Page 848 - My FlipBook

858 PATHOLOGY OF THE DENTAL PULP.
growth has taken place within the cavity, and has gradually been
squeezed out through the opening. In other instances the growth
seems to have occurred mostly at or without the orifice, exposing the
pulp. In the greater number of the cases I have examined the
growth seems to have been determined by the continual irritation of
the tissue of the pulp by the sharp corners of the opening into the pulp-
chamber. The growth itself is almost uniformly composed of granula-
tion-tissue of rather a low type, which remains in a very primitive state.
The accompanying illustration will give a good idea of this (Fig. 454).
Fig. 454.

-4, A Diagram of a First Lower Molar, with a ta\it} at a toiuplttch filled by a hypertrophy of the
pulp, which has urown out through the onhce, exposing the pi.lp at ft.
B, A Held illustrating the Tissue of the Growth, which is coiiijiosed almost entirely of granulation-
tissue of a very primitive type: a, a covering of epithelium presenting papilla;; ft, epithelium
apparently without papillae.
Occasionally I have seen the tissue much more developed, approaching
fibrous tissue in its structure. Many of these growths are covered on
the exposed surface with the usual squamous epithelium of the mucous
membrane of the mouth. This, evidently, has not developed from the
tissues of the ])ul]), but is a transplantation from the epithelium of the
adjacent gum, which has occurred after the fashion of skin-grafting.
With the frequent abrasions that occur in the act of mastication I can
readily understand how the epithelium could be transplanted, but I can-
not understand how this form of epithelium could be developed from the
tissues of the pulp. In a few nuances such a growth has been known
i
to become calcified. John Tomes' figures a case in M'hich the pulp
seems to have Ix-come somewhat hypertrophied after breakage of the
crown of the tooth, and afterward to have become calcified. Heider
^ Dental Surgery, p. 540.