological factor is obvious.  Aiman A. Ali, DDS, PhD.
  7. 7. Acute Reversible Pulpitis  Histopathological Features:     Pulp hyperemia (dilatation of blood vessels). Exudation. Inflammatory cell infiltration (neutrophils). Reactions usually remain localized adjacent to the cause. Aiman A. Ali, DDS, PhD.
  8. 8. Acute Reversible Pulpitis Treatment: cause. Remove the Aiman A. Ali, DDS, PhD.
  9. 9. Acute Irreversible Pulpitis Etiology: Acute Dental Caries.  Pulp exposure.  Sever Irritation.  Aiman A. Ali, DDS, PhD.
  10. 10. Acute Irreversible Pulpitis Clinical Features: Pain: Sever, spontaneous and continuous.  Little response to simple analgesics.  Pain increase when patient lies down. The etiological factor is obvious.  Aiman A. Ali, DDS, PhD.
  11. 11. Acute Irreversible Pulpitis  Histopathological       Features: Inflammation involves the whole dental pulp. Vascular dilatation and edema. Inflammatory [granular cell] infiltration. Odontoblasts near to the cause are destroyed. Formation of a minute pulp abscess. In a few days pulp undergoes liquefaction and necrosis. Aiman A. Ali, DDS, PhD.
  12. 12. Acute Irreversible Pulpitis Treatment: RCT. Aiman A. Ali, DDS, PhD.
  13. 13. Aiman A. Ali, DDS, PhD.
  14. 14. Chronic Pulpitis Etiology: Previous acute pulpitis.  Chronic Dental Caries.  Aiman A. Ali, DDS, PhD.
  15. 15. Chronic Pulpitis  Clinical    Features: Pain: absent or mild to moderate, dull ache and intermittent. Reaction to thermal changes is reduced in comparison to acute pulpitis. The etiological factor is obvious. Aiman A. Ali, DDS, PhD.
  16. 16. Chronic Pulpitis  Histopathological Features: Mononuclear inflammatory cell infiltration.  Evidence of fibroblastic activity.  Minute abscess if exist it is localized by granulation tissue.  Aiman A. Ali, DDS, PhD.
  17. 17. Chronic Pulpitis Treatment: RCT. Aiman A. Ali, DDS, PhD.
  18. 18. Aiman A. Ali, DDS, PhD.
  19. 19. Chronic Hyperplastic Pulpitis Pulp Polyp Etiology: Opened cavity.  Starts as chronic or acute.  Wide apical foramen [Children].  Aiman A. Ali, DDS, PhD.
  20. 20. Chronic Hyperplastic Pulpitis Pulp Polyp Clinical Features: Red pinkish soft nodule protruding into the cavity.  Almost in children and young adults.  Relatively insensitive to manipulation.  Most common in deciduous molars.  Must be differentiate from gingival polyp.  Aiman A. Ali, DDS, PhD.
  21. 21. Chronic Hyperplastic Pulpitis Pulp Polyp  Histopathological Features:  The    polyp consists of granulation tissue. It contains delicate connective tissue, fibers and blood vessels. Mononuclear inflammatory cell infiltration. The polyp is covered with SS epithelium. Aiman A. Ali, DDS, PhD.
  22. 22. Chronic Hyperplastic Pulpitis Pulp Polyp  Treatment: RCT or extraction of the tooth. Aiman A. Ali, DDS, PhD.
  23. 23. Periapical inflammation Periapical abscess Periapical Granuloma Chronic abscess or osteomyelitis Cellulitis Skin or mucosal sinus Bacteremia Periapical Cyst
  24. 24. Acute Abscess Etiology: Acute pulpitis.  Chronic periapical lesions.  Aiman A. Ali, DDS, PhD.
  25. 25. Acute Abscess Clinical Features: Pain: sever and increases with percussion.  Non-vital tooth.  The tooth is slightly extruded in its socket.  Fever and malaise and regional lymphadenitis.  Osteomyelitis and swollen of the adjacent area.  Aiman A. Ali, DDS, PhD.
  26. 26. Acute Abscess  Histopathological  Features: Zone of liquefaction composed of: • Exudates. • Necrotic tissue. • Dead neutrophils. Dilated blood vessels.  Inflammatory [granular cell] infiltration.  Aiman A. Ali, DDS, PhD.
  27. 27. Acute Abscess Treatment: Drainage.  Administration of antibiotics.  Supportive treatment.  Aiman A. Ali, DDS, PhD.
  28. 28. Aiman A. Ali, DDS, PhD.
  29. 29. Aiman A. Ali, DDS, PhD.
  30. 30. X-Ray Pulpitis: Evaluation of the pulp champer.  Evaluation of the periapical region.  Acute abscess: Thickening of periodontal membrane.  Loss of the lamina dura. Aiman A. Ali, DDS, PhD.
  31. 31. Electrical Pulp Tester     Acute reversible pulpitis. Acute irreversible pulpitis. Chronic pulpitis. Acute abscess. Aiman A. Ali, DDS, PhD.

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