Division of Pathological Stages of the Pulp
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Baume Classification[edit | edit source]
Normal Pulp (sound pulp)[edit | edit source]
- Positive cold test
- Negative percussion test
- Radiology
- May show varying degrees of pulpal calcification, but no evidence of resorption, caries or mechanical pulp exposure
- No endodontic treatment necessary
Reversible Pulpitis[edit | edit source]
- Inflammatory changes of the pulp
- Heals after filling
- Stimulation (hot and cold test) is uncomfortable to the patient but reverses quickly after irritation
- Upon test -> sharp, quickly reversible pain
- No night pain !
- CAUSES
- caries
- exposed dentin (mostly in cervical area)
- recent dental treatment
- defective restoration
- Histopathology
- Hyperemia pulpae
- Pulpitis acuta serosa
- Analgetics work
- Caries profunda simplex or pulpam penetrans
- Treatment
- After preparation of caries, indirect pulp capping
Irreversible Pulpitis[edit | edit source]
- Classification
- Symptomatic
- Asymptomatic --> will lead either to symptomatic or to necrotic pulp
- Typically irreversible pulpitis occurs when symptomatic irreversible pulpitis remains unteated, thus the pulp will eventually become necrotic
- Analgesics DOESN'T work
- Percussion test might be positive in the end because of edema of pulp and vessels in the apex
- Symptoms
- Pain without stimulus
- Sudden pain especially during supine position
- Night pain
- Pain fluctuates (vs periodontal pain --> stable pain!)
Pulp Necrosis and Gangrene[edit | edit source]
- Pulpal blood supply nonexistent
- Pulpal nerves are nonfunctional
- Results from symptomatic or asymptomatic irreversible pulpitis
- After the pulp becomes completely necrotic, the tooth will typically become asymptomatic until the time that the infection will spread to the periradicular tissues (per continuitatem spread)
- Negative response to cold stimulation
- Pulpal necrosis
- Complete
- Partial --> not all root canals of the tooth are involved
Links[edit | edit source]
Related Articles[edit | edit source]
Bibliography[edit | edit source]
- OTT, Daniel. Pulpitis [lecture for subject Restorative Dentistry, specialization Endodontics, LF1 Charles university]. Prague. April 2012.
