Authors: Langeland K, Rodrigues H, Dowden W.
Title: Periodontal disease, bacteria, and pulpal histopathology.
Journal: Oral Surg Oral Med Oral Pathol
Date: Feb 1974
Citation: 37(2):257-70
Category: Endodontic-Periodontal Relationships
Evidence-based Ranking: 4
Purpose/ Objectives: 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.

Material and Methods: Sixty teeth with various degrees of periodontal disease were extracted. All teeth do not have clinically identified caries. The teeth were histologically processed and evaluated with microscopes.

Observations: -The presence of inflammatory cells in the pulp occurred more frequently relative to the apical progress of the bacteria on the root surface. -In 47 cases, pulpal calcifications were present. -In seven cases, bacteria involved the apical foramen of one or more roots with varying degrees of pulpal inflammation. • Mandibular third molar with periapical radiolucency involved both roots. Histologic sections showed bacterial plaque involving the apical foramen of the mesial root but not the distal root. • Maxillary molar with periodontal involvement of all three roots before extraction. The histologic sections showed disintegrating pulp tissue in all roots.

Author’s Conclusion: The cumulative effect of periodontal disease, as indicated by the factors of calcifications, resorption, or inflammation from involved lateral canals, will be damaged pulp tissue, but total disintegration apparently occurs only when all main apical foramina are involved by bacterial plaque.

Reviewer’s Comments: A good study for perio-endo relationships.