Dental Pulp: Correspondences and Contradictions between Clinical and Histological Diagnosis.

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.

Considerations on the epidemiology, etiology and profile of periodontal--dental injuries in preschool population in Iasi county.

UNLABELLED: In recent years there has been a considerable increase in the number of temporary teeth injuries, this variability being determined by multiple etiologic factors, which we need to be aware of, as well as by predisposing conditions. AIM: To characterize the epidemiology, etiology and pathology of specific types of periodontal-dental trauma in a series of preschool children from Iasi County. MATERIAL AND METHODS: The study included a total of 672 subjects aged 3 to 7 years old, from both urban and rural areas of Iasi County. Statistical analysis was performed using STATISTICA software used in medical research. RESULTS: Prevalence of periodontal-dental trauma in the study group was 19.64%. Gender distribution in the study group showed a preponderance of males (62.12%). The risk of periodontal-dental trauma in deciduous teeth was 1.63 times higher in boys compared to girls. Fall accidents (41.67%) closely followed by playground accidents (31.82%) were the most common causes of periodontal-dental trauma in the study group. CONCLUSIONS: The prevalence of temporary dental trauma in the study group was relatively high, requiring the implementation of oral health promotion strategies and prevention programs, primarily addressed to parents and educators.

Clinical-radiological study on the role of biostimulating materials in iatrogenic furcation lesions.

UNLABELLED: Root perforation is an unwanted incident which may occur at any stage of endodontic treatment and can adversely affect tooth prognosis. AIM: To compare the recovery rate after treatment of root perforations in the interradicular area of the molars, using two different materials: MTA and ceramic nanoparticles mineral cement DiaRoot BioAggregate, by a clinical-radiological and statistical analysis over a period of up to 24 months. MATERIAL AND METHODS: The study was conducted on 28 molars from patients of both sexes, mean age 33.29 +/- 6.2DS, with iatrogenic perforation of pulp chamber floor. The teeth were divided into 2 groups according to the applied material: group 1--gray MTA (ProRoot MTA, Dentsply, Tulsa Dental), and group 2--BioAggregate (Diadent Group International, Vancouver). Patients included in the study were monitored and assessed by radiological examinations at 6, 12 and 18 months. RESULTS: Pulp chamber floor perforations are significantly associated with tooth location (chi2 = 35.60, r = 0.67, p = 0.00359, 95% CI). Both when the perforation was repaired with MTA and BioAggregate, the clinical improvement was significant (chi2 = 17.608, r = 0.58, p = 0.0035, 95% CI). CONCLUSIONS: Based on the results of this study, both MTA and BioAggregate are excellent materials for root perforation repair.

[Longitudinal study of the efficacy of conservative endodontic treatment for chronic periapical lesions]. / Studiu longitudinal privind eficienta tratamentelor endodontice conservatoare pe un lot de dinti cu leziuni periapicale cronice.

UNLABELLED: Our study aimed to assess the possibilities of healing in periapical lesions following endodontic therapy, using a standardised technique. MATERIAL AND METHODS: Study group included 34 patients with 15-45 age. 40 teeth with periapical granuloma and periapical difuse osteitis were endodontically treated. All teeth presented radicular obturations with adequate length and density consisting of gutaperca points and antiseptic sealer (Endoflas, Sanlor). Optimum coronal sealing was provided through prosthetic restorations or composite resins associated with glassionomer cements. All treated teeth were radiographically monitorised on a 24 months time interval. Periapical Index (PAI) were used for assessment of periapical healing processes. Recorded data were used for statistical analysis in SPSS 16 trial. RESULTS: The assessment of periapical status after 24 months showed a complete periapical healing for 42.5% teeth (PAI 1-2), partial periapical healing for 52.5% teeth and 5% endodontic failures. Median values for PAI indices decreased from an initial 4.75 value to 4.30 after 3 months, 3.33 after 12 months and 2.60 after 24 months. Wilcoxon tests confirm significant statistical differences between PAI indices at different time intervals. CONCLUSIONS: Adequate radicular obturation associated with optimum coronal sealing provide a favourable environment for periapical healing processes, providing success in endodontic therapy of chronic apical periodontitis. Time interval represents a major factor that influences periapical remineralisation degree.

Modifications of the dental pulp in marginal periodontitis. Electronomicroscopical contributions.

Histological studies on teeth with marginal periodontitis, but without cavity lesions have shown a frequent apparition of modifications in the pulp tissue structure. In this study, by using the electron microscopy method, we have shown a series of interesting aspects of the intimate modifications that appear on the level of all components of the pulp tissue. The observations show that the degree of affecting can be correlated to the type of marginal periodontitis, and at the same time they contribute to a right evaluation of the defensive abilities of the pulp of the teeth with marginal periodontitis.

Radiological and microscopic aspects of the denticles.

In this paper we have realized a study on 43 patients on which the retro-alveolar radiological exam has shown the existence of a calcareous structure within the pulp chamber having in view a better knowledge of this structure and its etiology, way of forming and pathological implications. For 16 of the patients the radiological exam was supplemented by a microscopic examination. Radiologically, the denticles were noticed more often in the pulp chamber of the molars. The examination of the histological samples has evidenced aspects such as the size, shape and structure of the denticles. The concentric disposition of the tissue elements shows that in the formation of a denticle there is a "center" around which a conjunctive substance avid of calcium salts is deposited. The microscopic aspects noticed on large denticles allowed us to sustain the hypothesis that in a large pulp chamber many denticles form simultaneously and grow up and merge generating a large-sized unique calcareous structure.