Chronic Hyperplastic Pulpitis (Pulp Polyp)
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Chronic Hyperplastic Pulpitis (Pulp Polyp)

Pulp And Periapical Infections

Oral Pathology And Medicine

Chronic Hyperplastic Pulpitis (Pulp Polyp)

Definition:

This is a unique form of pulpitis wherein the inflamed pulp, instead of perishing by continued suppuration reacts by excessive and exuberant proliferation.

Mode of Development: It occurs either as:

  • Chronic lesion from onset
  • Chronic stage of previously acute pulpitis

Pathogenesis:

Exuberant proliferation of pulpal connective tissue depends on following factors:

  • A balance between injurious agents and tissue resistance
  • Presence of low grade sustained inflammation
  • Well vascularized pulpal tissue and excellent tissue reactivity
  • Wide carious cavity
  • Young patient with good body resistance.

Clinical Features:

  • Age: Most common in children and young adults
  • Site: Mainly deciduous molars and first permanent molars
  • Pulp polyp clinically appear as small, pinkish red lobulated mass protruding from pulp chamber and fills caries defect and also extends beyond
  • Involves teeth with large carious lesions
  • Relatively insensitive to manipulation and may or may not bleed readily
  • Innervations of epithelium in epithelialized polyps may be seen.

Histologic Features:

  • Hyperplastic tissue is basically granulation tissue, consist of connective tissue fibers and young blood capillaries
  • Inflammatory cell infiltration chiefly by lymphocytes, plasma cells and sometime polymorphonuclear lymphocytes
  • Stratified squamous epithelial lining may be seen on surface of pulp polyp. It may show well formed rete pegs.

Treatment:

  • Extraction of tooth
  • Pulp extirpation

 

Images:

 

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