PULPAL RESPONSE TO PULP CAPPING AGENTS 

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 of asepsis; 4] Read More…

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 pRead More…

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 is reRead More…

TYPE OF PULPAL INFLAMMATION

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 as: calcific foci associated with an amorphous, partiaRead More…

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 appears as Read More…

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. TRead More…

CORRELATION BETWEEN CLINICAL PAIN & PULP NEUROBIOLOGY

  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 sprRead More…

SENSORY NERVES OF THE PULP

  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
Read More…

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 DiffRead More…