Chronic Hyperplastic Pulpitis: Etiology, Diagnosis, and Treatment

By | September 4, 2023

Chronic hyperplastic pulpitis, often referred to as pulp polyp, represents a unique and intriguing dental condition that warrants a comprehensive examination within the broader context of endodontics. This condition manifests as an overgrowth of pulp tissue in response to chronic irritation or inflammation within the pulp chamber. It is essential to delve into its etiology, clinical presentation, diagnostic considerations, and potential treatment modalities.

Chronic hyperplastic pulpitis Involving right mandibular first permanent molar

Etiologically, chronic hyperplastic pulpitis arises primarily in teeth with extensive carious lesions or those that have suffered traumatic injuries. The persistent irritation and inflammation within the pulp chamber lead to the proliferation of pulp tissue, which subsequently extends beyond the confines of the tooth’s crown. This tissue overgrowth is typically painless, making it distinct from acute pulpitis. The chronic nature of this condition allows for the adaptation of the dental pulp to the persistent inflammatory stimulus.

Clinically, chronic hyperplastic pulpitis presents as a reddish or pinkish, fleshy mass protruding from the pulp chamber or through a fractured tooth crown. This appearance is often likened to a “polyp,” hence the common term “pulp polyp.” Despite its relatively benign appearance, it can be associated with localized discomfort and bleeding upon provocation. Interestingly, this condition primarily affects children and young adults, possibly due to their enhanced capacity for pulp tissue repair and adaptation.

Diagnosing chronic hyperplastic pulpitis necessitates a thorough clinical and radiographic assessment. Clinical examination involves visualizing the polypoid tissue, assessing its color and consistency, and determining any associated symptoms. Radiographs provide crucial information about the extent of pulpal involvement and the overall dental health. Differential diagnoses must be considered, such as other pulpal pathologies or gingival overgrowths.

Treatment options for chronic hyperplastic pulpitis can vary based on the extent of tissue overgrowth and the patient’s symptoms. In cases with minimal discomfort and no signs of infection, a conservative approach may involve the removal of the excess tissue, followed by pulp capping or pulpotomy to preserve the vitality of the tooth. However, if there are signs of infection or abscess formation, root canal therapy or extraction may be indicated.

In conclusion, chronic hyperplastic pulpitis, or pulp polyp, represents a distinctive dental condition characterized by the proliferation of pulp tissue in response to chronic irritation or inflammation. Its etiology, clinical presentation, and management options should be thoroughly understood by dental practitioners. While conservative treatments can often preserve affected teeth, careful diagnosis and individualized treatment plans are essential to ensure the best outcomes for patients. Further research in this area could provide valuable insights into the pathogenesis and management of this intriguing dental condition, leaving room for academic discourse and potential refinements in clinical practice.