Fibrous pulpitis: acute and chronic, treatment

In dental practice the fibrous pulpitis – a fairly common phenomenon. In this article we will discuss about acute and chronic forms of pulpitis and how is their treatment.

What are the characteristic symptoms of the disease and its causes? Possible consequences in case of delayed treatment. The main rules of prevention and lots of other useful information.

The description of the disease

What is the fibrous pulpitis? Is an inflammatory process in dental pulp, which is accompanied by overgrowth of fibrous tissue in the cavity of the affected tooth. As a rule, it occurs because of an unhealed acute pulpitis and is a subspecies of the chronic forms of the disease.

The fibrous pulp can be:

  1. Chronic.
  2. In the acute stage, that is, acute.

The growth of fibrous tissue inside the tooth is the body’s response to damage (carious or mechanical) polovoy dental camera, thus, decreases pain from inflammation of the nerves.

History of the disease, usually determined by the presence of deep caries with subsequent occurrence of acute forms of pulpitis, which was not properly healed, so it’s important

But after some time the disease becomes necrotic phase when it dies a part of the pulp and «exposed» nerve gangrene in the tooth. This often leads to serious consequences (inflammation of the periosteum, loss of teeth). At this stage, the patient feels severe pain in the affected tooth and its surrounding tissues and can not do without the help of a dentist.


Why is there disease? The main reasons:

  • untreated acute pulpitis;
  • in primary teeth may occur as a primary disease;
  • mechanical damage of the tooth when opening the pulp chamber.
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The first complaints appear, when the disease passes into the acute stage and in the fibrous tissues of the pulp start necrotic processes.



The fibrous pulp has a distinctive history. Many people mistakenly believe that the main symptom is severe pain in the affected tooth, but it is not so. Pain appear only after the inflamed nerve during the course of disease.

Patients often feel a dull pain which appears after a thermal or mechanical impact on the problem tooth. She takes a long time and forcing people to take painkillers. If a carious cavity is located in a place least contact with the stimuli, the patient may nothing.

Sometimes the pain manifests at night. Doctors attribute this to the fact that the patient is just not paying attention to her, and at night, when the acute sensitivity of the body, the pain becomes noticeable. There is a theory that during sleep the pulp increases in size due to the lack of outflow of fluid and pressure on the nerve, causing pain.

Fibrous pulpitis and methods of treatment

Treatment is done surgically, which is divided into the vital and devital. For each of them there is a step by step guide.

► Vital method:

  1. Anesthesia.
  2. Cleaning of dental caries and access to the root channels.
  3. Treatment of the dental cavity with antiseptics.
  4. Length determination of the root canal using the apex locator or an x-ray.
  5. Resection of the root pulp and root canal extension.
  6. Re-treatment with antiseptics.
  7. Filling dental roots.

After the procedure the doctor proceeds to the restoration of the coronal portion of the tooth. It is carried out after a thorough x-ray, which will show how well sealed the channels.

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► Devital method:

  1. Cleaning of cavities from all affected tissues and appropriate preparation for its subsequent filling.
  2. Treatment with antiseptics followed by the opening of the pulp.
  3. Pulp capping devitalisation special tool.
  4. The installation of a temporary filling for a period of time the money.
  5. The removal of the temporary filling, the coating mummifying preparation.
  6. Installation of insulating pads.

All of the above stages of treatment are carried out in several visits to the dental office. This is due to specific actions devitalizing drugs.

It should be noted that this method does not guarantee absence of problems with the remaining pulp of the affected tooth in the future. Moreover, similar treatment of the tooth canals adversely affects its condition: it can change color, become more brittle, and its re-treatment or removal will be difficult.

Video: treatment of pulpitis.

The consequences

Due to the lack of appropriate treatment, part of the pulp may die, followed by gangrene nerve or necrotic processes. This leads to inflammation of the periodontal tissues and to other heavy consequences.

If as a result of untreated fibrous pulpitis, appears purulent process, it often provokes inflammation of the periosteum – flux. This disease may cause the removal of the affected tooth and allow the disease to spread throughout the oral cavity.

Complication fibrous pulpitis often gives rise to unpleasant mouth odor, teeth staining a dark color.

Due to the ever growing pain to become difficult meal, the affected tooth reacts to temperature changes.


Because of the fibrous pulpitis is a complication of the acute form of this disease, the main method of prevention is prompt and adequate treatment of acute pulpitis.

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However, fibrous pulpitis, though rare, but can be a primary disease. To avoid its occurrence must adhere to the following guidelines:

  • carefully carry out the oral hygiene using a toothbrush and toothpaste, but dental floss with mouthwash;
  • to monitor the status of the treated teeth.
  • screened regularly at the dentist;
  • immediately inform your doctor about the first signs of tooth decay;
  • to avoid possibilities of mechanical damage to teeth: don’t bite very hard objects, not teeth to open bottles, etc.

Prevention of pulpitis is of great importance for the health of the entire oral cavity. Timely treatment of this disease automatically prevents its appearance (except those caused by mechanical damage of the tooth).

Video: pulpitis under a filling and a crown, its types and diagnosis.

Further questions

► Code for ICD-10

According to the International classification of diseases, fibrotic pulpitis has code K04.03 – «Chronic pulpitis».

► What kind of doctor treats?

Treatment of fibrous pulpitis, like all others of its species, engaged a dentist. It is carried out by different methods and in several stages. For full recovery of the affected tooth need from 3 to 5 visits to the dentist.