Pulpitis

Pulpitis is the inflammation of the dental pulp, so the tissue in the tooth interior. It is caused by mechanical, thermal and chemical irritation ( such as during dental treatment ), or by bacteria, penetrate into carious lesions or with cracks or fractures in the tooth. Toothache symptoms of acute pulpitis. Is the stimulus for a short time or localized, healing occurs (reversible pulpitis ). If irritation persists, the inflammation becomes chronic. It can then take place the following processes:

• Irritation dentine: on the inside of the dentin, where the dentinal tubules open bared dentin under a cavity or by wear, a thicker layer of dentin is formed.
• Blood vessel reaction: which increases blood flow, red blood cells accumulate.
• Leukozyteninfiltrat: at that point the pulp inflammatory substances are released. These provide an increased permeability of the vessel walls, causing plasma and leukocytes escape.
• Increased formation of connective tissue fibers, this is done to make the pulp impervious to stimuli.
• In the advanced stage, local microabscesses may form, and the tissue dies and is encapsulated. It can develop at the border new odontoblasts to encapsulate the process with newly formed dentin.

First, the inflammatory response is localized (partial pulpitis ). Takes to the stimulus, the inflamed pulp in the crown area ( pulp cavity ), later the process may also spread into the root canal. If bacteria in the pulp, a, increases the concentration of endotoxins, and the inflammatory process intensifies. The tissue pressure increases locally by vascular reactions. This leads to local infarction, necrosis, and finally to Microabszessbildung. As a consequence of inflamed pulp tissue adjacent local and the cycle continues. The tissue dies off (infected necrosis, historically referred to as " gangrene "). Bacterial endotoxins can get into the periodontal space, it forms an odontogenic infection at the root tip ( apical periodontitis).

The pulp may die by trauma, when torn by tooth movement of the blood vascular bundle at the root tip. At an elevated heated ( for example, by dental treatment with insufficient cooling), the pulp may even die. As long as no bacteria invade the pulp sterile ( sterile necrosis) remains. In this case, no inflammatory reaction in the Parodontalbereich at the root tip is formed.

Even to the stage of pulp necrosis, the process can be completely painless and only noticed by one check or through external action, eg biting on a stone.

In the case of irreversible pulpitis or pulp necrosis in the implementation of a root canal treatment by the dentist is mandatory.

History

Already in ancient Mesopotamia knew the pulpitis. As a so-called disease cause tooth worm was adopted.

• Disease in dentistry