hello everyone welcome back moving towards the next part of the series of the diseases of dental pulp so in this particular video we are going to see about the reversible pulpitus so pulpit is is nothing but the inflammation of pulp now we know itis is nothing but the inflammation so inflammation of pulp is known as pulpit rest so now this pulpit is it can be classified as reversible or irreversible or it can also be classified as symptomatic where the patient are saying about the various symptoms or it can be a symptomatic pulpit so a symptomatic pulpit is it is a chronic type of pulpit so that disease it is like present in that particular patient from a very long period of time so that is nothing but the chronic pulpit is and symptomatic is acute type of pulpit is so the duration so the time duration is less in the symptomatic pulpit now this pulpit is it can also be classified as partial or total or it can be infected or sterile now over here this is the anatomic picture of your tooth so this is the enamel dentine and pulp now if the pulp so over here you can see this is the normal path so now if the normal pulp is having some noxious stimuli so that can lead to the inflammation so now over here so the example for the noxious stimuli there are many so we have seen about the causes of the diseases of dental pulp in the last part of the video so over here so for example the nox stimuli is the caries so now this carries it can lead to reversible pulpits so your normal pulp it turns into reversible is now reversible as a name says it can be reversed back to the normal pipe but now if you're not treating this reversible pulpit is so it will turn into irreversible pulpits so irreversible pulpit is where you need to go for root canal treatment now this irreversible pulpit is it can be of various scenarios so this irreversible proprieties it can be a symptomatic and it can be a symptomatic type of irreversible pulpit so the next two scenarios can be so this irreversible pulpit is can be presented as chronic hyperplastic pulpits that is nothing but your pulp polyp or it can also be like seen as internal resorption so this is the scenario now this irreversible pulpit is so if you're not treating this irreversible pulpit is also so this irreversible pulpit is it will turn into pulp necrosis in which the pulp it is necros so this is like the sequence of your purple disease so now though another symptom or another like disease of pulp it can be when the pulp is having the calcific degeneration so this can be because of the stimuli which is causing the degenerative pulpal changes so that will lead to the calcific degeneration and if the patient is having normal pulp and if there is ischemia which is induced by the traumatic injury so if the patient is having traumatic injury like fracture or anything so that can also lead directly to your pulpal necrosis so this is nothing but like a flow chart or the sequelae of the dental pulp disease so starting with the first disease that is the reversible pulpit is now in the subsequent videos we are going to see about each and every disease that we have already discussed in that flowchart so first disease now as i said there was this normal pulse so if there is any noxious stimuli so that will lead to the inflammation of the pulp and that will lead to your reversible pulpits now if you lick now as a name says reversible so it can be reversed back to the normal pulp so now if you're treating this reversible pulpit test at particular or proper time so your pulp it can get back to the normal situation so the reversible pulpit is it is defined as it is a my to moderate inflammatory condition of the pulp so now it is reversible because over here this is a mild to moderate inflammatory condition irreversible will be when it is a severe inflammatory condition in which you need to go for root canal treatment so it is caused by the noxious stimuli so over here now in this example the noxious stimuli is your careers now this carries is like limited is very limited to the enamel and somewhat to the dentine so this is nothing but a case of irreversible pulpit is now if you see this scariest lesion is going till the pulp like this so that will be nothing but your irreversible pulpit is so now this like reversible pulpit is it is caused by the noxious stimuli in which the pulp is capable of returning to the uninflamed state following the removal of the stimuli so now over here this is the stimuli that is causing the reversible pulpits now if you treat this properly so this is basically a class one so now you do the composite restoration so now what you have done is you have removed the stimuli so because of that your pulp it will return back to its normal position or normal like state so that is nothing but your reversible pulpitis now what are the causes of reversible pulpitis so the first cause can be trauma so if the patient is having trauma so this can be like because of various reason accidents during like playing sports or fight so that can lead to the disease of the pulp that will be nothing but your reversible pulpit is but now in this it is limited to the elise class one and two because now we know about the alice class one and two so one is when it is involving only the enamel and two is when it is involving enamel and dentine but now if it is three so that will be your irreversible pulpit is because now in that the pulp is involved the next cause