Inflammation of the pulp

Hyperemia
Partial acute serous pulpitis
Total acute serous pulpitis
Partial pulpal abscess
Total pulpal abscess
 Pulpita acută
Caria simplă Pulpita acută
Hiperemia seroasă parțială
purulenta partiala
preinflamatorie Pulpita acută Pulpita acută
Seroasă totală purulenta
totală
Hyperemia
Is the only form of reversible pulpitis
If diagnosed correctly and treated at the
right moment – the pulp will recover by
restitutio ad integrum
Characterised – histological by increase
in diameter of blood vessels
 Subjective signs
PAIN
1. Moment of appearance anytime a stimulus is applied
2. Modality of appearance provoked
3. Localised yes
4. Irradiating no
5. Provoking factors cold, (sweet, hot)
6. Factors that release the pain – removal of the stimulus
7. Intensity high
8. Character sharp, dull
9. Duration a few seconds- minutes after the removal of the
stimulus
10.Frequence - every time the provoking factor is applied
11.Association with vegetative manifestations - no
 Clinical examination
Deep carious lesion without opening of the pulp chamber
Amalgam restoration
Tooth prepared for a crown
Periodontal curettage, scaling +root planning

Palpation – sharp pain

Negative

Positive and intense response at cold stimuli

Response is occurring sooner and the pain
is lasting longer
Which should be preferred to the electrical one
Treatment:
Carious lesion: indirect pulp capping
direct pulp capping
final restoration
Hipersensitivity: varnishes in the cervical
or exposed areas
Acute Partial Serous Pulpitis
Inflammation – located in the coronal part
of the tooth
Vasodilatation is more important
Serous exudate occurs
Increased pressure in the pulp tissue
Compression of the pulp structures
 Subjective signs
PAIN
1. Moment of appearance if spontaneous AT NIGHT
2. Modality of appearance provoked, later - spontaneous
3. Localised yes
4. Irradiating no
5. Provoking factors cold
6. Factors that release the pain – warm
7. Intensity extremly high
8. Character sharp, dull
9. Duration a few HOURS after the removal of the stimulus
10.Frequence - IN CRISES
11.Association with vegetative manifestations - no
 Clinical examination
Deep carious lesion
The base of the cavity – high amount of wet, infected dentine

Palpation – sharp pain

Negative

Positive at lower intensities than normal

Pulp is in a state of hiperexcitability
Rx – no changes
Treatment
Vital pulpectomy = root canal treatment
Not vital pulpectomy = root canal
teratment
 Total acute serous pulpitis
Extended to both – coronal and radicular
pulp
Pressure is higher in the pulp tissue
Exudate increased in volume
 Subjective signs
PAIN
1. Moment of appearance especially during the night
2. Modality of appearance spontaneous
3. Localised NO
4. Irradiating IN THE HEMIARCH OR THE OPPOSED
ARCH
5. Provoking factors -
6. Factors that release the pain – NONE
7. Intensity VIOLENT
8. Character sharp
9. Duration PERMANENT
10.Frequence - FIRST IN CRISES THAN CONTINUOUS
11.Association with vegetative manifestations - no
 Clinical examination
Deep carious lesion
The base of the cavity – thin layer of infected dentine

Exploration of the deep areas of the cavity => lead to

the opening of the pulp chamber followed by a
violent pain, and the occurrence of a drop of blood

POSITIVE

Hiperexcitability
Treatment
Root canal treatment
Partial pulpal abscess
The inflammatory exudate – serous +
PMN + leucocytes + bacteria = PUS
In the pulp tissue – microabscesses are
present
In this stage the coronal pulp is involved
The pulp stars to loose is structure
The pressure – increases

 Subjective signs
PAIN
1. Moment of appearance after stimulus
2. Modality of appearance provoked
3. Localised yes
4. Irradiating no
5. Provoking factors - HOT
6. Factors that release the pain – COLD
7. Intensity VIOLENT
8. Character PULSATING ( sinchrone with heartbets)
9. Duration hours
10.Frequence - crises
11.Association with vegetative manifestations - no
 Clinical examination
Deep carious lesion
The base of the cavity – thin layer of infected dentine

Exploration of the deep areas of the cavity => lead to

the opening of the pulp chamber followed by a
violent pain, and the occurrence of a drop of PUS

NEGATIVE

HIPOexcitability
Treatment : vital pulpectomy
Total pulpal abscess
Microabscesses in coronal and radicular
pulp
Pressure increase by 5-6 times
Pulp losses more and more the structure
Evolution => necrosis
 Subjective signs
PAIN
1. Moment of appearance continous
2. Modality of appearance spontaneous
3. Localised NO
4. Irradiating IN THE HEMIARCH OR THE
OPPOSED ARCH
5. Provoking factors - increase by hot
6. Factors that release the pain – cold
7. Intensity VIOLENT
8. Character pulsating
9. Duration PERMANENT
10.Frequence - CONTINUOUS
11.Association with vegetative manifestations - no
 Clinical examination
Deep carious lesion
The base of the cavity – thin layer of infected dentine

Exploration of the deep areas of the cavity => lead to

the opening of the pulp chamber followed by a
violent pain, and the occurrence of a drop of PUS
Temporary release of the pain

POSITIVE

HIPOexcitability
Treatment: vital pulpectomy +
root canal dressing until the second appointment
PAIN Hyper PASP TASP PAPP TAPP
emia

HOMEWORK
By using this template please create your own sheet in Word or Excell,
print it, fill it with the correct answers in handwriting, write your name and group
and deliver it to your group assistant or Friday at the lecture.