1. Dr. Shahzadi Tayyaba Hashmi
pulpitis
Dr. Shahzadi Tayyaba Hashmi

2. 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

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

4. 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

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

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

7. CLASSIFICATION
Reversible pulpitis
Irreversible pulpitis

8. 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

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

10. 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

11. 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

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

13. 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