Scientific Online Resource System

Варненски медицински форум (Varna Medical Forum)

Irreversible Pulpitis Of Primary Teeth

Dobrinka Mitkova Damyanova


Acute inflammation of the pulp starts with the slowing of blood flow in the area of irritation with the presence of agglutination of red blood cells - erythrocytes in the middle of the blood vessels and accumulation of polymorphonuclear leukocytes. Under the action of chemotaxic factors, the leukocytes move to the inflammation site. In disintegration, leukocytes select proteolytic enzymes in large quantities, resulting in areas of purulent exudate occurring in the pulp. Other bioactive aggressive substances in the inflammation act and as a result, the permeability of the vessels also increases. This is the mechanism via which the cells leave the blood circulation and the plasma and move from the bloodstream into the pulp tissue. The process described predetermines the development of inflammation, irritation of nerve endings and causes spontaneous pain.


irreversible pulpitis, pulpal inflammation, primary teeth

Full Text


Bjørndal L, Mjör IA. Pulp-dentin biology in restorative dentistry. Part 4: Dental Caries – Characteristics of Lesions and Pulpal Reactions. Quint Int. 2001;32:717–736.

BJØRNDAL LARS. Dentin and pulp reactions to caries and operative treatment:biological variables affecting treatment outcome. ENDODONTIC TOPICS. 2002; 2:1601-1538.

Bjørndal L, Darvann T. A light microscopic study of odontoblastic and non-odontoblastic cells involved in the tertiary dentinogenesis in well-defined cavitated carious lesions. Caries Res. 1999; 33: 50–60.

Bjørndal L. Buonocore memorial lecture. Dentin Caries: Progression and clinical management. Operative Dentistry. 2002; 27: 211–217, in press.

Black GV. A Work on Operative Dentistry in Two Volumes, Vol. II. The Technical Procedures in Filling Teeth, 2nd edn. Chicago: Medico-Dental Publishing Co, 1908.21

Hasselgren G. Treatment of the exposed dentin-pulp complex. In: Ørstavik, D, Pitt Ford, TR, eds. Essential Endodontology. Prevention and Treatment of Apical Periodontitis. Oxford: Blackwell Science 1998, pp. 192–210.

Kerkhove Jr BC, Herman SC, Klein AI, McDonald RE. A clinical and television densitometric evaluation of the indirect pulp capping technique. J Dent Child. 1967; 34:192–201.

King JB, Crawford BA, Lindahl RY. Indirect pulp capping: a bacteriologic study of deep carious dentine in human teeth. Oral Surg Oral Med Oral Pathol. 1965;20:663–671.

Bjørndal L, Darvann T, Bro-Nielsen M, Larsen R, Thylstrup A. An automated image analysis applied to the odontoblast-predentine region in undemineralized tooth sections in permanent third molars. Arch Oral Biol. 1997;42:329–332.

Bjørndal L, Darvann T, Lussi A. A computerized analysis of the relation between the occlusal enamel caries lesion and the demineralized dentin. Eur J Oral Sci. 1999; 107:176–182.

Leksell E, Ridell K, Cvek M, Mejare I. Pulp exposure after stepwise versus direct complete excavation of deep carious lesions in young posterior permanent teeth. Endod Dent Traumatol. 1996;12:192–196.

Magnusson BO, Sundell SO. Stepwise excavation of deep carious lesions in primary molars. J Int Ass Child. 1977;8:36–40.

Massler M. Treatment of profound caries to prevent pulpal damage. J Pedod. 1978; 2: 99–105.

Brännström M, Lind PO. Pulpal response to early caries. J Dent Res. 1965;44:1045–1050.

Bjørndal L, Darvann T, Thylstrup. A quantitative light microscopic study of the odontoblast and subodontoblastic reactions to active and arrested enamel caries without cavitation. Caries Res. 1998;32:59–69.

Bjørndal L, Thylstryp A. A practice-based study on stepwise excavation of deep carious lesions in permanent teeth. A 1-year follow-up study. Community Dent Oral Epidemiol. 1998;26:122–128.

Bjørndal L, Larsen T, Thylstrup A. A clinical and microbiological study of deep carious lesions during stepwise excavation using long treatment intervals. Caries Res. 1997;31: 411–417.

Bjørndal L, Thylstrup A, Ekstrand KR. A method for light microscopy examination of cellular and structural interrelations in undemineralized tooth specimens. Acta Odontol Scand. 1994;52:182–190.

Bjørndal L, Thylstrup A. A structural analysis of approximal enamel caries lesions and subjacent dentin reactions. Eur J Oral Sci. 1995;103:25–31.

