PULP POLYP
DEFINITION:
Pulp polyp is the productive pulpal inflammation due to an extensive carious exposure of a young pulp. It is characterised by the development of granulation tissue, covered at times by epithelium and resulting from long-standing low grade infection. Pulp polyp is also known as Chronic open hyperplastic pulpitis or Pulpitis aperta.
1. Host immunity is strong.
2. Bacterial virulency is low.
3. Large carious cavity and good blood supply due to large apical foramina.
PATHOGENESIS:
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HISTOPATHOLOGY:
1. The hyperplastic pulp tissue lesion presents the feature of granulation tissue mass, consisting of numerous proliferating fibroblasts and young blood capillaries.
2. Inflammatory cell infiltration by lymphocytes, plasma cells and sometimes polymorphonuclear neutrophils in tissue are common.
3. Stratified squamous epithelium is present on the surface of hyperplastic pulpitis which resembles oral epithelium.
4. The epithelium surface shows well-formed rete peg formation.
5. The epithelial cells on surface are believed to be desquamated epithelial cells which came either from buccal mucosa or from salivary gland ducts.
CLINICAL FEATURES:
1. Seen often in deciduous 2nd molar and permanent 1st molar in children or young adults.
2. The involved tooth is asymptomatic and is feebly sensitive to thermal stimuli.
3. Pulp polyp appears as small, pinkish, red lobulated mass, which protrudes from pulp chamber and fills up the carious cavity.
4. The affected tooth has a large open carious cavity, which is present for long duration.
5. It is a hyperplastic tissue growth (granulation tissue) through the opening of the pulp chamber into the tooth cavity and bleeds profusely on provocation.
TREATMENT:
-Endodontic treatment
-Tooth extraction.
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