Pathogenic mechanisms in pulpal disease.

The unpredictable response of the dental pulp to clinical insults is frequently encountered in the daily practice of dentistry. Even though the pulp often shows remarkable capacity for recovery, painful symptoms and pulp tissue breakdown may follow such clinical insults as caries, dental trauma, or operative dental procedures. In recent years pulp biology research has provided a deeper insight into the basic mechanisms that govern pulpal defense and repair. This communication focuses on dentin permeability to bacterial antigens and how bacterial elements may be processed and dealt with by the dentin-dental pulp complex.