Heidi Emmerling, RDH, PhDDHYG 138 Oral Pathology

Fall 2009

Pulpitis (P 63 Syll)

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 2

General InformationIrritants:

Microorganisms

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 3

General InformationIrritants:

MicroorganismsTrauma

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 4

General InformationIrritants:

MicroorganismsTraumaIatrogenic Dentistry

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 5

General InformationIrritants:

MicroorganismsTraumaIatrogenicChemical

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 6

General InformationIrritants:

MicroorganismsTraumaIatrogenicChemicalSystemic Disorders

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 7

General InformationIrritants:

MicroorganismsTraumaIatrogenicChemicalSystemic Disorders

Diabetes

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 8

General InformationIrritants:

MicroorganismsTraumaIatrogenicChemicalSystemic Disorders

DiabetesSickle Cell Anemia

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 9

Hyperemia SymptomsPain (Temp and

Sweet/Sour)Usually sharp pain

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 10

Hyperemia SymptomsPain (Temp and

Sweet/Sour)X-Rays (Normal

w/poss caries)

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 11

Hyperemia SymptomsPain (Temp and

Sweet/Sour)X-Rays (Normal w/poss

cariesVitality Test (Readings

Lower than Normal)

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 12

Hyperemia SymptomsPain (Temp and

Sweet/Sour)X-Rays (Normal w/poss

cariesVitality Test (Readings

Lower than Normal)Pain after irritant is

removed?

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 13

Hyperemia SymptomsPain (Temp and

Sweet/Sour)X-Rays (Normal w/poss

cariesVitality Test (Readings

Lower than Normal)Pain after irritant is

removed? It’s Ser(i)ous

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 14

Acute Serous PulpitisSame as Hyperemia except more…

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 15

Acute Serous PulpitisSame as Hyperemia except more

Severe

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 16

Acute Serous PulpitisSame as Hyperemia except more

SevereProlonged

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 17

Acute Supportive Pulpitis

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 18

Acute Supportive PulpitisPP= PM PainUsually more of a dull ache than Serous

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 19

Acute Supportive PulpitisX-Rays

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 20

Acute Supportive PulpitisX-Rays

Everything Appears Normal (Caries)

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 21

Vitality Tests ComparisonSupportive SerousPercussionEPT Ice Heat

PercussionEPTIce Heat

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 22

Vitality Tests Comparison P 65 Syll)

Supporative SerousPercussion Tender Percussion Tender

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 23

Vitality Tests ComparisonSupporative SerousPercussion TenderEPT Exaggerated or

No Response

Percussion TenderEPT Exaggerated

(low number)

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 24

Vitality Tests ComparisonSupporative SerousPercussion TenderEPT Exaggerated or

No ResponseIce Relieves Pain

Percussion TenderEPT Exaggerated

(low number)Ice: Quick Pain

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 25

Vitality Tests ComparisonSupportive SerousPercussion TenderEPT Exaggerated or

No ResponseIce Relieves PainHeat Increases Pain

Percussion TenderEPT Exaggerated

(low number)Ice: Quick Pain Heat: No Response

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 26

Chronic PulpitisSymptoms:

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 27

Chronic PulpitisSymptoms:

Usually asymptomatic w/occasional sharp pain

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 28

Chronic PulpitisX-Rays:

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 29

Chronic PulpitisX-Rays:

Either Negative or Radiolucency at Apex, Depending on Stage of Pulpitis

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 30

Chronic PulpitisVitality Tests

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 31

Chronic PulpitisVitality Tests

Usually Negative

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 32

Chronic PulpitisTreatment

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 33

Chronic PulpitisTreatment

RCT

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 34

Pulp Stones

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 35

Pulp Polyp

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 36

Sequelea to PulpitisPeriapical Abscess

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 37

Sequelea to PulpitisPeriapical AbscessPeriapical Granuloma

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 38

Sequelea to PulpitisPeriapical AbscessPeriapical GranulomaRadicular Cyst

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 39

Sequelea to PulpitisPeriapical AbscessPeriapical GranulomaRadicular CystTooth Resorption (P 67 Syll)

External (Outside)

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 40

Sequelea to PulpitisPeriapical AbscessPeriapical GranulomaRadicular CystTooth Resorption (P 67 Syll)

External (Outside)Internal (Inside)

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 41

Sequelea to PulpitisPeriapical AbscessPeriapical GranulomaRadicular CystTooth Resorption (P 67

Syll)Condensing Osteitis

Fall 2009DHYG 138 Oral Path Heidi Emmerling, RDH, PhD 42