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Pulpal Pathosis
FACTORS AFFECTING RESPONSE OF PULP
connective tissues.
cell death and inflammation.
Pulpal Pathosis
The degree of inflammation is proportional to the intensity and
severity of tissue damage.
Depending on the severity and duration of the insult and the host
response
pain
Thepain depends on:
Age Changes in the Pulp
volume
vascularity & cellularity.
collagen fiber content.
healing potential.
pulp stones and diffuse calcification
4
Pulpitis: Histopathology
5
Poor correlation between microscopic changes &
clinical symptoms.
Pulpitis: Histopathology
• Reactionary dentin
local microcirculation
 Immune reactions
Closed pulpitis:
6
Healing of Pulp
• Injured odontoblasts
removal of irritant
reactionary dentin
Ca(OH)2 agents stimulate
formation of a calcified barrier.
7
Pulp Necrosis
LESION PROGRESSION
localized inflammation
inflammatory mediators.
vascular permeability.
capillary pressure capillary permeability
an exudate forms.
rigid walls
passive compression
collapse of the venules
"compartmentalized“
Pain is often caused by
different factors.
Release of mediators of inflammation
causes pain directly by lowering the
sensory nerve threshold.
These substances also cause pain indirectly
by increasing both vasodilation in arterioles
and vascular permeability in venules,
resulting in edema and elevation of tissue
pressure. This pressure acts directly on
sensory nerve receptors.
Increased tissue pressure, the inability of
pulp to expand, and the lack of collateral
circulation may result in pulpal necrosis and
the development of a subsequent
periradicular pathosis.
Pain of Brannstrom
back-and-forth
movements of fluids within the dentinal
tubules stretch and stimulate the nerve
fibers.
Physiology of Pulpal Pain
Odontogenic pain
Sensibility of the dental pulp
2typesofsensorynervefibres
1. myelinated Afibres (A-deltaand
A-betafibres)
2.Unmyelinated C fibres
Dentin tubule fluid movement
Dehydration Heat Cold
Dentinal
tubule
and fluid
Dentin
Odontoblast
movement
A-delta
fibers
no
proprioceptive nerve
the origin
radiate
Referred Pain
referred pain.
pulpal C-fibers slow conducting
intense, slow, dull pain.
ipsilateral
Anterior teeth
posterior teeth
Mandibular posterior teeth
Common Characteristics of Pulpal Pain
Quality of pain
An identifiable condition
Response to local noxious stimulation
Pulpal pain tends to get better or worse
Local anesthesia

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Disorders of the Dental Pulp.pptx

  • 2. FACTORS AFFECTING RESPONSE OF PULP connective tissues. cell death and inflammation. Pulpal Pathosis
  • 3. The degree of inflammation is proportional to the intensity and severity of tissue damage. Depending on the severity and duration of the insult and the host response pain Thepain depends on:
  • 4. Age Changes in the Pulp volume vascularity & cellularity. collagen fiber content. healing potential. pulp stones and diffuse calcification 4
  • 5. Pulpitis: Histopathology 5 Poor correlation between microscopic changes & clinical symptoms.
  • 6. Pulpitis: Histopathology • Reactionary dentin local microcirculation  Immune reactions Closed pulpitis: 6
  • 7. Healing of Pulp • Injured odontoblasts removal of irritant reactionary dentin Ca(OH)2 agents stimulate formation of a calcified barrier. 7 Pulp Necrosis
  • 8. LESION PROGRESSION localized inflammation inflammatory mediators. vascular permeability. capillary pressure capillary permeability an exudate forms. rigid walls passive compression collapse of the venules "compartmentalized“
  • 9.
  • 10. Pain is often caused by different factors. Release of mediators of inflammation causes pain directly by lowering the sensory nerve threshold. These substances also cause pain indirectly by increasing both vasodilation in arterioles and vascular permeability in venules, resulting in edema and elevation of tissue pressure. This pressure acts directly on sensory nerve receptors. Increased tissue pressure, the inability of pulp to expand, and the lack of collateral circulation may result in pulpal necrosis and the development of a subsequent periradicular pathosis. Pain of Brannstrom back-and-forth movements of fluids within the dentinal tubules stretch and stimulate the nerve fibers.
  • 11. Physiology of Pulpal Pain Odontogenic pain Sensibility of the dental pulp 2typesofsensorynervefibres 1. myelinated Afibres (A-deltaand A-betafibres) 2.Unmyelinated C fibres
  • 12. Dentin tubule fluid movement Dehydration Heat Cold Dentinal tubule and fluid Dentin Odontoblast movement A-delta fibers
  • 14. Referred Pain referred pain. pulpal C-fibers slow conducting intense, slow, dull pain. ipsilateral Anterior teeth posterior teeth Mandibular posterior teeth
  • 15. Common Characteristics of Pulpal Pain Quality of pain An identifiable condition Response to local noxious stimulation Pulpal pain tends to get better or worse Local anesthesia