Determination of endotoxins in the vital pulp of human carious teeth: association with pulpal pain.

OBJECTIVES: The aims of this investigation were to determine the presence or absence of endotoxins in the pulp of symptomatic and symptom-free human carious teeth, to quantify the amount of endotoxins present, and to associate the presence of endotoxins with the acute pulpal pain. MATERIAL AND METHODS: Pulpal tissue was sampled from 28 single-rooted carious teeth (15 symptomatic, 13 symptom-free) derived from 28 patients. Samples were also taken from the pulp of 5 noncarious control teeth. During sampling an effort was made to collect an equal weight of pulpal tissue in all cases (approximately 8 mg). The extraction of endotoxins was performed with the use of phenol-water. The assay and quantitative determination of endotoxins was performed with the use of a limulus lysate test. The data were analyzed statistically by using the independent t test. RESULTS: Endotoxins were detected in pulpal tissues of all carious teeth in the symptomatic (mean average, 0.15773 ng/mL; SD = 0.045811) and symptom-free group (mean average, 0.10723 ng/mL; SD = 0.010925). In noncarious control teeth, endotoxins were not detected. The presence of endotoxins was significantly higher in the group of symptomatic teeth than in the group of symptom-free teeth (P <.001). CONCLUSIONS: The presence of endotoxins in the pulpal tissue of all the carious teeth indicates that they may play a major role in the pathogenesis of human pulpal diseases. Since a significantly higher level of endotoxins was detected in the pulp of symptomatic carious teeth than in that of symptom-free carious teeth, an association of endotoxins levels with severity of pulpal pain is probable.

Determination of endotoxins in caries: association with pulpal pain.

AIM: The aims of this study were: (i) to determine the presence or absence of endotoxins in the superficial and deep layers of carious lesions of symptomatic and asymptomatic teeth with vital pulps; (ii) to quantify the amount of endotoxin present; and (iii) to associate the presence of endotoxins with the acute pulpal pain derived from the irreversible pulpitis. METHODOLOGY: Two specimens of carious dentine were taken under aseptic conditions from symptomatic teeth with irreversible pulpitis (n = 9) and asymptomatic teeth with reversible pulpitis (n = 11). The first specimen was taken from a layer of superficial caries and the second from a deeper one. Sound dentine was also collected from intact teeth without restoration and used as a noncarious control group (n = 4). During the patient sampling procedure an effort was made to collect an equal quantity of caries and sound dentine in all cases (approximately 6 mg). The extraction of endotoxins was performed using the Phenol-water method. The assay and quantitative determination of endotoxins was performed by the Quantitative Chromogenic test using Limulus Lysate. Data were analysed statistically using either independent or paired t-tests. RESULTS: The results indicated that endotoxins were present in the superficial and deep layers of caries of all symptomatic teeth with irreversible pulpitis (0.15078 and 0.12111 ng mL-1, respectively), with significantly greater amount (P < 0.01) in the superficial compared to the deep layer. Endotoxins were found in superficial and deep layer of caries of all asymptomatic teeth with reversible pulpitis (0.12091 and 0.07163 ng mL-1, respectively), with significantly greater amounts (P < 0.001) in the superficial compared to the deep layer. The results also demonstrated that significantly greater concentrations (P < 0.005) of endotoxins were present in the superficial carious layer of symptomatic compared with asymptomatic teeth (0.15078 and 0.12091 ng mL-1, respectively). Likewise, significantly greater amounts (P < 0.001) of endotoxins were present in the deep carious layer of symptomatic compared with asymptomatic teeth (0.12111 and 0.07163 ng mL-1, respectively). In sound dentine no endotoxins were detected. CONCLUSIONS: This study demonstrates that endotoxins are present in carious lesions of symptomatic and asymptomatic teeth. The amount of endotoxin was significantly greater in the superficial compared to the deep layer of carious dentine. More endotoxins are present in caries of painful teeth compared with those without symptoms.

Dens invaginatus in a mandibular lateral incisor.

A rare case of dens invaginatus involving a non-carious mandibular lateral incisor with periapical periodontitis is reported. Invaginated teeth present technical difficulties in their clinical management because of their abnormal anatomy. In the present case, non-surgical root canal therapy was chosen. A one-year follow-up clinical and radiographic examination showed a non-symptomatic tooth with osseous healing proceeding.

[Clinico statistical study of the dental education and dental care in the clinic of endodontics. 1. Endodontic therapy of pulpless teeth]. / Klinikostatistike melete tes parechomenes ekpaideuses kai perithalpses sten klinike tes endodontias.

In this clinico statistical study we tried to evaluate the program of education and the dental care provided by the clinic of Endodontics of the Athens University Dental School. The material for this study was the data from 2726 pulpless teeth. The endodontic treatment was done by the students of the 5th year at the Department of Endodontics during the year 1983-1987. The statistical analysis of the material of all the cases was based on: the possibility of perfect obluration of the root canal and the existence of periapical lesions in relation to the teeth group, the jaw and the age of the patient. The evaluation of the results proved that the education and treatment were satisfactory in quantity and quality. It was also found that the success of the obturation depended on the teeth group and had nothing to do with age. It was also found that the biggest percentage of periapical lesions concerned the anterior teeth.

[Study in SEM of the number and size of the main and accessory foramens of the first lower premolars]. / Melete ton akrorrizion ton proton kato progomphion sto elektroniko mikroskopio saroses (EMS).

The authors in this study have been used the apexes, 4 mm in length, from 93 first lower premolars, from patients over 45 years old. All specimens were prepared for SEM visualization. It was found that in 84.95% of them there was present at least one accessory foramen. All accessory foramens has a diameter less than 100 microns, with a mean value 52 microns. Also in a 74.19% of the 93 teeth, there was present a second main foramen. These foramens had a diameter more than 100 microns, with a mean value 368 microns. Finally it was found that when an extra main foramen was present, the mean value of the diameter remained the same and not smaller than that of the teeth with one main foramen. This may be of a significant clinical value, because this means that the pulp takes extra volumes of blood from these extra foramens.