Pathological changes in the dental pulp

Zubna pulpa je rahlo vezivno tkivo koje se nalazi u središtu zuba. Uslijed djelovanja različitih štetnih podražaja može doći do njene upale i patoloških promjena. Upala može imati akutni ili kronični tijek ovisno o vrsti i jačini štetnog podražaja te o obrambenim snagama organizma. Akutnu upalnu reakciju karakterizira crvenilo i toplina, zbog povećanog krvnog protoka, oticanje zbog povećane propusnosti krvnih žila te bol zbog povećanog volumena koji pritišće živčane završetke i otpuštanja upalnih medijatora. Kod kronične upale dominira celularni odgovor i proliferacija stanica, bol je obično minimalna ili je nema. Patološke promjene zubne pulpe dijelimo prema patohistološkoj i prema kliničkoj klasifikaciji. U patohistološkoj podjeli razlikujemo hiperemiju, akutne i kronične pulpitise te nekrozu i gangrenu. S druge strane, u kliničkoj klasifikaciji razlikujemo reverzibilni i ireverzibilni pulpitis te internu resorpciju i nekrozu. U kliničkoj praksi bitno je razlikovati reverzibilne od ireverzibilnih patoloških promjena jer je ponekad moguće našim preventivnim postupkom spriječiti da upala prijeđe u ireverzibilni oblik. Od ostalih promjena u pulpi se mogu pronaći kalcifikacije u obliku difuznih kalcifikacija ili pulpnih kamenaca.Dental pulp is a soft bonding tissue located in the center of the tooth. Various harmful stimuli may cause inflammation and pathological changes in the dental pulp. Inflammation can have an acute or a chronic course depending on the type and strength of the harmful stimulus and on the defense forces of the organism. The acute inflammatory reaction is characterized by redness and heat due to increased blood flow, swelling due to increased blood vessel permeability, and pain due to increased volume that presses nerve endings and releasing inflammatory mediators. In chronic inflammation, cellular response and cell proliferation dominate, pain is usually minimal or nonexistent. Pathological changes of the dental pulp are divided according to pathohistological and clinical classification. The pathohistological classification is divided into: hyperemia, acute and chronic pulpitis, necrosis and gangrene. The clinical classification, on the other hand, is divided into: reversible and irreversible pulpitis, internal resorption and necrosis. In clinical practice, it is important to know the difference between reversible and irreversible pathological changes because it is sometimes possible, by our preventive procedure, to prevent inflammation from becoming an irreversible form. Other changes that can be found in the pulp are calcifications. They can be found in the form of diffuse calcifications or pulp stones