z牙髓病和根尖周病.pptVIP

牙髓病和根尖周病 参考书目 Endodontics Ingle （the 5th edition） Pathway of the Pulp Stephen Cohen （the 8th edition） Dental Pulp Selzer and Bender （the 2th edition） Clinical classification、symptomsand diagnosis of pulpal disease Classification Diagnostic procedures Classification of pulpal disease Histologic diagnosis Clinical diagnosis Histologic diagnosis Histologic examination Removing the pulp Impossible and unrealistic Lack of correlation between clinical signs and symptoms and the actual histologic status of the pulp Clinical classification Based on the patient’s symptoms and the results of clinical tests Describe the extent of pulpal disease Help the clinicians to selecting the correct treatment methods Reversible pulpitis (Hyperemia) not a disease, but a symptom pulp state: vasodilator/hyperaemia asymptomatic thermal stimuli (usually cold) quick, harp, hypersensitive response subsides as soon as the stimulus removed Reversible pulpitis Irritants caries periodontal scaling root planing microleakage unbased restorations Reversible pulpitis Prognosis irritant removed further appropriately treated —pulp will revert to an asymptomatic uninflamed state irritant remains —symtoms pesist /more widespread —irreversible pulpitis Reversible pulpitis Distinguished from irreversible pulpitis --- thermal test reversible pulpitis momentary, painful response subsides as soon as the stimulus removed irreversible pulpitis painful, linger after the stimulus removed Reversible pulpitis Distinguished from irreversible pulpitis ---complaint of spontaneous (unprovoked) pain reversible pulpitis no! irreversible pulpitis yes! Irreversible pulpitis Acute pulpitis Chronic pulpitis chronic pulpitis with a closed pulp chamber chronic ulcered pulpitis hyperplastic pulpitis residual pulpitis retrograde pulpitis