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CHAPTER XVI. —
THE CONSERVATIVE TREATMENT OF THE DENTAL PULP—
DEVITALIZATION AND EXTIRPATION OF THE PULP.

By Louis Jack, D. D. S.

As the dental pulp by its supply of nutritive pabulum maintains
the vitality of the dentin and increases the resisting power of the tooth,
it is important when this organ becomes exposed to agencies which
threaten its destruction, to attempt its preservation when the condi-
tions are favorable to that object. A further reason for maintaining
the vitality of the dentin is that when the pulp becomes devitalized the
loss of cohesive force which occurs as a consequence leads sooner or
later to the fracture and early loss of the tooth—this final result being
delayed in proportion to the inherent strength of the tooth and the
period of life at which devitalization takes place.
The treatment of teeth when the pulp has been approximately
reached by the invasion of dental caries has been previously consid-
ered (Chapter VII.). Here will be set forth a rational line of treatment
when the carious action has encroached upon that organ.

Normal Characteristics and Pathological Tendencies op
THE Dental Pulp.
The minute anatomical elements of the dental pulp are given in
Chapters II. and III. The salient features of these elements which
have to be kept in view in connection with treatment are
(1) The minuteness of the apical foramina, which restricts the efferent
"
circulation when the vascular phenomenon known as '•' determination
occurs.
(2) The ultimate nervous distribution immediately beneath the odon-
toblastic layer, forming a plexus which renders the whole surface of the
organ highly sensitive when the blood supply is increased as the effect
of irritation.
(3) The arrangement of the capillary circulation in loops which arise
from the vertical vessels. This relation of the vessels lessens the tend-
ency to inflammatory diflFusion.
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