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Clinical, radiological, and histological correlation in diagnosis of pulpitis
Maryam Raoof1, Elahe Vazavandi2, Molook Torabi Parizi3, Nima Hatami4, Sakineh Mohammadalizadeh5, Sara Amanpour3, Jahangir Haghani3
1 Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran; Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry of Amsterdam, University of Amsterdam and Vrije Universities Amsterdam, Amsterdam, The Netherlands
2 Department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Mashhad Univercity of Medical Science, Mashhad, Iran
3 Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran
4 Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran
5 Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
Correspondence Address:
Dr. Elahe Vazavandi
Department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Mashhad Univercity of Medical Science, Mashhad
Iran
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1735-3327.340110
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Background: To establish an endodontic diagnosis, a clinician should consider a variety of factors. Various studies have failed to demonstrate a strong correlation between histological findings with clinical and radiographic assessments. This study sought to evaluate the histopathological features of reversible and irreversible pulpitis diseases and their correlation with clinical diagnosis in extracted human molar teeth.
Materials and Methods: In this experimental ex vivo study, 75 molars with caries and three intact molars were used. According to the radiographic findings and clinical criteria and the need for root canal therapy, samples were categorized as having normal/reversible pulpitis and irreversible pulpitis. Immediately after extraction, an exposure was made at 2 mm below the cementoenamel junction. Formalin-fixed specimens were decalcified, sectioned and stained with hematoxylin and eosin for histological examinations using light microscopy. Variables including the type and severity of the inflammation, hyperemia, necrosis, fibrosis and the existence of an odontoblastic layer and dentin bridge were evaluated. The Fisher's exact test and the Chi-squared test were used for statistical analysis. P <0.05 was considered as significant.
Results: Acute inflammation, hyperemia and pulp exposure were significantly more common among subjects with irreversible pulpitis (P < 0/005). However, fibrosis was significantly higher in the reversible group (P < 0/005). There were no statistically significant differences between the groups regarding the other variables.
Conclusion: Some discrepancies between clinical, radiographic and histological findings were observed in our experimental study. Indeed, effective clinical practice requires consideration of all discrepancies found.
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