can be a thermal shock so when you are preparing the cavity so at that time also your pulp it can be injured so that can lead to the reversible pulpits the next cause can be excessive dehydration of the cavity or irritation of the exposed dentine so if you are preparing the cavity so that can also be like you're dehydrating the cavity so if you're doing the preparation so now we know we have like the water spray when we are doing the preparation so that your like the temperature change it remains normal and your cavity it is not like excessively dehydrated because that can like injure your pulp or if there is irritation of the exposed antenna so now if there is abrasion so in that case also or there is a region so in that case you will see the dentine is exposed so because of that there is irritation to the dentine so that can lead to reversible pulpits the next cause can be placement of a fresh amalgam filling in contact with the cast restoration so now this is nothing but the galvanic shock so when you are placing two like unlike or two dissimilar like metals towards each other so that will lead to galvanic shock and that is nothing but a reason of causing reversible pulpitis the next can be the chemical stimuli such as the person is eating too sweet or too sour or when there is like cold hot like food stuff so at that time there is reversible pulpitis and the next is the most common is your kds so over here so now over here you can see this is the insertion of the deep restoration and that can lead to pulpitis so this are like the various causes of reversible pulpitis now what are the symptoms of reversible pulpit is so symptomatic reversible pulpit is it is characterized by short sharp pain which is lasting for a moment so now this is a very important point so the reversible pulpit is in this the patient will say that yes i am having pain but now this pain it will be short sharp and it is lasting only for some seconds so now this pain it is always specific to stimuli so now if the patient is saying if i am eating something too cold or if i am eating something too hot or if i am eating something too sour or sweet so that time only i'm having that pain so that pain is always specified to a stimuli so if the patient he removes the stimuli themselves so they'll say that i feel relieved when the stimulus is removed so in this the reversible pulpit is always specific to stimuli now in this pain it is instantly relieved on the removal of the stimuli as soon as you remove the stimuli whichever or whatever is causing that pulpit is so the pain it is instantly relieved so it is more often brought on by cold than hot and by cold air so basically it's like most of the patient they'll come saying that i feel pain when i'm drinking cold water so basically reversible pulpit is more oftenly brought by eating or drinking something too cold so it does not occur spontaneously and it does not continue when the cause is removed so this is the main lake symptom that it is not occurring spontaneously so if the patient say that my pain like it occurs spontaneously so that means it is a irreversible pulpit and it is not a reversible pulpit so this is the major symptom that the pain it is not spontaneous and it does not continue when you're removing the stimuli so the symptom is the pain is short sharp it is lasting only for a moment and it is specified to some stimuli and as soon as you are removing the stimuli the pain also it is instantly relieved now how are you going to diagnose the case of reversible pulpitis so it is based on the study of symptoms and the clinical test so application of cold is an excellent method of locating and diagnosis where exactly reversible pulpit is is located to licks with specific truth because now in this also we have seen in the symptoms that application of cold is the major symptom of reversible pulpit is so as soon as the patient is coming to a clinic and they say that i feel pain while i'm eating something or drinking something cold so what you can do is you can do the cold test so first like diagnosis method can be pain so now as we have seen in the symptoms that the pain is of short duration and it is seizing when the irritant is removed and it is usually caused by cold sweet sar similar and the pain it may be it may become chronic if you are not treating it properly and pain it is of short duration but it may continue for weeks or even month so the pain is basically over here it is like lasting for some seconds only and as soon as you are removing the stimulant the pain is also relieved so that is the first diagnostic method like depending on the symptom the next will be the visual examination and the history so when you are like visually examining the tooth so you can see that there can be carries or there is traumatic occlusion or some undetected fracture that the patient has gone through some traumas you are going to take proper history to ask whether they have suffered from any trauma or not the next diagnostic method can be radiographs you take the radiograph of the tooth and you see in that the pdl and the minor dura it is completely normal because in this reversible pulpit is the pulp is not involved so in this the pdl and the minor ura it will be completely normal and in other words periopical tissue is normal so periapically you won't see anything which is present so over here this is the picture like how exactly it looks so over here this is