Dental Pulp: Correspondences and Contradictions between Clinical and Histological Diagnosis

Abstract

Dental pulp represents a specialized connective tissue enclosed by dentin and enamel, the most highly mineralized tissues of the body. Consequently, the direct examination as well as pathological evaluation of dental pulp is difficult. Within this anatomical context, our study aimed to evaluate the correlation between dental pulp lesions and clinical diagnosis. Pulpectomies were performed for 54 patients with acute and chronic irreversible pulpitides and for 5 patients (control group) with orthodontic extractions. The morphological features were semiquantitatively assessed by specific score values. The clinical and morphological correspondence was noted for 35 cases (68.62%), whereas inconsistency was recorded for 16 cases (31.38%). The results of the statistical analysis revealed the correlations between clinically and pathologically diagnosed acute/chronic pulpitides. No significant differences were established between the score values for inflammatory infiltrate intensity, collagen depositions, calcifications and necrosis, and acute, respectively chronic pulpitides. We also obtained significant differences between acute pulpitides and inflammatory infiltrate and calcifications and between chronic pulpitides and inflammatory infiltrate, collagen deposition, and calcifications. On the basis of the predominant pathological aspects, namely, acute and chronic pulpitis, we consider that the classification schemes can be simplified by adequately reducing the number of clinical entities.

Histology‐based profile of inflammatory mediators in experimentally induced pulpitis in a rat model: screening for possible biomarkers

“…Similar to the events during wound infections occurring at other sites, PMNs are recruited abundantly and provide the first line of defence in pulp tissue (Cooper et al 2017). Neutrophil infiltration has been reported to be the key feature in defining the severity of pulp lesions in acute pulpitis in humans (Giuroiu et al 2015). On the one hand, neutrophils help clear infections by engulfing and destroying invading microorganisms.…”

Surgical Sealing of Laterally Localized Accessory Root Canal with Resin Containing S-PRG Filler in Combination with Non-Surgical Endodontic Treatment: A Case Report

“…Thus, we hypothesized that the pulp tissue in the apical region had calcification ability. As prolonged pulp inflammation is known to be related to pulp calcification such as the pulp stone [ 23 ] we assumed that the bacterial remnants from the primary carious treatment received at around 10 years of age induced chronic pulpal inflammation, which may have caused the calcification in the apical region. As we were unable to feel any dentin bridge-like hard tissue by hand during non-surgical endodontic treatment, this hard tissue was suggested to be fragile and flimsy.…”

Therapeutic effect of one-time root canal treatment for irreversible pulpitis

“…In this context, severe tooth pain can occur when the patient is not exposed to external stimuli and may cause pain in the head and face, which may lead to challenges during diagnosis and treatment. 14,15 Currently, the clinical management of pulpitis primarily involves root canal therapy. The main purpose of this approach is to thoroughly clean the infected dental pulp while at the same time cleaning the dentin and removing toxic decomposition products of the teeth.…”