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PubMedDate not supplied

Cyclic Amp phosphodiesterase activity in normal and inflamed human dental pulp.

Cyclic AMP phosphodiesterase (cAMP PDE) seems to be important in pulp tissues. High levels of cAMP PDE have been demonstrated to be in dental pulp cells. In the present study cAMP PDE activity was analyzed in normal healthy human dental pulps, in reversible pulpitis and in irreversible pulpitis. Enzymatic cAMP PDE control values for normal healthy pulps were 12.14 +/- 3.74 nmols/mg of proteins. In reversible pulpitis the cAMP PDE activity increased almost 2.5 times. In irreversible pulpitis specimens the values increased 4.5 times compared with normal healthy pulps activity. The differences between the groups (control vs. reversible pulpitis and vs. irreversible pulpitis) were statistically significant. These results could point to a role of cAMP PDE in the initial pulp response after injury.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMedDate not supplied

Cyclic GMP phosphodiesterase activity role in normal and inflamed human dental pulp.

Cyclic GMP phosphodiesterase (cGMP PDE) plays an important role in pulp tissues. High levels of cGMP PDE are found in dental pulp cells. In the present study cGMP PDE activity was analyzed in normal healthy human dental pulps, in reversible pulpitis and in irreversible pulpitis. Enzymatic cGMP PDE control values for normal healthy pulps were 4.74+/-0.32 nmol/mg of proteins. In reversible pulpitis the cGMP PDE activity increased almost 3 times. In irreversible pulpitis specimens the values increased 4.5 times compared with the normal healthy pulps activity. The differences between the groups (control vs. reversible pulpitis and vs. irreversible pulpitis) were statistically significant. These results point to a role of cGMP PDE in the initial pulp response after injury.

3',5'-Cyclic-GMP Phosphodiesterases↗
PubMed1996

Correlation of clinical pain symptoms with histopathological changes of the dental pulp: a review.

Pulpalgia is strong and often throbbing and it can start and stop spontaneously. When evoked, pain in pulpitis outlasts the stimulus. The pain is difficult to localise and often radiates to other parts of the face. But the pain symptoms vary. There are cases of severe pulpitis progressing to abscess formation and even necrosis without any symptoms (silent pulpitis). In some cases slight pulpal inflammatory changes will cause severe pain. It seems that correlation between clinical symptoms and histopathological condition of the pulp is not clear. Pulpal inflammatory changes may cause hypersensitivity of the intradental nerves. Vasodilation, increased vascular permeability and extravasation will cause increased intrapulpal pressure. This could spontaneously activate the pulpal nerves. The increased pressure will selectively activate the C-fibres while blocking the A-fibres which are more vulnerable to hypoxia. This would explain the change in pain symptoms during progress of pulpitis to dull type of pain. Some of the inflammatory mediators can excite the pulpal nerves while others even have an analgesic effect. Some of the exogenous compounds (bacterial metabolites and substances released during the breakdown of dentine) induce nerve activity in the pulp while others have a depressing effect. The net effect will probably depend on the relative proportions and concentrations of these substances in the pulp. This would also explain the variability of pain symptoms in pulpitis. Also the condition of dentine with blocked or patent dentinal tubules is important. If the substances with depressive effect are predominantly in greater proportions and concentrations, and if the dentinal tubules are blocked, this could be the case of "silent pulpitis".

Dentin↗
PubMed1998

Superoxide dismutase activity in healthy and inflamed pulp tissues of permanent teeth in children.

The free radicals play an important role in the tissue damage. Oxygen-derived free radicals are controlled by various cellular defense mechanisms consisting of enzymatic such as superoxide dismutase, catalase, glutathion peroxidase and nonenzymatic scavenger components. Superoxide dismutase (SOD) is responsible for the dismutation of the superoxide radicals into hydrogen peroxide and molecular oxygen. In this study, pulp samples extirpated from the teeth of the 27 children between 10-15 ages which diagnosed to be healthy, reversible pulpitis or symptomatic irreversible pulpitis were evaluated for the activity of superoxide dismutase enzyme. There were statistically significant differences between healthy and reversible pulpitis, and between reversible and symptomatic irreversible pulpitis groups. The SOD activity of the reversible pulpitis group were significantly lower than the irreversible pulpitis and healthy pulp groups. The evaluation of the data revealed that the quantity of SOD as a vitality protector enzyme is low at the beginning of the inflammation as a consequence of rapidly depletion and/or destruction of this enzyme, but as the inflammation proceeds the pulp tissue showed adaptation to this situation.

Adolescent↗
PubMed2000

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.

Adolescent↗
PubMed1999

Effects of gender and acute dental pain on thermal pain responses.