the normal pdl space and labyrinthura and there are no very radicular legion which you can see the next like diagnostic method can be you can see about the depth of caries or the restoration which may be evident showing that yes it can be reversible pulpits the next like diagnostic method is the percussion test so you are doing the percussion test you are percussing the truth and you are seeing so that percussion it will show the negative response so this is the major click thing so if there is top positive so in that case you have to see that the pulp is involved so if it is negative so in that case it is reversible pulpit is so that means the tooth is normal to percussion and palpation and they are having no mobility the next is the vitality test so you are doing the vitality test with the help of electric pulp tester so it will like the pulp it responds readily to the cold stimuli and the electric pulp tester it requires less current to cause the pain because it is reversible pulpitis so this is how you're going to diagnose the reversible pulpits so now what you will see histopathologically so the reversible pulpit is it may range from hyperemia to mild to moderate inflammatory changes which is limited to the area of the involved entire tubules so now in the definition only we have seen that reversible pulpit is it is a mild to moderate inflammatory changes which we'll see in this so it will show histopathologically it will show that there will be increased blood volume of the pulp then there will be edema of the tissue then there will be white cell infiltration because now there is inflammation so we know the first like cell of defense is your white cell so there will be more and more white cells which you will see histopathologically and there will be repetitive dentine formation so now if the stimulus is present so what are basically does as a defense mechanism so what it will do is it will lead to the formation of the repetitive dentine so histopathologically you'll see there is the formation of the reparative dentine so now how are you going to treat the reversible pulpit so the best treatment for reversible palpitas is preventing only the reversible pulpits so prevention is now we know prevention is better that cure so what you can do is you can keep the patient on periodic follow-up so you can do the periodic care to prevent only the development of kds so you can ask the patient to visit the dentist every three to six months so that you are not developing only the carries in that patient so that is nothing but prevention of it so if now for example if the care is it has developed so what you can do is you can do the early insertion of the filling if the cavity has developed so basically over here so this is the class one cavity so what you can do is you can do the preparation and the filling of it as early as possible the next treatment like the prevention modality can be the desensitization of the neck of the teeth where the gingival recession is there now over you can see there is enjoyable recession so now in gingival recession we know there is sensitivity because of the root exposure so what you can do is you can desensitize that area the next modality can be you can use cavity varnish or the cement base before inserting the main filling material so you can place the base or liner before placing your main material that can be your amalgam or composite the next is taking care properly when you're doing the cavity preparation and polishing so whenever you're doing the polishing and the preparation of the cavity so that time you should take proper care so that you are not causing any injury to the pulp so these are the various recommended methods to prevent pulpits the next is removal of the noxious stimulant will usually bring back the pulp to its healthy state so as soon as you're removing the noxious stimulant your pump it will go back to its normal state that can be cold sweet sar so now in this once the symptoms it has subsided so pulp vitality it is done to see that the pulp necrosis it hasn't occurred so now if you see that the symptoms are not there so if the patient say no i'm not feeling pain but still you need to do the pulp vitality just to check whether pulp necrosis is present or not the next is when the pain it does not subside even after removal of stimuli so that means it is a irreversible pulpit case and you are going to start with your root canal treatment that is nothing but the pulp extraction is to be done so this is the treatment of the reversible pulpit test so basic treatment is preventing it and if the care is it has occurred so in that case you are going to treat it as early as possible so the prognosis is favorable because now it is a reversible pulpit in which the pulp it will go back to its healthy state when the stimulus is removed but now it is like limited when you are doing it as early as possible but if you don't like diagnose it properly or if the patient is on not coming on time so that will develop into irreversible pulpitis which is when you need to go for your root canal treatment so the prognosis is favorable in the case of reversible pulpits so that was all about reversible pulpiters that you should know and how you should diagnose and like treat it properly now in the next video we are going to see about the irreversible pulpit is and so on so this was all about it i hope you found this video helpful thank you so much