Acute pulpitis. Etiology and treatment

Abstract

Introduction. Dental pulp inflammation (pulpitis) represents a totality of functional and structural biochemical reactions and processes, having an adaptive, compensatory and restorative character and evolving in a succession of phases due to the pathogen action. All acute and chronic diseases of the pulp and periodontium are the cause of the formation of odontogenic inflammatory processes, which cause pain and serve as foci of infection, either exacerbating or triggering general or systemic illnesses. Dental pulp diseases are treated in a well-established order, taking into account all the aspects, such as etiology, epidemiology, prophylaxis, diagnosis and treatment. The success in pulp diseases depends on the ability to choose the optimal methods and techniques for each type of diagnosis and clinical picture. In the case of non-qualitative endodontic treatment, the organism sensitization occurs and in some cases complications develop, such as: massive destruction of bone tissue, which can trigger septicemia, meningitis, sinus thrombosis, endocarditis, mediastinitis etc. It is unacceptable to have bad or superficial knowledge of topographic anatomy of teeth, by the endodontist. It is also worth noting that besides the knowledge of endodontic instruments and materials, it is of great importance to know the techniques of mechanical and medicated preparation as well as the root canal filling. Aim of the study. To determine the most rational and effective methods of treatment of acute pulpitis. Materials and methods. Ten patients (4 women and 6 men) aged 19-40 years (10 teeth - 1 canine, 5 premolars and 4 molars) were subjected to complex examination and treatment. Following the clinical and paraclinical examination, 4 patients with acute diffuse pulpitis and 6 patients with acute focal pulpitis were diagnosed. In the treatment we applied the direct capping method, vital pulp amputation and extirpation in acute focal pulpitis and the method of vital pulp extirpation in diffuse acute pulpitis. Results. Of all the cases with the diagnosis of acute focal pulpitis, the relapse was observed only in patients who were treated by the direct capping method (2 patients). In the case of the other patients, both acute focal pulpitis and acute diffuse pulpitis were treated by surgical methods (vital pulp amputation and extirpation), positive results being obtained, without relapses or complications. Conclusions. The method of vital pulp amputation and extirpation resulted in a higher efficiency of the treatment of acute pulpitis, compared to the conservative method.