Dr. Shahzadi Tayyaba Hashmi pulpitis Dr. Shahzadi Tayyaba Hashmi

INTRODUCTON Pulpitis is the most common cause of dental pain and loss of teeth in younger persons The usual cause is caries penetrating the dentine, but there are other possibilities Pulpitis if untreated, is followed by the death of pulp and spread of infection through the apical foramina into the Periapical tissues

DEFINITION An inflammation of the pulpal tissue that may be acute or chronic, with or without symptoms, and reversible or irreversible

CAUSES OF PULPITIS Dental caries is the most common cause of pulpitis Trauma or injury that may open the pulp chamber & let bacteria enters Mechanical trauma e.g. exposure during operative procedures allowing bacteria enter the pulp or scaling that lead to pulp exposure Chemical sources e.g. teeth with gingival rescission & pulp exposure to acids

CAUSES OF PULPITIS A)Bacterial: C) Iatrogenic: B)Traumatic: Dental caries 1. pulp exposure Cracks in crown 2. filling materials Periodontal pockets Malformed teeth B)Traumatic: Crown fracture Root fracture Abrasion Bruxism

PATHOGENESIS Any cause of the above Exposure of the pulp Invasion by bacteria Pulpitis

CLASSIFICATION Reversible pulpitis Irreversible pulpitis

REVERSIBLE PULPITIS Reversible pulpitis is a transient condition The diagnosis of reversible pulpitis implies that the pulp is capable of full recovery if the irritating factors subside or are removed Pain quality: Pain is usually sharp and intense Duration: Short duration (pain remains for 5-10 minutes). Quickly subsides after removal of the stimuli Stimuli : reaction to hot, cold or sweet with immediate onset Body position: Unaffected by changes in the position of the body

TREATMENT : remove any caries present, and place suitable pulp protection & then permanent restorations placed

IRREVERSIBLE PULPITIS Usually occurs as a result of more severe insults of one of the causes Typically, it may develop as a progression from a reversible state. Symptoms: Pain quality: throbbing pain Duration: spontaneous pain which may lasts from minutes to hours Body position: affected by body position Site & radiation: In the latter stages the periodontal ligament becomes involved & the pain will be localized

Irreversible pulpitis Stimuli:. On the early stage –pain may develop spontaneously or from hot or cold stimuli Late stage – only to hot but relived by cold Timing: the pain worsen at night

Treatment: Involves either root canal therapy or extraction of the tooth

Comparison of pain symptoms in reversible and irreversible pulpitis REVERSIBLE PULPITIS IRREVERSIBLE PULPITIS Elicited Spontaneous Sharp Dull Less than 20 minutes duration More than 20 minutes duration Unaffected by body position Affected by body position Easily localized Often difficult to localize Do not referred to nearby location radiate to nearby location such as l lateral aspect of face or other teeth in the arch