Mjör IA. Dentin-predentin complex and its permeability. Pathology and treatment. Overview. J Dent Res. 1985;64 (spec iss):621–627.

Fusayama T. Intratubular crystal deposition and remineralization of carious dentin. J Biol Buccale. 1991;19:255–262.

Frank RM, Voegel JC. Ultrastructure of the human odontoblast process and its mineralization during dental caries. Caries Res. 1980;14:367–380.

Larsen MJ, Bruun C. Caries chemistry and fluoride-mecahnisms of action. In: Thylstrup, A, Fejerskov, O, eds. Textbook of Clinical Cariology. Copenhagen: Munksgaard. 1994:231–257.

Shimizu C, Yamashita Y, Ichijo T, Fusayama T. Carious change of dentin observed on longspan ultrathin sections. J Dent Res. 1981;60:1826–1831.

Pashley DH. Dentin-predentin complex and its permeability: physiologic overview. J dent Res. 1985: 64 (spec iss):613–620.

Thylstryp A, Qvist V. Principal enamel and dentine reactions during caries progression. In: Thylstrup, A, Leach, SA, Qvist, V, eds. Dentine and Dentine Reactions in the Oral Cavity. Oxford: IRL Press. 1987, pp. 3–16.

Kleter GA, Damen JJ, Buijs MJ, Ten Cate JM. Modifications of amino acid residues in carious matrix. J Dent Res.1998;77:488–495.

Jontell M, Gunraj MN, Bergenholtz G. Immuno competent cells in the normal dental pulp. J Dent Res. 1987; 66:1146–1153.

Izumi T, Kabayashi I, Okamura K, Saika H. Immunohistochemical study on the immunocompetent cells of the pulp in human non-carious and carious teeth. Arch Oral Biol. 1995;40:609–614.

Jontell M, Okiji T, Dahlgren U, Bergenholtz G. Immune defence mechanisms of the dental pulp. Crit Rev Oral Biol. Medical 1998; 9:179–200.

Kamal AMN, Okiji T, Kawashima N, Suda H. Defense responses of dentin/pulp complex to experimentally-induced caries in rat molars: An immunohistochemical study on kinetics of pulpal Ia antigen-expressing cells and marcophages. J Endod. 1996; 23:115–120.

Yoshiba N, Yoshiba K, Nakamura H, Iwaku M, Ozawa H. Immunohistochemical localization of HLA-DR-positive cells in unerupted and erupted normal and carious human teeth. J Dent Res. 1996;75:1585–1589.

Michaelson P L, Holland G R. Is pulpitis painful? IntEndod J. 2002; 35: 829–832.

Bramstrom M, Lind P O. Pulpal response to early dental caries. J Dent Res. 1965;44: 1045–1050.

Khorakian F, Mazhari F, Asgary S, Sahebnasagh M, AlizadehKaseb A, Movahhed T, SarrafShirazi AR. Two-year outcomes of electrosurgery and calcium-enriched mixture pulpotomy in primary teeth: a randomised clinical trial. Eur Arch Paediatr Dent. 2014;15(4):223-8.

Langeland K. Tissue response to dental caries.Endod Dent Traumatol. 1987;3:149–171.

Reeves R, Stanley H R. The relationship of bacterial penetration and pulpal pathosis in carious teeth.OralSurg Oral Med Oral Pathol. 1966; 22:59–65.

Rosenberg L, Atar M, Daronch M, Honig A, Chey M, Funny MD, Cruz L. Observational: Prospective Study of Indirect Pulp Treatment in Primary Molars Using Resin-modified Glass Ionomer and 2% Chlorhexidine Gluconate: A 12-month Followup. Pediatr Dent. 2013;35(1):13-7.

Sushynski JM, Zealand CM, Botero TM, Boynton JR, Majewski RF, Shelburne CE, Hu JC. Comparison of gray mineral trioxide aggregate and diluted formocresol in pulpotomized primary molars: a 6- to 24-month observation. Pediatr Dent. 2012;34(5):120-8.

Kaewkamnerdpong Iss, Krisdapong S. Oral diseases associated with condition-specific oral health-related quality of life and school performance of Thai primary school children: A hierarchical approach. Community Dent Oral Epidemiol. 2018; 12361.

Hill H, Birch St, Tickle M, McDonald R, Brocklehurst P. The technical efficiency of oral healthcare provision: Evaluating role substitution in National Health Service dental practices in England. Community Dent Oral Epidemiol. 2017;45(4):310-316.

Bjorndal L, Mjor I A: Pulp-dentin biology in restorative dentistry. Part 4: Dental caries – Characteristics of lesions and pulpal reactions. Quintessence Int. 2001; 32: 717–736.


Font Size