PULP BIOLOGY
Pulpal complications of caries, extensive wear or other external irritation may result in symptomatic or asymptomatic inflammation, followed by partial or progressive pulp tissue degradation and necrosis. Appropriate treatment of diseased pulp may aim to preservation of vitality of the pulp, either completely or partially, and can thus be regarded as “preventive endodontics”. Understanding of the physiology and pathology of dentin-pulp complex is a prerequisite for the proper diagnosis and thus the correct choice of treatment. This review describes the basic structure and physiology of a healthy dental pulp and the principles of the initiation and progression of inflammatory reactions in the low-compliance environment of pulp chamber and root canals. The mechanisms of the pain and hypersensitivity, as well as the means that the dentin-pulp complex may react to a repeated or persistent pain-producing irritation, are also discussed. The chosen treatment modalities may vary from caries excavation and cavity sealing, partial or complete pulpotomy to an endodontic treatment, and will be discussed in detail in other articles in this theme dealing with the diagnostics, vital pulp therapies and emergency treatment.
