Changes in the pulp of teeth with General diseases

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The lack of adequate clinical research methods the state of pulp (especially the intact teeth) led to the fact that clinicians fix their attention only on those pathological processes in the pulp, which are accompanied by pain, i.e., acute and subacute pulpit. As it is well known that not only in some diseases of tooth hard tissues or periodontal (gum disease, increased abrasion, thermal and chemical trauma, periodontal disease, and others), but for a number of common diseases in the pulp determined expressed morphological changes of inflammatory and dystrophic, flowing without pain. These diseases pulp in routine clinical practice are not diagnosed. They are found only in those cases when the pathological process in the pulp's gone too far and has led to change the color of tooth crown or in marked changes in the surrounding tissues.
The question of morphological changes in the pulp with General diseases devoted a little work, but all of them are of great interest.
Several authors (A. I. Kudryashov, 1894; M. M. Tiesenhausen, 1934; A. P. Urushadze, 1946) studied the condition of the pulp in infectious diseases (typhoid, lobar and catarrhal inflammation of the lungs, cholera, septicaemia, pienia, syphilis, malaria, influenza, smallpox, and in all cases noted in those or other changes. So, for example, of typhoid fever and cholera vessels pulp seemed dramatically advanced and densely filled with blood, and with cholera around each vessel (without exception) was determined hemorrhage; when syphilis was determined sclerosis pulp; the number of vessels was reduced; they were not filled with blood; loose connective tissue pulp in many places was replaced by beams heavier fabric, and in some cases the cellular elements, taking the wrong form, was not a paint.
Morphological changes in the pulp and periodontium with hypertension studied in detail Khamarkhanova (1952). Accordingly reasons of death of the author subdivided studied her jaw blocks into three groups: the first cases of hypertension, where the cause of death was a brain hemorrhage; second, renal failure, which ended with the death from uremia; the third cases where the death was caused by heart failure. In all cases it is found in the pulp of teeth changes that were mostly similar, differing only in intensity and length. Odontoblast in most cases, was in a state of vacuolar and fatty degeneration. In coronal pulp was determined pronounced sclerosis and net atrophy (if the latter was blurred expressed, in the root part edema was observed). Root pulp was sclerotic (fibrous), places were visible areas of hyalinosis, many petrifikatov.
Particularly noteworthy are changes in vessels. Most sharply expressed in an intim, which in most cases is represented swollen and loosened. The endothelium cells go into the lumen of the vessels; the kernel of their picnotify, brightly colored. In some cases, there proliferation of endothelial cells and peeling them into the lumen of the vessels. In the inner elastic membrane seen inflammation, thickening, loss of sinuosity, pushing fibres to the muscle layer. The intimal thickening and hypoplasia of the inner elastic membrane often resulted in narrowing blood vessels and even deformation them with education bugliarisi protrusions. In rare cases determined necrosis intima (in the form of fine-grained decomposition).
The defeat of vessels and surrounding tissues were identified in the first and second groups. In the first group were noted, and the biggest change in the pulp, which in all cases were determined hemorrhage. The latter was observed mainly in the crown pulp and less frequently in the root. Special attention deserves the fact that along with fresh hemorrhage in the pulp author observed and places of old hemorrhages, and these patients had old foci of hemorrhage in the brain.