Dental Pulp: Correspondences and Contradictions between Clinical and Histological Diagnosis

Table 1

Main criteria used in differential diagnosis between acute and chronic pulpitis.

Differential diagnosis between acute and chronic pulpitis
Criteria	Acute pulpitis	Chronic pulpitis
Dental history	First dental pain in the causal tooth which goes to dental emergencies	More episodes of dental pain caused which did not lead the patient to go at dental emergencies
Painkiller	Pain does not respond to analgesics	Pain goes to analgesics
Pain type	Intense, sharp, progressive	Dull or annoying
Onset	Suddenly, fulminatory	Insidious
Duration/time frame of occurrence	From a few hours to 24–48 hours	From several minutes to several hours (up to 2 hours)
Pain location	Irradiance, diffuse	Located
Stimulus	Heat and cold	A painful embarrassment often felt during chewing
Percussion in the tooth	Positive response	Negative response
Pulp test	Hyperexcitability at a lower intensity of thermal stimulant	Hypoexcitability at a higher intensity of thermal stimulant
Causes	Primary acute deep tooth decay or fillings adjacent but with pulp chamber closed	Primary chronic dental caries or recurrent under fillings adjacent but with pulp chamber closed or open.; Affected teeth with dental erosion or vital teeth prepared for fixed prosthetic crown.
Radiograph	Coronary radiolucent areas (caused by tooth decay or erosion) or radiolucent coronal dentin under a filling but very close to the celling of pulp chamber