Pulpitis
Inflammation of the pulp is called pulpitis (plural: pulpitides).
Causes
On the one hand, infections are possible causes, mainly due to bacteria, e.g. in the course of crown, cervical or root caries or exposure of the pulp as a result of accidents. On the other hand, "sterile" types of pulpitis occur without the involvement of bacteria. These are caused by severe mechanical (contusion, rupture), chemical or thermal irritation (over-heating).
Extent/Localisation
The inflammation can be limited to one section of the pulp (partial p., e.g. in the coronal region), or affect the entire pulp (total p., often with periodontitis apicalis). As well as closed forms with intact pulp cavity (p. clausa), there are also exposed forms (p. aperta, pulp polyp).
Symptoms
Acute or chronic hypersensitivity to temperature, acid, contact, pressure (biting) or vibration (percussion/tapping) stimuli may occur, though it is also possible to have rest pain without any cause and sporadic or continuous complete freedom from pain. The results of the vitality test are generally negative after destruction of the nerve process in the pulp cavity, in some cases (wet gangrene) also false positive.
Severity/Process/Therapy
Reversible forms can be healed (by elimination of the cause); irreversible forms result in necrotic decay of the pulp tissue (gangrene). In these cases root treatment (endodontic treatment) is indicated.
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anamnesis form | Anamnesebogen |
Wax build-up technique Wax build-up technique The various anatomical structures (such as cusp tips and slopes as well as marginal ridges) are usually built up one after another by adding small portions of wax (often using differently coloured waxes for didactic purposes). The firm, special waxes first have to be melted at room temperature. This can be carried out by warming small portions on differently shaped working tips of hand instruments in an open flame (such as a gas burner) or using electrically heated instruments which provide for more accurate temperature control and avoid contamination (e.g. electric wax-knife, induction heaters, wax dipping units). The wax is applied drop-by-drop to ensure that the warmer molten wax added last fuses seamlessly with the firm, cooler material. After hardening, the wax pattern can be reduced by sculpting, milling guidance surfaces or drilling to add retainers. Modern procedures include flexible, occlusal preforms for adding contours to soft wax. In addition, wax preforms, such as for occlusal surfaces or bridge pontics, are available in various shapes and sizes. Recently, irreversible, light-curing materials have been introduced for use instead of reversible thermoplastic waxes. Wax preforms To ensure that the wax pattern can be released without being damaged, model surfaces, opposing dentition and preparations must be hardened/sealed with special lacquer (applied by spraying, brushing or dipping). These waxes are mostly relatively rigid/elastic after cooling. Attaching wax sprues to a removable framework supported on double crowns using a hand instrument When employing the lost wax technique, prefabricated wax sprues, bars and reservoirs are attached to the patterns. Once the pattern has been released and its sprues waxed onto the crucible former, it is invested in a casting ring with refractory investment material. The wax can then be burnt out residue-free and casting completed. Unlike standard wax build-up techniques, a diagnostic wax-up is not intended for fabricating an indirect restoration, but rather for simulating the appearance and/or external contouring for producing orientation templates. |