Periodontal disease, bacteria, and pulpal histopathology.

By Langeland K, Rodrigues H, Dowden W

Date: 08/1974
Journal: Oral Surg Oral Med Oral Patho

Summary:  

Purpose:

to correlate the presence of bacterial plaque over the entrance of either a lateral canal or a main canal with an inflammatory response in the root pulp.

Materials and Methods:

 – n: 60 teeth with various degrees of periodontal disease.

-Periodontal disease was dx clinically by the use of prob, mobility, and radiographic analysis.

-Teeth were bisected immediately after extraction.

-Teeth were then fixed, decalcified, serially sectioned, and stained with H&E, Masson’s trichrome to show the presence of collagen and epithelium, Brown & Brenn method to stain bacteria, and by the alcian blue-PAS method to demonstrate both bacteria and inflammatory cells.

-Teeth were divided to apical, middle, and coronal zones to evaluate it microscopically.

Most highlighted results:

-Coronal zone: vital and uninflamed pulpal tissue. Bacteria were not present at the level of the canal orifice in the PDL space, and there were no inflammatory cells, but calcifications were present in the coronal pulp and RCs.

-Only 31 teeth PDL were evaluated. All of the studied PDL showed inflammatory cells

-In 47 cases pulpal calcifications were present. On the root surface resorption was observed in 40 cases.

-There was an increase in frequency of resorption as the depth of bacterial penetration increased.

-In 7 cases bacteria involved the apical foramen with a varying degrees of pulpal inflammation

-Clinical Significance:

The cumulative effect of periodontal disease, as indicated by the factors of calcifications, apposition of calcified tissue, resorption, or inflammation from root caries or from involved lateral canals, will damage pulp tissue, but total disintegration is only when all main apical foramina are involved by bacterial plaque.