1.急性(xing)（Acute pulpitis）多(duo)為外傷引起(qi)，主要(yao)表現為劇烈(lie)地自發(fa)性(xing)痛(tong)(tong)，特點如下(xia)：①疼痛(tong)(tong)常(chang)(chang)(chang)突(tu)然(ran)發(fa)作，早期(qi)呈(cheng)間歇(xie)性(xing)，一般(ban)約持(chi)續數分鐘，隨后(hou)數小時(shi)(shi)間歇(xie)期(qi)，病(bing)員尚可(ke)指(zhi)患(huan)牙(ya)。隨病(bing)情發(fa)展，發(fa)作期(qi)延(yan)長，間歇(xie)期(qi)縮短，逐(zhu)漸(jian)轉變為持(chi)續性(xing)劇痛(tong)(tong)，并沿同側三(san)支神經(jing)分布區放散（如上牙(ya)向(xiang)頸部(bu)、耳前、顴頰部(bu)；下(xia)牙(ya)向(xiang)耳下(xia)、耳后(hou)、下(xia)頜部(bu)放散），往(wang)(wang)往(wang)(wang)不能(neng)明(ming)(ming)確指(zhi)出患(huan)牙(ya)部(bu)位。②疼痛(tong)(tong)往(wang)(wang)往(wang)(wang)夜間較(jiao)劇，臥倒時(shi)(shi)尤(you)甚(shen)。③早期(qi)冷(leng)、熱刺激(ji)(ji)(ji)均可(ke)激(ji)(ji)(ji)發(fa)或加劇疼痛(tong)(tong)，以冷(leng)刺激(ji)(ji)(ji)痛(tong)(tong)較(jiao)明(ming)(ming)顯(xian)(xian)；后(hou)期(qi)或化膿時(shi)(shi)，熱刺激(ji)(ji)(ji)疼痛(tong)(tong)，冷(leng)刺激(ji)(ji)(ji)僅可(ke)使疼痛(tong)(tong)暫時(shi)(shi)緩解。后(hou)期(qi)患(huan)者常(chang)(chang)(chang)含冷(leng)水，或吸冷(leng)空氣以減(jian)輕疼痛(tong)(tong)，此(ci)種癥(zheng)狀對診斷(duan)有(you)一定幫助。④檢查時(shi)(shi)常(chang)(chang)(chang)可(ke)見(jian)患(huan)牙(ya)穿(chuan)髓，探痛(tong)(tong)明(ming)(ming)顯(xian)(xian)。

　　2.慢(man)(man)性(xing)牙(ya)(ya)(ya)(ya)髓(sui)(sui)炎(yan)(yan)（Chronic pulpitis）由于齲病(bing)等大多是慢(man)(man)性(xing)病(bing)變，對牙(ya)(ya)(ya)(ya)髓(sui)(sui)有(you)長(chang)期持續的(de)刺激，可使牙(ya)(ya)(ya)(ya)髓(sui)(sui)發生慢(man)(man)性(xing)炎(yan)(yan)癥(zheng)的(de)過(guo)(guo)程(cheng)。在慢(man)(man)性(xing)牙(ya)(ya)(ya)(ya)髓(sui)(sui)炎(yan)(yan)發展過(guo)(guo)程(cheng)中(zhong)，如多形(xing)核白細胞增(zeng)(zeng)多，則釋放(fang)的(de)溶酶體酶也增(zeng)(zeng)多，而使炎(yan)(yan)癥(zheng)加劇，臨(lin)床上即可出現(xian)(xian)急(ji)性(xing)發作的(de)癥(zheng)狀。牙(ya)(ya)(ya)(ya)體慢(man)(man)性(xing)損傷、、牙(ya)(ya)(ya)(ya)本質化學(xue)刺激都可使牙(ya)(ya)(ya)(ya)髓(sui)(sui)呈現(xian)(xian)慢(man)(man)性(xing)炎(yan)(yan)癥(zheng)的(de)過(guo)(guo)程(cheng)。慢(man)(man)性(xing)牙(ya)(ya)(ya)(ya)髓(sui)(sui)炎(yan)(yan)臨(lin)床上分為三類：慢(man)(man)性(xing)閉鎖(suo)性(xing)牙(ya)(ya)(ya)(ya)髓(sui)(sui)炎(yan)(yan)，慢(man)(man)性(xing)開放(fang)性(xing)牙(ya)(ya)(ya)(ya)髓(sui)(sui)炎(yan)(yan)及慢(man)(man)性(xing)增(zeng)(zeng)生性(xing)牙(ya)(ya)(ya)(ya)髓(sui)(sui)炎(yan)(yan)。慢(man)(man)性(xing)開放(fang)性(xing)牙(ya)(ya)(ya)(ya)髓(sui)(sui)炎(yan)(yan)又(you)叫作慢(man)(man)性(xing)潰瘍牙(ya)(ya)(ya)(ya)髓(sui)(sui)炎(yan)(yan)。慢(man)(man)性(xing)增(zeng)(zeng)生性(xing)牙(ya)(ya)(ya)(ya)髓(sui)(sui)炎(yan)(yan)又(you)稱(cheng)牙(ya)(ya)(ya)(ya)髓(sui)(sui)息肉(rou)。

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