CHRONIC HYPERPLASTIC PULPITIS (PULP POLIP)

Clinical Features
This condition occurs in children and young adults who have large exposures of the pulp in which the entire dentinal roof often is missing. The most frequently involved teeth are the deciduous or succedaneous molars, which have large pulp chambers in these age groups.

   Mechanical irritation and bacterial invasion result in a level of chronic inflammation that produces hyperplastic granulation tissue that extrudes from the chamber and often fills the associated dentinal defect (figure 1-1). The apex may be open and reduces the chance of pulpal necrosis secondary to venous compression. The tooth is asymptomatic except for a possible feeling of pressure when it is placed into masticatory function.

Figure 1.1 - Pulp Polip on Mandible Left First Molar

 Histopathologic Features

Chronic hyperplastic pulpitis demonstrates a cap of subacutely inflamed granulation tissue resembling that seen in a pyogenic granuloma. The surface of the polyp may or may not be covered with stratified squamous epithelium, which migrates from the adjacent gingival or arises from sloughed epithelium  within the oral fluids. The deeper pulp tissue demonstrates a chronic inflammatory infiltrate.

Treatment and Prognosis

Chronic hyperplastic pulpitis is treated by extraction of the tooth or by root canal therapy.