PULPITIS Inflammation of dental pulp Main source for dental pain Causes Dental caries- the most common cause Traumatic exposure to pulp # of crown Repeated dental procedure

Pathogenesis Any causes above Exposure to pulp Invasion by bacteria- Streptococus Inflammation of pulp

pathogenesis

Acute (rapid, severe onset, short duration) Types Acute (rapid, severe onset, short duration) Open – communication between pulp cavity & oral cavity) closed Chronic (slow , long duration, mild pain) Open Closed

Acute-Closed Micro organism- virulent & large no. Clinical features Early stage - Hypersensitivity to hot & cold Later more persistent Pain- sharp, severe & stabbing Sometimes not localized Tender Tooth discoloration Swelling of gum

Acute-Open Common Acute exposure with micro organisms Occurs at late stage of caries Abscess formed drain out of cavity

Clinical features Hypersensitivity hot & cold in early stage Less pain Slight tender

Chronic-closed No communication B/W pulp & oral cavity Pulp tissue destruction at the site of micro organism entry Infection remains localized for long time with remaing pulp tissue intact or destruction occurs slowly Clinical features Hypersensitivity Early stage- to hot n cold Late stage- only to hot but relieved by cold

Usually occurs on widely opened cavity Chronic-open Usually occurs on widely opened cavity Pulp is destroyed & replaced by granulation tissue & become epithelialised to form polyp PAINLESS

Pulp may not be healthy to save Diagnosis Test of healthy pulp Tapping of tooth directly Sensitivity if present indicates the spread of inflammation to surrounding tissue hot & cold sensitivity If pain persists even after stimulus removal or Pain persists spontaneously Pulp may not be healthy to save

Test of pulp- dead or alive Electric pulp tester It helps to recognize the pulp whether it’s alive or dead but not healthiness If person feels the electric charge delivered to the tooth the pulp is alive

Treatment If pulp viable just remove irritant n healed itself Removal of caries n restoration by filling If pulp dead RCT Tooth extraction antibiotic is given- penicillin in acute cases

Root canal treatment Root canal treatment is the process where the dentist removes the pulp( i.e. pulp extirpation) from an infected tooth and replaces it with dental filling

if the rct is not done,the tooth may have to be extracted Indications for RCT Dental caries : an untreated cavityis a common cause of pulp infection. the reduced blood supply also limits the pulp’s ability to heal itself Pulpitis the pulp can become damaged from trauma or facture Abscess once the pulp become infected, the infection can spread to the bone around the tooth forming abscess if the rct is not done,the tooth may have to be extracted Repeated dental procedures on tooth

Procedure First an opening is made through the occlusal area of posterior teeth and lingual surface of anterior teeth After the diseased pulp is removed, the pulp chamber & root canal is enlarged & shaped in preparation for being filled If more than one visit is needed, a temporary filling is placed in the opening of the tooth The temporary filling is removed and the pulp chamber & root canal permanent restoration is done In final step, a crown is usually placed over the tooth to restore its natural shiny apperance

all RCT procedures are done by isolating the tooth with a rubber dam to provide saliva-free environment. RCT may be done in single or multiple visits depending on complexity of the tooth X-rays are taken to determine the length of the root & to monitor the various aspects of treatment

Root files are used to clean the unhealthy pulp

Filling Temporary filling material - Zinc oxide or zinc phosphate Permanent – Gutta Percha

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