Lecture on Reversible Pulpitis

Overview

• Focus on reversible pulpitis, a type of inflammation of the dental pulp.
• Discusses classification, causes, symptoms, diagnosis, histopathology, and treatment.

Classification of Pulpitis

• Reversible vs Irreversible:
  • Reversible: mild to moderate inflammation of the pulp, can return to normal if treated.
  • Irreversible: severe inflammation, requires root canal treatment.
• Symptomatic vs Asymptomatic:
  • Symptomatic: acute pulpitis.
  • Asymptomatic: chronic pulpitis.
• Other classifications: partial/total, infected/sterile.

Pathway of Dental Pulp Disease

• Begins with reversible pulpitis due to noxious stimuli (e.g., caries).
• If untreated, leads to irreversible pulpitis and potentially pulp necrosis.
• Other conditions include calcific degeneration and traumatic injury-induced ischemia leading to necrosis.

Reversible Pulpitis

• Definition: Mild to moderate inflammatory condition; pulp can return to uninflamed state after stimulus removal.
• Causes:
  • Trauma (sports, accidents).
  • Thermal shock (cavity preparation).
  • Excessive dehydration/irritation of exposed dentine.
  • Galvanic shock (dissimilar metals in fillings).
  • Chemical stimuli (sweet, sour, hot, cold foods).
  • Commonly caused by caries limited to enamel and dentine.

Symptoms

• Characterized by short, sharp pain lasting for a moment.
• Pain specific to stimuli (e.g., cold, sweet, sour, etc.).
• Pain relieved when stimulus is removed.
• Not spontaneous; does not continue after stimulus is removed.

Diagnosis

• Symptoms Study: Short, sharp pain; pain ceases with removal of irritant.
• Visual Examination: Check for caries, traumatic occlusion, or fractures.
• Radiographs: Normal PDL and lamina dura.
• Percussion Test: Negative response indicates reversible pulpitis.
• Vitality Test: Cold stimuli and electric pulp tester used.

Histopathology

• Ranges from hyperemia to mild/moderate inflammatory changes.
• Shows increased blood volume, tissue edema, white cell infiltration, and reparative dentine formation.

Treatment

• Prevention: Regular dental check-ups to avoid caries development.
• Early Intervention: Prompt filling of cavities.
• Desensitization: For gingival recession areas.
• Cavity Varnish/Base: Use before main filling.
• Proper Care During Procedures: Avoid injury during cavity preparation.
• Remove noxious stimuli to restore pulp health.
• Outcome: Favorable prognosis if treated early.

Conclusion

• Favorable prognosis for reversible pulpitis if treated promptly.
• Untreated cases can progress to irreversible pulpitis requiring more extensive treatment like root canal.
• Next session will cover irreversible pulpitis.