Masses in The Dental Pulp
Denticles are calcified masses in the dental pulp. One discerns between true denticles that have tubules like dentin and false denticles that have a concentrically lamellated structure. Irrespective of being identifiable as true or false, they may lie free in the dental pulp, being connected with the wall of the pulp chamber, or lie entirely within the dentin in case of formation of excessive secondary or tertiary dentin. Depending on this topographical relationship with the tooth, they are classified as either free, attached, or embedded.
In addition to calcifications in the form of denticles, the pulp may contain diffuse calcifications, occurring as metaplastic ossification along collagen fibres or blood vessels. Through merging of these calcifications with each other, large masses may form . However, they lack the inner structure and circumscribed nature shown by the true or false denticles.
In case of internal resorption, the dental pulp transforms into granulation tissue with multinucleated osteoclasts accumulating at the pulpo-dentinal border. There, they resorb the dentin, thus increasing the size of the pulp chamber [1]. Simultaneously, irregular masses of hard tissue resembling both bone and dentin may be formed haphazardly in the enlarged pulp chamber, partly onto the pulp wall, but also free. Functionally, this hard tissue deposition does not have any reparative properties. After resorption of a sufficient amount of dentin, the highly vascularised granulation tissue may be seen through the remaining translucent enamel as a pink spot.
Histologically, pulpitis does not show any differences from inflammatory infiltrates found elsewhere in the body. It may be classified as either acute, subacute, or chronic depending on the composition of the inflammatory infiltrate. Sometimes, abscess formation may occur. The odontoblasts that line the pulp chamber have usually disappeared. Areas of tertiary dentin may still be observed as a consequence of their past activities to wall off the pulp against the carious attack.
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