Histological evaluation of a tooth with hyperplastic pulpitis and periapical osteosclerosis.
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The objective of this study was to investigate the expression of surface markers on T lymphocytes and the Th1/Th2 immune response in pulpal inflammation associated with specific bacteria. Pulpal inflammation was experimentally induced in rat mandibular incisors by drilling, without coolant, to open pulp chambers. Streptococcus mutans (S. mutans group), Porphyromonas endodontalis (P. endodontalis group), and a sterile cotton pellet only (control group) were inoculated in the canal. The expression of CD25 and CD54 on CD4+, and CD8+ lymphocytes in pulp tissues was determined by using a flow cytometer. The levels of interleukin (IL)-2, interferon (IFN)-gamma, and IL-4 were measured by ELISA. Flow-cytometric analysis showed that the mean ratio of CD4+:CD8+ was 0.96 in the control group, 0.99 in the S. mutans group, and 0.52 in the P. endodontalis group. An increase in CD25 and CD54 expression on CD4+ T lymphocytes was related to the bacterial infection (p < 0.05) and accompanied an increase in IL-2 concentration. The higher concentration of IFN-gamma than IL-4 in the P. endodontalis group suggested a Th1 reaction in the early stage of pulpal inflammation induced by P. endodontalis.
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This study reports on the occurrence of class II antigen expressing cells in inflammatory lesions experimentally induced in the rat incisor pulp. Concanavalin A and lipopolysaccharide of Bacteroides gingivalis were applied to the exposed pulp following a preparation through alveolar bone and dental tissues in the midpart of the root. In a set of control teeth, pulpal exposures were capped with Cavit without the placement of antigenic material. Animals were killed after 3, 12, 24, 48 or 96 hours. Pulp tissue specimens were subjected to immunohistochemical analysis utilizing a monoclonal mouse anti-rat class II antigen antibody. Semi-quantitative assessment of positively stained cells was carried out under the light microscope. Significantly more class II antigen expressing cells were identified in the challenged pulps than in the controls at all experimental periods. The increase in cells peaked at 48 hours to taper off at the subsequent 96-hour observation. The rapid and intense influx of class II antigen expressing cells suggests that these cells are associated with the initial defence of the dental pulp.
Correlations were sought between the number and type of microorganisms recovered from sampled carious dentin and the cellular responses observed in dental pulpal tissues from a sample of 65 vital, carious teeth extracted from adult humans who had declined the option of tooth restoration. Standardized homogenates of carious dentin were plated using selective and nonselective media under anaerobic and microaerophilic conditions. Pulpal responses were characterized histopathologically on the basis of the nature of the cellular infiltrate and the extent of degenerative changes. A significant association between the number of Prevotella intermedia and Prevotella melaninogenica in carious dentin and extensive, principally mononuclear, inflammatory infiltration was evident despite a high degree of complexity and intersubject variability in the microbial flora. There was no apparent association between other microorganisms or total microbial load and the histopathological category.
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Bovine serum albumin (BSA) was topically applied to exposed dentin to assess whether inflammatory reactions can be induced in the pulp of monkeys immunized against BSA. Four cynomolgus monkeys received repeated injections of BSA emulsified with Freund's incomplete adjuvant. Pulp challenge was performed by applying BSA in freshly cut dentin cavities prepared on the buccal surface in 34 teeth. In 29 control teeth ovalbumin (OVA) was applied. Control applications of BSA were also performed in 15 teeth prepared in three nonimmunized monkeys. Forty-eight hours after the initiation of the pulp challenge the monkeys were sacrificed and the pulp tissue examined in the light microscope. Topical application of BSA to freshly exosed dentin in immunized monkeys resulted in severe inflammatory lesions in the pulp, characterized by bleeding and extravascular infiltration of large numbers of leukocytes. Extensive tissue damage was an important feature in several pulps. Identical applications of OVA in control teeth and BSA applications in nonimmunized monkeys produced no such reactions. The results indicate that interactions between antigens and antibodies can occur within the dentin-pulp area and following the formation of immune-complexes, severe injury to the pulp can be induced.
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Dental charts and records of 71 dogs were received and 84 intact tooth crowns were noted to have been entirely discolored in shades of pink, purple, grey, or tan. Endodontic therapy was performed on 49 of these teeth allowing gross examination of the entire pulp. In exploratory pulpotomy was performed in 15 teeth prior to exodontic therapy in order to assess the integrity of the coronal pulp. Gross signs of partial or total pulp necrosis were present in 59 (92.2%) of these teeth. The pulp was not observed grossly in 20 teeth which received exodontic therapy. Overall, of the 84 teeth evaluated, 36 (42.9%) had no radiographic signs of endodontic disease. Gross or radiographic signs of endodontic disease were absent in only 2 (4.1%) discolored teeth receiving endodontic therapy. Based on the low incidence of vital, affected teeth in the dogs of this study, endodontic on exodontic therapy is recommended for discolored teeth.
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