pulpatrauma

Pulpatrauma, or pulpal trauma, denotes injury to the dental pulp resulting from mechanical, thermal, chemical, or electrical factors, typically following dental trauma such as blunt impact, falls, sports injuries, or accidents. The pulp's response ranges from no symptoms to inflammation and tissue death; outcomes depend on the extent of injury, tooth maturity, and promptness of treatment.

Pulpal responses are commonly categorized as normal, reversible pulpitis, irreversible pulpitis, or pulp necrosis. In reversible pulpitis pain is transient and pulp remains capable of healing. Irreversible pulpitis involves spontaneous lingering pain and eventual pulp degeneration. Pulp necrosis indicates death of pulp tissue, often leading to periapical pathology. In some cases the pulp may become hyperemic or inflamed without immediate necrosis. Trauma can also cause calcific metamorphosis or pulpal canal obliteration over time, especially in younger patients.

Diagnosis relies on history, clinical examination, and pulp vitality testing (thermal or electric tests), though tests may be unreliable in children or recently injured teeth. Radiographs assess fracture patterns, luxation, root development, resorption, and periapical changes. A dentist may also monitor the tooth over time to detect delayed pulp necrosis.

Management depends on the injury type, pulp status, and tooth maturity. Emergency care includes addressing pain, cleaning, repositioning displaced teeth, and splinting if indicated. Vital pulp therapy (partial or full pulpotomy, direct pulp capping) may preserve vitality in immature teeth with limited exposure or inflammation. Irreversible pulpitis or necrosis generally requires endodontic treatment; in immature teeth, procedures aimed at apexogenesis or regenerative endodontics may be considered. Regular follow-up is essential to assess healing and function.