Pulp Polyp Clinical Presentation

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

History

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  • Pulp polyps are usually asymptomatic.

  • Direct pressure during mastication may cause mild-to-moderate tenderness.

  • Localized bleeding may occur when the soft tissue is manipulated or traumatized.

  • Most lesions are associated with a history of a long-standing carious lesion, a fractured tooth due to trauma, or a combination or these 2 insults. [3] Pulp polyps reach a maximum size within a couple of months and then remain static.

  • There are rare examples of incomplete removal of a natal tooth that results in the formation of a pulp polyp. [4] Mobility of the tooth and sensitivity to percussion are usually absent.

  • Drainage of a purulent exudate is not a characteristic finding.

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Physical

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  • A spongy, soft tissue nodule extrudes from the cavitated or fractured surface of a tooth.

  • The surface varies from pink and smooth to red and white and granular. Red and ulcerated lesions are vascular and bleed when manipulated.

  • Polyps typically enlarge to fill the entire cavitated area or pulpal chamber of the tooth.

  • Soft tissue may merge with the adjacent attached gingiva.

  • Polyps usually develop in carious primary molars and first permanent molars because, anatomically in young persons, these teeth have large pulp chambers. Less frequently, maxillary central incisors in both dentitions are affected.

  • A pulp polyp is a single lesion, but multiple teeth may be affected.

  • Teeth with open or incomplete apexification of the root apices are the most susceptible.

  • Extrusion of the opposing molar or tipping of the adjacent teeth with space loss may be observed when significant destruction of the crown occurs.

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Causes

Causes of a pulp polyp include the following:

  • Carious tooth with significant loss of tooth structure

  • Loss of a dental restoration that results in pulpal exposure

  • Fractured tooth due to trauma with a pulpal exposure

  • Pulpal tissue with access to a good blood supply

  • Possible hormonal (estrogen and progesterone) influence

  • Possible hypersensitivity reaction

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