INTRODUCTION Pulp is an extremely sensitive tissue that can only elicit pain.

It can be subjected to many irritations resulting from dental caries, exposure to excessive heat or cold, and mechanical, chemical, or electrical stimulation. In a healthy tooth, the enamel and periodontal tissues act as mechanical and insulating coverings. If the enamel or cemental tissues covering the root are damaged or removed, the underlying dentin is exposed. The dentin then becomes sensitive to external irritants because of the movement of fluid in and out of the dentinal tubules. This fluid movement causes stimulation of the sensitive pain receptors inside the dentin pulp. Injuries such as dental caries, trauma, developmental defects and/or diseases, or dentistogenic (dentist-caused) injuries can have a negative effect on the pulp. Among the diseases that occur in the pulp are acute pulpitis, chronic pulpitis, pulp abscesses, hyperplastic pulpitis, and a number of degenerative changes (diseases) that take place. Acute and ch ronic pulpitis and pulp abscesses are commonly encountered in clinical dental practice.

it may be accompanied by fever. ACUTE PULPITIS Acute inflammatory changes in the pulp are often caused by bacteria that have gained access to the exposed pulp.PULP HYPERAEMIA This form represents the first stage of pulp inflammation and can be considered reversible. CHRONIC PULPITIS Chronic pulpitis may be the result of persistent mild to moderate irritation of the pulp or it may follow a period of acute pulpitis. Pulp hyperaemia is characterised by the destruction of od ontoblasts and the invasion of the subodontoblastic region by lymphocytes and plasma cells. as well as dilation of arteries and arterioles with a clearly increased flow velocity of the blood. Chronic pulpitis may also develop into an acute infection . severe pulsating pain is caused by the rapid build up of pressure within the tooth. Chronic pulpitis may either resolve itself or continue with slow destruction of the entire pulp. involving also the periapical tissues. Inflammation can spread to the periapical tissues and cause the tooth to loosen and be sensitive to externally applied pressure. and malaise. These changes are accompanied by symptoms which can be correspondingly severe. If the condition is severe enough. Clinically. headache. It may pass beyond the periapical tissues to involve the surrounding bone and perforate the periosteum and overlying tissues to drain either into the mouth or through the skin. it gradually may involve the entire pulp. As the inflammation progresses. . The active growth of the organisms in the environment of the pulp produces rapid destructive changes. These changes may cause an initial inflammation or a flare-up of a chronic inflammation. Release of pressure by opening into the pulp chamber brings almost immediate relie f.

. 90 % of which are necessarily anaerobic bacterial species. Those micro-organisms enter the dentine tubules to a depth of approx. Gangrene is the necrosis of the tissue due to ischemia with superimposed bacterial infection . of which the presence of virulent organisms that have reached the pulp from the mouth. It is the end result of pulpitis in which total necrosis of tissue occurs. Chronic pulpitis is usually characterized by intermittent periods of mild to moderate pain or no pain at all.e. 400 µm which means that the dentine immediately adjacent to the pulp cavity should always be considered infested by bacteria in infected necrosis. Necrosis of the pulp reported in sickle cell anaemia where there is blockage of pulp microcirculation by sickle erythrocytes. It is associated with a foul odour when opened for endodontic treatment.40% are cocci. These intermit tent periods are associated with periods of increased activity and buildup of pressure in the pulp chamber and root canals PULP NECROSIS Infected pulp necrosis is associated with the destruction of dead pulp caused by bacterial infection.either acute or chronic result in complete nec rosis of pulp tissues. The pulpitis associated with bacterial infection so the term pulp gangrene. Sometimes dry gangrene of pulp occurs i. approx. It is usually the final stage of all forms of pulpitis. Infected pulp necrosis is caused by mixed bacterial infection of up to 10 million bacteria. n onpurulent nonvital pulp due to traumatic injury or infarction. Untreated pulpitis .

the pulp is seriously exposed and there is massive infection. usually by removal of decay and the placement of a filling. or referred pain. IRREVERSIBLE PULPITIS This is the condition where the pulp is irreversibly damaged.OPEN PULPITIS In open pulpitis. This infection leads to chronic inflammation of the pulp CLOSED PULPITIS Here the apex of the pulp is closed. The pulp is still alive. notably hot. This may include a carious lesion that has not reached the pulp. water and touch. that the pulp will return to its normal. of the pulp tissue. The pulp can not recover from the insult and damage. REVERSIBLE PULPITIS This is the condition where the pulp is inflamed and is actively responding to an irritant. Symptoms associated with irreversible pulpitis may include dull aching. and sweet. decay that has reached the pulp of the tooth introduces bacteria into the pulp. For example. Symptoms include transient pain or sensitivity resulting from many stimuli. or death. cold. Clinical signs may include reduced response to electronic pulp testing and painful response to thermal stimuli. Today electronic pulp tes ters are rarely used . but the introduction of bacteria into the pulp will not allow the pulp to heal and it will ultimately result in necrosis. healthy state. This means that once the irritant is eliminated. The pulp is still considered to be vital. pain from hot or cold (though cold may actually provide relief) lingering pain after removal of a stimulus. spontaneous pain.

between 0±1. and is a fraction of the volume of voids over the total volume. GALVANIC SHOCK This is the pain produced as a result of galvanic currents caused by sim ilar or dissimilar metals in dental restorations. COROSION This is a chemical or electrochemical process through which a r estorative material is attacked by natural agents such as air. deterioration or weakening of the material. The pulp of a tooth with irreversible pulpitis may not be left alone to heal. and other similar metals as their outermost layer undergoes a chemical reaction POROSITY Porosity or void fraction is a measure of the void (i.e. brass. water or saliva resulting in partial or complete dissolution. aluminum. Instead they should only be used to test the vitality of teeth. . or as a percentage between 0±100%. The tooth may be endodontically treated whereby the pulp is removed and replaced by gutta percha.for diagnosis of the reversibility of pulpitis due to their unreliable nature.. This may be required if there is insufficient coronal tissue remaining for restoration once the root canal therapy has been completed TARNISH Tarnish is a thin layer of corrosion that forms over copper. silver. "empty") spaces in a material. An alternative is extraction of the tooth.

It occurs as a result of long term exposure to high levels of stress that are below the yield strength of the material. Creep always increases with temperature. .CREEP Creep is the tendency of a restorative material to slowly move or deform permanently under the influence of stresses. and near melting point. Creep is more severe in materials that are subjected to heat for long periods.

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