Acute exacerbation of chronic pulpitis:
a- Reversible pulpitis.
C- Acute periodontitis. ***
D- Acute exacerbation of chronic pulpitis.
Definition:
is a mild to moderate inflammatory condition of the pulp caused by noxious stimuli in which the pulp is able to return to a non-inflammatory state after the stimulus is removed.
Histopathology:
It can vary from hyperemia to mild to moderate inflammatory changes limited to the area of the involved dentinal tubules, as in dentinal caries.
Reparative dentin, disruption of the odontoblastic layer, dilated vessels, extravasation of edematous fluid, and the presence of chronic inflammatory immunocompetent cells are seen, even though acute inflammation cells may be present.
Etiology:
Any agent capable of damaging the pulp. Some circulatory changes such as those associated with menstruation or pregnancy, common cold or sinusitis. The same irritant can cause hyperemia in one pulp and secondary dentin in another.
Symptoms:
A sharp pain that lasts a moment is characteristic.
More frequent with cold food or drinks than with hot and cold air. It is not spontaneous and does not continue when the cause is removed.
The clinical difference with non-reversible pulpitis is quantitative.
Diagnostic signs:
Acute pain lasting seconds and disappears when the stimulus is removed. Cold, sweet or bitter cause pain, which can become chronic.
He reacts normally to percussion, palpation, mobility, the periapical tissues are normal on radiographic examination.
Differential Diagnosis:
The pain is usually transient, lasting seconds, whereas in irreversible pulpitis it can last several minutes or more.
Treatment:
The best treatment is prevention.
When it is already present, removal of the noxious stimulus and a sedative cure are usually sufficient.
Once symptoms have resolved, the tooth needs to be tested for vitality to rule out necrosis.
If the pain persists, the pulpal inflammation should be considered irreversible.
Labels
Endodontics