Division of Pathological Stages of the Pulp

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Opened pulp

Baume Classification[edit edit | edit source]

Normal Pulp (sound pulp)[edit edit | edit source]

  • Positive cold test
  • Negative percussion test
  • Radiology
May show varying degrees of pulpal calcification, but no evidence of resorption, caries or mechanical pulp exposure
  • No endodontic treatment necessary


Reversible Pulpitis[edit edit | edit source]

  • Inflammatory changes of the pulp
  • Heals after filling
  • Stimulation (hot and cold test) is uncomfortable to the patient but reverses quickly after irritation
  • Upon test -> sharp, quickly reversible pain
  • No night pain !
  • CAUSES
caries
exposed dentin (mostly in cervical area)
recent dental treatment
defective restoration
  • Histopathology
Hyperemia pulpae
Pulpitis acuta serosa
  • Analgetics work
  • Caries profunda simplex or pulpam penetrans
  • Treatment
After preparation of caries, indirect pulp capping


Irreversible Pulpitis[edit edit | edit source]

  • Classification
Symptomatic
Asymptomatic --> will lead either to symptomatic or to necrotic pulp
  • Typically irreversible pulpitis occurs when symptomatic irreversible pulpitis remains unteated, thus the pulp will eventually become necrotic
  • Analgesics DOESN'T work
  • Percussion test might be positive in the end because of edema of pulp and vessels in the apex
  • Symptoms
Pain without stimulus
Sudden pain especially during supine position
Night pain
Pain fluctuates (vs periodontal pain --> stable pain!)


Pulp Necrosis and Gangrene[edit edit | edit source]

  • Pulpal blood supply nonexistent
  • Pulpal nerves are nonfunctional
  • Results from symptomatic or asymptomatic irreversible pulpitis
  • After the pulp becomes completely necrotic, the tooth will typically become asymptomatic until the time that the infection will spread to the periradicular tissues (per continuitatem spread)
  • Negative response to cold stimulation
  • Pulpal necrosis
Complete
Partial --> not all root canals of the tooth are involved


Links[edit edit | edit source]

Related Articles[edit edit | edit source]

Bibliography[edit edit | edit source]

  • OTT, Daniel. Pulpitis [lecture for subject Restorative Dentistry, specialization Endodontics, LF1 Charles university]. Prague. April 2012.