PULPAL RESPONSE TO PULP CAPPING AGENTS  (VITAL PULP THERAPY): Anticipating Pulpal Reaction To Dental Materials: 1] ability of the dental material to stimulate tissue repair; 2] ability of the dental material to seal the interface between the tooth preparation and the restoration; 3] role of microbes in pulpal disease (from caries, oral environment) à maintenance […]

Inflammation in Response to Mechanical, Thermal & Chemical Insults

lnflammation in Response to Mechanical, Thermal & Chemical Insults (Pulp Protection During & After Tooth Restoration) Source of Pulp Damage before, during, and after restoration: As caries advances through dentin, bacteria or their metabolic by-products lead to pulp damage and/or death; Immediately after tooth restoration, the trauma directly related to the preparation and placement of a […]

Materials Used in Pulp Protection

Varnishes and other surface treatments – (a) Varnishes: Properties Very low viscosity containing a relatively large proportion by volume of a volatile solvent Purpose of use For application to dentine in order to decrease permeability Disadvantages ®  Because of the high proportion of solvent, and subsequently the large volume reduction on drying, the ultimate film […]

Differential Diagnosis of Pulpitis

Differential Diagnosis (Reversible vs. Irreversible Pulpitis): (1) Case history: The chief complaint & history of present illness provides valuable information in diagnosing the pulpal condition, even before performing the oral examination. (2) “Pulp Sensibility” Tests: They include thermal (cold, heat) and electric pulp tests (EPT). The term “pulp vitality” is a misnomer. These tests reproduce […]


Inflammation is a series of events that occur in vascular connective tissue (pulp), with the aim to neutralize or eliminate the damaging factors and to initiate tissue repair. In short, it is the host response to injury. Early changes include: fibrosis and thickening of basement membrane of small blood vessels of pulp. Repair is observed […]

Dentin Defenses: Reparative Dentin

Dentin Defenses: Dentinal tubules are a potential pathway for the diffusion of noxious chemicals or microorganisms to the pulp. The dentin has a limited capacity for its own defense – by the complete or partial closure (obliteration) of the tubules via the following processes: Defense Process Definition Source Mechanism Dentinal Sclerosis   Histologically, sclerosed dentin […]

Sources of “Insults” to the Pulp

Insults Reason For Pulpal Damage Dental caries Microbial invasion and host inflammatory response to microbes and their byproducts. Microleakage in restored teeth The presence of a gap between the tooth and restoration leads to bacterial entry and resultant pulpal inflammation. Trauma (Mechanical trauma; With intact tooth structure) This is associated with luxation / avulsion injuries. […]


  CLINICAL CONDITION HISTOLOGICAL PICTURE Hypersensitive exposed dentin Elevated number of nerve fibers in underlying pulp and dentin (“nerve sprouting” occurs in response to inflammatory stimuli). Silent Pulpitis Fibrotic changes in pulp forms a barrier between the lesion & the nerve fibers. Co-existence of vital pulp & periapical lesions May be caused by CGRP nerve […]


  SENSORY NERVE TYPE FEATURES Nerve endings of myelinated A-delta fibers ·     Involved in sharp pain sensations. ·     Most sensitive to stimuli that cause movement of dentinal fluid à “hydrodynamic stimuli”. ·     It is still unknown whether these receptors are present in dentin, predentin, odonbtoblastic layer, pulp, or a combination of these sites. C-fibers ·     […]

Dental Pulp

Contents Introduction Sensory nerves of the pulp Correlation between Clinical symptoms (pain) & Pulp neurobiology Pulpal response to injury & disease Sources of “insults” Dentin Defenses Pulpal inflammation in response to bacteria Types of Pulpal Inflammation (pulpitis) Clinical & Histological Features of Pulpitis Differential Diagnosis of Pulpitis Pulpal Inflammation in Response to Mechanical, Thermal and […]