ETIOLOGY AND PATHOGENESIS OF HYPERTROPHIC PULPITIS

Abstract

Hypertrophic pulpitis, also known as chronic hyperplastic pulpitis, is a unique inflammatory condition of the dental pulp, typically seen in young individuals, characterized by the overgrowth of granulation tissue from the pulp chamber due to long-standing carious exposure. This paper explores the etiology, pathogenesis, clinical presentation, diagnostic methods, and current therapeutic approaches to hypertrophic pulpitis. The etiological analysis shows that this condition is usually triggered by deep dental caries, trauma, or persistent bacterial infection in teeth with open pulp chambers. The pathogenesis is primarily influenced by chronic low-grade infection, adequate vascular supply, and an immune response that promotes tissue proliferation instead of necrosis. Clinically, the condition manifests as a red or pink polypoid mass emerging from the pulp chamber, often asymptomatic unless disturbed. A comprehensive review of literature-based data was conducted to assess the common patterns of presentation and treatment outcomes. The results indicate a higher incidence in molars of younger patients, with conservative management (e.g., pulpotomy or root canal therapy) yielding favorable outcomes if performed early. The discussion highlights the immunological and histopathological mechanisms underlying the condition, emphasizing the balance between inflammation and regenerative potential of pulp tissue. In conclusion, hypertrophic pulpitis represents a chronic, non-necrotic pulpal response to irritation that, if correctly diagnosed and managed, has a good prognosis. Early intervention is key to avoiding irreversible pulpal damage and tooth loss.