Pulpitis is an inflammation of the dental pulp due to an untreated tooth decay, injury or multiple restorations. Its main symptom is pain. Diagnosis is based on clinical findings and confirmed by radiographs. The treatment includes the removal of the caries, the restoration of the damaged tooth and occasionally a root canal treatment or extraction of the tooth.
Pulpitis may occur if
Pulpitis is an inflammation of the dental pulp due to an untreated tooth decay, injury or multiple restorations. Its main symptom is pain. Diagnosis is based on clinical findings and confirmed by radiographs. The treatment includes the removal of the caries, the restoration of the damaged tooth and occasionally a root canal treatment or extraction of the tooth. Pulpitis may occur when caries has progressed deep into the dentin A tooth requires multiple invasive procedures Violation of the lymph and blood supply to the pulp destroyed Pulpitis we called Reversible: Pulpitis begins as circumscribed inflammation and the tooth can be saved by a simple filling , Irreversible: Swelling within the rigid outer shell, through the dentin impaired blood circulation, whereby the pulp is necrotic and thus susceptible to infection. COMPLICATIONS infection-related consequences of pulpitis include apical periodontitis, the periapical abscess, phlegmon and osteomyelitis of the jaw. The spread of the maxillary teeth out can cause purulent sinusitis, meningitis, brain abscess, orbital cellulitis or cavernous sinus thrombosis. An outgoing of mandibular teeth infection can cause Ludwig’s angina, a parapharyngeal abscess, mediastinitis, pericarditis, empyema, and jugular vein thrombophlebitis. Symptoms and signs In reversible pulpitis occurs the pain when a stimulus (usually cold or sweet) is applied to the tooth. If the stimulus is removed, the pain subsides within one to two seconds. In irreversible pulpitis the pain occurs spontaneously or still keeps minutes after removal of the stimulus. A patient may find it difficult to locate the tooth from which the pain emanates and thereby confuse even upper and lower jaws (but not the left or right side of the mouth). The pain may disappear because of pulp necrosis for a few days. When the pulp necrosis is complete, the pulp does not react to heat or cold, but often to vibrations. As the infection develops and extends over the apical foramen spreads, the tooth is extremely sensitive to pressure and percussion. A periapical (dentoalveolar) abscess lifts the tooth out of its socket, and the tooth feels “high” when the patient bites. Diagnosis Clinical Investigation Sometimes X-rays of teeth Diagnosis is based on history and clinical examination, the provocative stimuli uses (application of heat, cold and / or percussion). Dentists can also use an electric pulp tester, which indicates whether the pulp is alive but not whether it is healthy. If the patient’s small electrical charge that is delivered to the tooth feels, the pulp is alive. X-rays help to clarify whether the inflammation has spread beyond the apex of the tooth out, and the exclusion of other diseases. Treatment drilling and filling with reversible pulpitis root canal treatment and crown or extraction with irreversible pulpitis antibiotics (eg. As amoxicillin) on infection In a reversible pulpitis can maintain the vitality of the pulp, if the tooth, is usually treated by caries removal and then restored , Irreversible pulpitis and its sequelae make endodontic treatment (root canal treatment) or tooth extraction required. In endodontic therapy, an opening is drilled in the tooth and the pulp removed. The root canal system is thoroughly cleaned, processed (molded) and then filled with gutta percha. After the root canal treatment, adequate healing is characterized clinically by resolution of symptoms and radiographically by bone filling in the radiolucent zone at the root tip over a period of several months. When patients systemic signs of infection have (. E.g., fever), an oral antibiotic is prescribed (500 mg amoxicillin every 8 h; in patients who are allergic to penicillin, Clindamycin 150 mg or 300 mg every 6 hours). If symptoms persist or worsen, root canal treatment is repeated usually if a root canal has been overlooked, but it should then also alternative diagnoses (eg. As temporomandibular joint disorder, occult tooth fracture, neurological disease) are considered. In very rare cases, a subcutaneous or mediastinal emphysema by use of compressed air or a dental drill in an air turbine during a root canal treatment or extraction developed. These devices can force air into the tissue around the tooth socket around which then propagates along the fascia. Diagnostic criterion for this is the acute onset of swelling of the jaw and neck area with characteristic friction rub the swollen skin on palpation. A treatment is usually not necessary, although occasionally prophylactically an antibiotic is added. Summary An pulpitis is an inflammation of the pulp due to deep cavities, trauma or extensive dental restoration. Sometimes an infection (eg. As periapical abscess, cellulitis, osteomyelitis) developed. Pulpitis may be reversible or irreversible. In a reversible pulpitis the pulp is necrotic, a cold or sweet stimuli causing pain, lasting usually 1 or 2 s, a repair only requires drilling and filling. In irreversible pulpitis the pulp is necrotic, a cold or sweet stimuli causing pain that lasts usually minutes and a root canal treatment or extraction is necessary. Pulp necrosis is a later stage of irreversible pulpitis; the pulp does not react to heat or cold, but often to shocks, and a root canal or extraction is required.