Signs and symptoms of pulpitis
- Increased sensitivity to hot and cold stimuli
- Prolonged throbbing pain
- Reversible pulpitis: intermittent, brief discomfort with no lingering pain
- Positive pulp vitality tests
- Irreversible pulpitis: constant severe pain with sharp and lingering thermal pain

Causes of pulpitis
- Bacterial infection from dental caries
- Mechanical trauma or physical damage to the tooth
- Inflammation from repetitive trauma or periodontitis
- Opportunistic infection of the pulp by oral microorganisms
- Penetrating decay leading to exposure of the pulp chamber

Responses to pulpitis
- Inflammatory response in the pulp
- Innate immune response using receptors to recognize microbial patterns
- Odontoblasts attracting immature dendritic cells
- Accumulation of pulpal dendritic cells in response to infection
- Transition to adaptive immune response with antigen recognition and antibody production

Inflammatory mediators in pulpitis
- Cytokines, including IL-8, increased in symptomatic and asymptomatic irreversible pulpitis
- Interaction of cytokines in the pulp
- B cells and T cells involved in lymphocyte response
- Macrophages as class II antigen-presenting cells
- Activation of macrophages by priming and activating stimuli

Role of macrophages in pulpitis
- Macrophages as professional phagocytes in innate immune responses
- Activation of macrophages by T-helper cells and chemical mediators
- Elimination of pathogens in both innate and adaptive immune responses
- Importance in tissue homeostasis and repair after inflammation
- Increased number of macrophages with progression of caries