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Pulp Polyp Follow-up

  • Author: Catherine M Flaitz, DDS, MS; Chief Editor: Arlen D Meyers, MD, MBA  more...
 
Updated: Apr 30, 2014
 

Further Outpatient Care

See the list below:

  • Periodic dental examinations are recommended to monitor the success of the root canal therapy or to intercept problems associated with the premature loss of a tooth.
  • Orthodontic treatment may be needed to restore the occlusion.
  • If a tooth is extracted, either a dental implant or fixed dental prosthesis (bridge) is a treatment option to restore function and aesthetics.
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Complications

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  • Space discrepancy from crown destruction or premature loss of a tooth may result in a crowded malocclusion, supereruption of an opposing tooth, or the impaction of a succedaneous tooth.
  • Without definitive treatment, some of these long-standing, nonvital teeth may progress to symptomatic disease, including periapical inflammatory disease and (rarely) cellulitis and osteomyelitis of the jaws.
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Prognosis

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  • The prognosis is excellent. No risk for recurrence exists once definitive treatment has been rendered.
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Patient Education

See the list below:

  • Reinforce the importance of routine oral health care to prevent the development of deep carious lesions that may cause inflammatory pulpal disease and more serious sequelae.
  • For excellent patient education resources, visit eMedicineHealth's Oral Health Center. Also, see eMedicineHealth's patient education article Toothache.
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Contributor Information and Disclosures
Author

Catherine M Flaitz, DDS, MS Distinguished Teaching Professor of Oral and Maxillofacial Pathology and Pediatric Dentistry, Department of Diagnostic and Biomedical Sciences, University of Texas Health Sciences Center at Houston School of Dentistry

Catherine M Flaitz, DDS, MS is a member of the following medical societies: American Academy of Oral Medicine, International Association of Oral Pathologists, American Academy of Pediatric Dentistry, American Academy of Oral and Maxillofacial Pathology, American Dental Association, International Association for Dental Research

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: American Academy of Pediatric Dentistry Board of Trustees; Commissioner of Dental Accreditation; Chief of Dentistry Nationwide Children's Hospital<br/>Serve(d) as a speaker or a member of a speakers bureau for: American Academy of Pediatric Dentistry Speakers Bureau<br/>Received research grant from: Trimira LLC; GC America; C3-Jian; others<br/>Travel Grant from GC America; American Academy of Pediatric Dentistry for Continuing Education Presenter for: Multiple speaking engagements for dental meetings.

Coauthor(s)

M John Hicks, DDS, MD, PhD, MS Professor with Tenure, Department of Pathology and Immunology, Baylor College of Medicine; Medical Director of Ultrastructural Pathology, Department of Pathology, Texas Children's Hospital; Professor of Pediatrics, Baylor College of Medicine; Adjunct Professor, Department of Pediatric Dentistry, School of Dentistry, University of Texs Health Science Center at Houston

M John Hicks, DDS, MD, PhD, MS is a member of the following medical societies: American Academy of Oral and Maxillofacial Pathology, American Society for Clinical Pathology, College of American Pathologists, International Academy of Pathology, International Association of Oral Pathologists

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Drore Eisen, MD, DDS Consulting Staff, Department of Dermatology, Dermatology Research Associates of Cincinnati

Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, American Dental Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;RxRevu;SymbiaAllergySolutions<br/>Received income in an amount equal to or greater than $250 from: Symbia<br/>Received from Allergy Solutions, Inc for board membership; Received honoraria from RxRevu for chief medical editor; Received salary from Medvoy for founder and president; Received consulting fee from Corvectra for senior medical advisor; Received ownership interest from Cerescan for consulting; Received consulting fee from Essiahealth for advisor; Received consulting fee from Carespan for advisor; Received consulting fee from Covidien for consulting.

Additional Contributors

Gregory J Raugi, MD, PhD Professor, Department of Internal Medicine, Division of Dermatology, University of Washington at Seattle School of Medicine; Chief, Dermatology Section, Primary and Specialty Care Service, Veterans Administration Medical Center of Seattle

Gregory J Raugi, MD, PhD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References
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  2. Abdel Jabbar NS, Aldrigui JM, Braga MM, Wanderley MT. Pulp polyp in traumatized primary teeth--a case-control study. Dent Traumatol. 2013 Oct. 29(5):360-4. [Medline].

  3. Raslan N, Wetzel WE. Exposed human pulp caused by trauma and/or caries in primary dentition: a histological evaluation. Dent Traumatol. 2006 Jun. 22(3):145-53. [Medline].

  4. Vergotine RJ, Hodgson B, Lambert L. Pulp polyp associated with a natal tooth: case report. J Clin Pediatr Dent. 2009 Winter. 34(2):161-3. [Medline].

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  8. Caliskan MK, Turkun M, Oztop F. Histological evaluation of a tooth with hyperplastic pulpitis and periapical osteosclerosis. Int Endod J. 1997 Sep. 30(5):347-51. [Medline].

  9. Camp JH. Diagnosis dilemmas in vital pulp therapy: treatment for the toothache is changing, especially in young, immature teeth. Pediatr Dent. 2008 May-Jun. 30(3):197-205. [Medline].

  10. Nair RG, Samaranayake LP, Philipsen HP, Graham RG, Itthagarun A. Prevalence of oral lesions in a selected Vietnamese population. Int Dent J. 1996 Feb. 46(1):48-51. [Medline].

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  12. Neville B, Damm D, Allen C, Bouquot J. Pulpal and periapical disease. Oral and Maxillofacial Pathology. 3rd ed. St. Louis, Mo: WB Saunders; 2009. 120-53.

  13. Piskin B, Aktener BO, Karakisi H. Neural changes in ulcerative and hyperplastic pulpitis: a transmission electron microscopic study. Int Endod J. 1993 Jul. 26(4):234-40. [Medline].

  14. Smulson MH, Sieraski SM. Histopathology and diseases of the dental pulp. Weine FS. Endodontic Therapy. 5th ed. St. Louis: Mo: Mosby; 1996. 84-165.

  15. Southam JC, Hodson JJ. Neurohistology of human dental pulp polyps. Arch Oral Biol. 1973 Oct. 18(10):1255-60. [Medline].

  16. Southam JC, Hodson JJ. The growth of epithelium, melanocytes, and Langerhans cells on human and experimental dental pulp polyps. Oral Surg Oral Med Oral Pathol. 1974 Apr. 37(4):546-55. [Medline].

  17. Whitaker SB, Singh BB, Weller RN, Bath KR, Loushine RJ. Sex hormone receptor status of the dental pulp and lesions of pulpal origin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999 Feb. 87(2):233-7. [Medline].

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Pulp polyps involving the primary, first, and second mandibular molars in a young child with extensive dental caries.
Picture 2. Pulp polyp involving the permanent second mandibular molar in a young adult with multiple carious teeth.
Fibrosed pyogenic granuloma of the mandibular gingiva that partially surrounds a carious molar with crown destruction. Reactive gingival lesions that extend into a large carious lesion of an adjacent tooth may resemble a pulp polyp.
Low-power photomicrograph of a pulp polyp demonstrating inflamed fibrovascular tissue that is lined by stratified squamous epithelium (hematoxylin and eosin, original magnification X40).
Intermediate-power photomicrograph of a pulp polyp with superficial bacteria and exogenous, pigmented material overlying the surface epithelium (hematoxylin and eosin, original magnification X100).
 
 
 
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