Endodontics

Overview pulp disease refers to pulp tissue disease, including pulpitis, pulp and pulp necrosis degeneration. As pulp tissue in the teeth hard tissue enveloping, only through the apical, lateral root canal Vice contact with the outside world. Pulp acute inflammation, vascular congestion, exudation accumulate, leading to increased pressure within the medullary cavity, nerve compression, be inflammatory exudation pain stimuli so very dramatic. Cause pathogenesis one. Microbial infections of bacteria pulp is the most important disease risk factors, its bacteria is mainly facultative anaerobic bacteria and the anaerobic bacteria, and as Streptococcus, actinomycosis, such as Lactobacillus. Bacterial infection ways : (a) the defect tooth infection, such as deep caries, dental trauma, Severe tooth wear and other serious defects, bacteria and toxins through the dentinal tubules or wear myeloid point penetrated pulp. (2) by periodontal infections, bacteria and toxins after periodontal pocket, apical, lateral vice invasive root canal and pulp. (3) the source of blood infections, bacteria and toxins through blood and penetrated pulp is very rare, but not impossible. 2. Chemical stimulation (1) Drug stimulate hole after disinfection system administration, such as phenols can be stimulated to pulp. (2) filling material directly stimulate the deep holes with ZP deductible, composite resin filling costs may directly stimulate acting as a neutralizer to remove. 3. Physical stimulation (1) thermal stimulation system to use when the hole gas turbine cooling water must, otherwise lead to congestive pulp. hemorrhage caused inflammation. (2) Current stimulate the mouth if two different metals were restored contact, through saliva may have potential difference. right pulp a modest boost. (3) changes in the air pressure in high-altitude aircraft or Sham snorkelers, the pressure could lead to changes pulp acute lesions. (4) if the trauma can lead to diabetes and other degenerative pulp, tumor can affect the pulp and blood-borne infection in the pulp disease rarely see. A clinical performance. Acute inflammation (acute pulpitis) for the more traumatic, dramatic performance of spontaneous pain, Features are as follows : ① regular sudden onset of pain, early intermittent were generally lasted a few minutes, followed by several hours of intermittent period, patient can still refers to the teeth. As the illness progressed, the attack extend intermittently shortened, a gradual change of continuing pain, and three along the ipsilateral neural diffuse distribution (as teeth to the neck, ears, malar cheek; Under teeth to the ear, the ears, Submandibular diffuse), often not clear that the teeth were. ② pain often at night than drama, especially when posted. ③ early cold and hot stimulation may trigger or exacerbate pain, pain with cold stimulate more obvious; Suppurative or later, the thermal pain stimulus, Cold stimulus alone can temporarily alleviate the pain. Patients often late with cold water, cold air or smoke to relieve pain, such symptoms for the diagnosis of definite help. ④ checks often can be seen wearing teeth pulp, and exploring obvious pain. 2. Chronic pulpitis (Chronic pulpitis) such as dental caries is the most chronic degenerative conditions, the pulp is the long-term sustainability of stimuli that will enable pulp chronic inflammatory process. Chronic pulpitis in the development process, such as polymorphonuclear leukocytes increased, the release of lysosomal enzymes also increased, so inflammatory intensified, there can be clinically acute symptoms. Chronic injury teeth, periodontal disease, dentin chemical stimulation can make pulp showed chronic inflammation process. Chronic pulpitis clinically divided into three categories : chronic atresia Pulpitis, chronic open pulpitis and chronic proliferative pulpitis. Chronic open pulpitis also called chronic ulcer pulpitis. Chronic hyperplastic polyp pulpitis also known as pulp. Chronic pulpitis diagnosis : ① chronic irritation pain, X-rays showed a sharp membrane cavity weeks has been widened, hard plates damaged; ② a history of spontaneous pain; ③ probing have to wear pulp, bleeding, pain; ④ a deep caries or deep blind bag or serious chronic tooth injury. Attention to the pulp and gingival nipple polyp growth into the neighborhood by occlusal surface inside, and pulp bottom with a long polyp identification. Otherwise, the consequences will be serious. Initial treatment of chronic pulpitis use indirect pulp capping. Other cases of chronic pulpitis teeth after using Mummification, the former is used to dental pulp with. Young people in particular root development has not yet completed the permanent use pulpotomy. Acute exacerbation of chronic pulpitis when first emergency treatment, is under local anesthesia pulp drainage, painkillers and other drugs. To ease the pain, teeth after using Mummification, anterior used pulpectomy, retrograde pulpitis used to myeloid Combined with periodontal treatment.