OBJECTIVE: Considerable research suggests that females exhibit greater sensitivity to laboratory pain procedures than do males; however, whether the presence of acute clinical pain influences this sex difference in pain sensitivity has not been investigated. The present experiment investigated the effects of sex and acute dental pain on laboratory pain responses. DESIGN: Thermal pain onset and tolerance were determined in 46 dental patients (15 male, 31 female) experiencing pain due to acute irreversible pulpitis and in 33 healthy controls (13 male, 20 female). In addition, measures of mood and coping were obtained in all participants. All subjects participated in two experimental sessions. The first session took place immediately before the patients underwent endodontic treatment for relief of pulpal pain. The second session took place approximately 1-2 weeks later, when pulpitis patients were pain free after treatment. During each session, thermal pain onset and tolerance were assessed with a 1-cm2 contact thermode applied to the right volar forearm using an ascending method of limits. RESULTS: During both sessions, thermal pain onset and tolerance were lower in control females than in control males; however, male and female pulpitis patients did not differ in their thermal pain responses during either session. Pulpitis patients also showed greater affective distress than controls. CONCLUSIONS: These data suggest that the sex difference in thermal pain sensitivity frequently reported in pain-free subjects appears to be absent in patients presenting with acute dental pain. However, this effect cannot be explained solely based on the presence of clinical pain because the effect on pain threshold and tolerance persisted into session 2, when pulpitis patients were pain free. Potential explanations for these results are discussed.

Acute Disease↗
PubMed2005

Relationship of patient complaints and signs to histopathologic diagnosis of pulpal condition.

The correlation between the histopathologic examination of pulp biopsy specimens and patients' complaints and signs was investigated. The sensitivity, specificity and reliability of each complaint and sign, and the characteristics of pain that are associated with treatable and untreatable pulp states is proposed. Pulp specimens were obtained from teeth that required endodontic treatment. Clinical data were recorded to identify each patient's complaints. The pulp specimens were processed and the histopathologic diagnoses were categorised and correlated with the patients' complaints. Of the 240 cases, 100 (41.7%) were diagnosed as atrophic pulp or pulposis; 4 (1.7%) as acute pulpitis; 64 (26.7%) as transitional stage; 56 (23.3%) as chronic pulpitis, and 16 (6.7%) as acute pulpitis superimposed on a chronic pulpitis. Results showed that previous pain (p < 0.05), spontaneous pain (p < 0.01), and prolonged pain on cold stimuli (p < 0.05), were significantly more frequent in the patients with chronic pulpitis compared to those with pulposis or transitional stage. We concluded that clinicians must consider the sensitivity and specificity of patient complaints and signs in order to perform a diagnosis based upon clinical evidence.

Acute Disease↗
PubMed2000

Bradykinin levels in dental pulp by microdialysis.

Bradykinin is a potent mediator of pain and inflammation. To examine extracellular levels of bradykinin in human dental pulp, CMA/20 microdialysis probes were inserted into the pulp tissue of 22 teeth diagnosed with normal pulp or with irreversible pulpitis before their extraction or endodontic therapy. Probes were perfused with a modified Locke-Ringer's buffer and bradykinin levels in the dialysate evaluated using a radioimmunoassay. Mean extracellular levels of bradykinin within pulp tissue diagnosed with irreversible pulpitis were significantly higher (262.26 +/- 83.79 fmol/ml) than that found within normal pulp (19.41 +/- 6.47 fmol/ml). Highest levels of bradykinin were detected in pulp tissue diagnosed with irreversible pulpitis when the patient had reported pain in the past, compared with patients who were in pain just before their visit. These observations suggest that the bradykinin system is activated during pulpitis and may contribute to pain and inflammation.

Bradykinin↗
PubMed2002

Tissue levels of matrix metalloproteinases in pulps and periapical lesions.

The purpose of this study was to evaluate the tissue levels of matrix metalloproteinase (MMP)-1, -2, -3 and their distributions in inflamed human dental pulps and periapical lesions. Samples were subjected to enzyme-linked immunosorbent assay and/or immunohistochemistry by using specific antibodies to MMP-1, -2, and -3. Results from enzyme-linked immunosorbent assay were analyzed by using the Mann-Whitney U test and presented as p values. The concentrations of MMP-1 in all experimental groups were significantly higher than in the control (p < 0.05). The acute pulpitis and control groups were significant different in terms of their MMP-2 levels (p < 0.05). The concentration of MMP-3 in acute pulpitis was significantly higher than the control and chronic pulpitis groups (p < 0.05). Immunohistochemically, MMP-1 and MMP-3 were localized in the infiltrating neutrophils, macrophages, and extracellular matrix of the acute pulpitis group. These results suggest that MMPs play an important role in the pulp tissue destruction of acute, inflamed pulp.

Acute Disease↗
PubMed2005

Calcitonin gene-related peptide receptor expression in healthy and inflamed human pulp tissue.

