Authors: Czarnecki RT, Schilder H.
Title: A histological evaluation of the human pulp in teeth with varying degrees of periodontal disease.
Journal: J Endod
Date: Aug 1979
Citation: 5(8):242-53
Category: Endodontic-Periodontal Relationships
Evidence-based Ranking: 4
Purpose/Objectives: To establish the degree to which pulpal pathosis is associated with periodontal disease as opposed to other complications such as caries, operative procedures or periodontal manipulation. Materials & Methods: The study involves histological examination of 46 human teeth in patients ranging in age from 14-89 years. The teeth were previously treatment planned for extraction. Prior to extraction, all teeth were evaluation both clinically and radiographically (probing depths, mobility, soft-tissue recession, occlusal evaluation, furcation involvement, radiographic analysis of bone level, and verification of no prior periodontal therapy). Electric and thermal pulp tests were performed on each tooth, as was tenderness to percussion. Thirty-nine of the teeth were normal, six were necrotic and one was “hyperemic”. The teeth were then extracted as atraumatically as possible and the pulp was promptly fixed. The pulps of the teeth were then examined microscopically. Results: All four teeth in the “normal” group appeared WNL histologically; only one tooth in the “gingivitis” group contained pulp tissue that was not WNL; of the 34 teeth in the “periodontitis” group, six teeth contained pulps that were not WNL. In all groups, all teeth that were “intact” (caries/restoration free) were WNL. Author’s Conclusion: No correlation could be found between the severity of periodontal disease in itself and the presence or absence of pulpal pathosis. Validity of Conclusion: Conclusions are of questionable validity. Reviewer’s Comments: Good study; the authors use the term “within normal limits” throughout the paper in relation to the histologic appearance of the pulpal tissue – this may be somewhat subjective. If their definition of WNL is lenient, this could have an impact on their findings and the overall conclusions of the study.