Iatrogenic injury to the pulp in dental procedures: aspects of pathogenesis, management and preventive measures.

This review calls attention to the fact that iatrogenic ('dentistogenic') injury to the dental pulp is not an insignificant problem in clinical dentistry. On a short-term basis pulpal inflammatory lesions and hypersensitive teeth are frequently associated with procedures that involve removal of the dental hard tissue structures. Although the pulp is likely to recover, reparative processes induced by the insult may impair pulpal function on a long-term basis. In this paper current concepts regarding pathogenic mechanisms associated with injuries induced in the pulp by restorative and periodontal treatment procedures are reviewed. Aspects of the management of accidental pulp exposures are also described as well as measures to prevent or reduce iatrogenic injuries to the pulp.