AIM: To use radioreceptor analysis for comparing calcitonin gene-related peptide (CGRP) receptor expression in human pulp tissue samples collected from teeth having a clinical diagnosis of acute irreversible pulpitis, healthy pulps and teeth with induced inflammation. METHODOLOGY: Six pulp samples were obtained from teeth having a clinical diagnosis of acute irreversible pulpitis. Another eight pulp samples were obtained from healthy premolars where extraction was indicated for orthodontic purposes. In four of these premolars, inflammation was induced prior to pulp collection. All the samples were processed and labelled with 125I-CGRP. Binding sites were identified by 125I-CGRP and standard CGRP competition assays. RESULTS: CGRP receptor expression was found in all human pulp tissue samples. Most receptors were found in the group of pulps from teeth having a clinical diagnosis of acute irreversible pulpitis, followed by the group of pulps having induced inflammation. The least number of receptors was expressed in the group of healthy pulps. The Kruskal-Wallis and Mann-Whitney (post-hoc) tests showed statistically significant differences between the groups (P < 0.05). CONCLUSION: CGRP receptor expression in human pulp tissue is significantly increased during inflammatory phenomena such as acute irreversible pulpitis.

Adult↗
PubMed2007

Substance P receptor expression in healthy and inflamed human pulp tissue.

AIM: To use radioreceptor analysis for comparing substance P (SP) receptor expression in human pulp tissue samples collected from teeth having a clinical diagnosis of acute irreversible pulpitis, healthy pulps and teeth with induced inflammation. METHODOLOGY: Five pulp samples were obtained from teeth having a clinical diagnosis of acute irreversible pulpitis. Another 10 pulp samples were obtained from healthy premolars where extraction was indicated for orthodontic purposes. In five of these premolars inflammation was induced prior to pulp collection. All of the samples were processed and labelled with 125I-SP. Binding sites were identified by 125I-SP and standard SP competition assays. Kruskal-Wallis and Mann-Whitney (post-hoc) tests were used to establish statistically significant differences between the groups. RESULTS: Substance P receptor expression was found in all human pulp tissue samples. Most receptors were found in the group of pulps from teeth having a clinical diagnosis of acute irreversible pulpitis, followed by the group of pulps having induced inflammation. The least number of receptors was expressed in the group of healthy pulps. Statistical analysis revealed significant differences between the group of healthy pulp and both inflamed pulp groups (P < 0.01). CONCLUSION: Substance P receptor expression in human pulp tissue is significantly increased during inflammatory phenomena such as acute irreversible pulpitis.

Adolescent↗
PubMed2007

Elevated expression of Cu, Zn-SOD and Mn-SOD mRNA in inflamed dental pulp tissue.

AIM: To determine the mRNA expression levels of copper-zinc superoxide dismutase (Cu, Zn-SOD) and manganese SOD (Mn-SOD) in healthy and inflamed human dental pulp tissue. METHODOLOGY: Sixteen patients with symptomatic irreversible pulpitis (eight females and eight males) were selected for study. Normal healthy pulps were removed from extracted mandibular third molar teeth from 10 systemically healthy individuals (six females and four males). QRT-PCR analysis of Cu, Zn-SOD and Mn-SOD mRNA expression was carried out in 16 cases of irreversible pulpitis and in 10 cases of systemically healthy donors. The Shapiro-Wilk's test was used to test the normality of data, whereas the Mann-Whitney U-test was used to evaluate the significance of the differences between groups. Differences in the expression levels were considered to be statistically significant for P-values <0.05. RESULTS: A significant increase (P < 0.05) occurred in both Cu, Zn-SOD and Mn-SOD mRNA expression in cases of irreversible pulpitis. The increase in Mn-SOD level was significantly higher (P < 0.05) than the change observed for Cu, Zn-SOD. CONCLUSIONS: The development of pulpitis is associated with elevated transcription of both Cu, Zn-SOD and Mn-SOD; pulp tissue inflammation generated higher Mn-SOD transcription compared with Cu, Zn-SOD.

Adolescent↗
PubMed2000

Detection of interleukin-8 in exudates from normal and inflamed human dental pulp tissues.

OBJECTIVE: The purpose of this study was to investigate the level of IL-8 in exudates clinically obtained from normal and inflamed human dental pulp tissues so as to reveal the possible relationship between IL-8 and pulpitis. METHODS: Samples of 2 microliters of pulpal exudate from each normal or clinically diagnosed as acute or chronic pulpitis teeth was obtained by filter paper strips and IL-8 level was measured by ELISA method. RESULTS: No IL-8 was detected in the samples from normal pulp, but significant amount of IL-8 appeared in inflamed pulp tissues, and the level of IL-8 in exudates of acute stage of pulpitis was higher than that of chronic stage (P < 0.01). CONCLUSIONS: This study demonstrates that IL-8 is produced and accumulated in pulp inflammation and may play a role in the occurrence and development of human pulpitis.

