1-25. HYPERPLASTIC PULPITIS
Hyperplastic pulpitis is occasionally encountered in deciduous teeth as an
enlargement of the pulp following carious destruction of the tooth crown. It is an
unusually excessive reaction to inflammation. The exposed pulpal tissues extrude
through a communication to the oral cavity and an excessive inflammatory reaction
results. It is seen as a soft palpable mass (pulp polyp) overlying the pulp chamber,
exposed within the crown portion of the tooth. There is usually no pain associated with
1-26. DEGENERATIVE CHANGES OF THE PULP
Since the pulp of the tooth is subjected to a variety of bacterial, mechanical, or
chemical irritations, degenerative changes often occur within the pulp. Types of
degenerative changes include calcific degeneration, pulp stones, and fibrosis.
Degenerative changes seldom have any clinical significance. To a certain extent, they
are normal physiological processes. They do, however, make any future endodontic
treatment more difficult for the dental officer.
Section V. DISEASES OF THE PERIAPICAL TISSUE
After the pulp dies, the inflammatory process will frequently extend through the
apical or lateral foramina into the adjacent tissues. Among the resulting diseases are
acute periapical inflammation, periapical granuloma, radicular cyst, and periapical
abscess. Extensions of infections originating in teeth may lead to such conditions as
osteomyelitis and Ludwig's angina.
1-28. ACUTE APICAL PERIODONTITIS
Acute inflammation of the periapical tissue usually represents an extension of
acute pulpal inflammation. The periapical tissues become inflamed and the tooth is
usually very tender when used in mastication. No pathology is seen in the bone on a
radiograph. The treatment consists of either root canal therapy or extraction.
1-29. CHRONIC APICAL PERIODONTITIS
A chronic inflammatory condition may occur and cause little or no pain. It may
persist for a long time and pathology is usually seen in the bone on a radiograph. There
may also be a sinus track present in the gingiva adjacent to the tooth.