Acute Disease↗
PubMed2000

Histopathology of the pulp of primary molars with active and arrested dentinal caries.

The purpose of this study was to compare the histological appearance of the pulp of human primary molars with active and arrested lesions. The sample consisted of 36 primary molars (18 with active lesions and 18 with arrested lesions) extracted from 35 children between 5 to 9 years of age. The histological diagnosis was classified in normal pulp, transitional stage, partial pulpitis, total pulpitis and total necrosis, and then subdivided in three subgroups: treatable, untreatable and questionable. Results showed that normal pulp or transitional stage (treatable category) was diagnosed in 50% of teeth with arrested lesions, compared to 11.1% of teeth with active lesions. Partial pulpitis (questionable category) was present in 38.8% with arrested lesions compared to 22.2% with active lesions. Total pulpitis and total necrosis (untreatable category) was diagnosed in 11.2% with arrested lesions compared to 66.7% with active lesions. The observed frequencies of histological categories between both groups were statistically significant (P < 0.05). Histologically, pulp reaction under active and arrested lesions in primary molars revealed the formation of a basophilic calcio-traumatic line at the junction of the primary and reparative dentin, formation of reparative dentin and a regular odontoblastic layer in 60% of the cases. Results indicated that the type of lesion (active or arrested) is a good indicator of the histological status of the pulp.

Basophils↗
PubMed1992

A clinical evaluation of root resorption by formocresol treatment in 120 cases of pulpotomy in permanent molars.

The effect of a formocresol pulpotomy of a 120 permanent molar showed external and internal resorption on distal root in lower molar, and palatal root in the upper molar. In this study 33.3% were male and 66.7% were female. The age distribution of patients was 16 to 20 years of age and 21 to 25 years of age. The rate of resorption for chronic pulpitis was more than acute pulpitis. The success of formocresol pulpotomy treatment at the end of the 10th year for acute pulpitis was 92.26% in contrast to 84% for chronic pulpitis.

Acute Disease↗
PubMed1983

An evaluation of dental pain using visual analogue scales and the Mcgill Pain Questionnaire.

A verbal and a visual scale to assess pain, the McGill Pain Questionnaire and the Visual Analogue Scales, were administered to 50 patients suffering from pulpitis and 50 patients suffering from pericoronitis. The results show that words chosen to describe dental pain of different etiologies include throbbing, sharp, aching, and annoying. Additional descriptive words used by patients with pulpitis, pericoronitis, and postoperative dental pain are sore and shooting and tender. Women who have pulpitis and pericoronitis report higher levels of pain than do men. The greater sensitivity of the scores obtained from the variables, number of words chosen, and pain rating intensity scale not only showed a significant difference between males and females, but also could distinguish between the two dental conditions. The value of the MPQ as a diagnostic tool in cases where it is difficult to elucidate the cause is limited.

Adult↗
PubMed1990

Changes in the pulpal vasculature during inflammation.

The reaction and vascular changes of pulpal vessels in experimentally induced acute and chronic pulpitis in dog teeth were investigated using corrosion resin casts and scanning electron microscopic examination. Following a cavity preparation without water cooling, increased permeability of blood vessels occurred in the primary stage of acute pulpitis. This was evidenced by the extravasation of resin in the vascular resin casts. This phenomenon was found initially in the venular network and in the post capillaries of the capillary network located under the dentin. In the resin casts of the vascular network underneath the cavity morphological change was minimal. This is in contrast to an expanded and tortuous granulomalike vascular network which was found around an abscess in chronic pulpitis.

Animals↗
PubMed1997

Detection of human IL-2 in normal and inflamed dental pulps.

Irreversible pulpitis has been associated with an increase in the number of pulpal T-cells. Interleukin-2 (IL-2) stimulates T-cell proliferation and signals the release of other proinflammatory mediators associated with connective tissue degradation. IL-2 has been suggested to be a useful marker of pathologic inflammatory activity in periodontal and systemic disease conditions. The purpose of this study was to analyze normal and inflamed dental pulps for the presence of immunoreactive IL-2 (iIL-2). Normal healthy pulpal tissue was obtained from 17 impacted third molars and inflamed samples were obtained from 12 symptomatic carious molars clinically diagnosed with irreversible pulpitis. Pulpal tissues were collected, prepared, and analyzed for histological status and iIL-2 concentration by a modified ELISA technique. iIL-2 was detected in all vital pulpal tissues. A t-test revealed significant differences in iIL-2 concentrations when inflamed pulpal tissues were compared to normal healthy samples (T = -2.75, p < 0.05). These results suggest that iIL-2 may serve as a marker of pathologic inflammatory activity in irreversible pulpitis.

Analysis of Variance↗