Morphometric Analysis of Teeth with Inflamed Pulp

Abstract

The most common method of evaluating pulp tissue reactions to injury is by a qualitative assessment of pulp tissue alterations. This evaluation method is subjective and difficult to quantify; stereological methods are more suitable, for they can quantify important tissue components, and so more objectively describe pulp tissues.

This study compares a morphometric and a descriptive method of classification for pulp tissue analysis by using 15 teeth with inflamed pulp tissue, and 12 teeth experimentally pulp-capped with calcium hydroxide. Morphometric analysis allowed for volumes of remaining dentin, pulp tissue, inflamed pulp tissue, and reparative dentin to be calculated. In addition, volume densities of polymorphonuclear and mononuclear leukocytes, odontoblasts, fibroblasts, erythrocytes, vessels, and residual tissue were calculated for comparison among different experimental teeth.

The morphometric method provided a quantitative description of tissue reactions. The descriptive method of classification was adequate when inflamed tissue subjacent to the cavity was evaluated, but was less precise than the morphometric method in describing reactions deeper in the tissue. The descriptive method could delineate the amounts and types of inflammatory cells only in non-quantified terms, while the morphometric method could quantify and locate them. It also yielded a quantified evaluation of the healing sequence of experimentally pulp-capped teeth.

In conclusion, a morphometric method can yield more quantitative data on pulp tissue reactions than can a descriptive method of classification.

Get full access to this article

View all access options for this article.

References

Benjamin, N. ; Cleaton-Jones, P. ; and Leidal, T.I. (1985): Histometric Evaluation of Odontoblast Response to Nobetec® and Syper Syntrex®, Endodont Dental Traum 1:180-184.

Bergenholtz, G. (1977): Effect of Bacterial Products on Inflammatory Reactions in the Dental Pulp, Scand J Dent Res 85:122-129.

Bergenholtz, G. ; Lekholm, U. ; Liljenberg, B. ; and Lindhe, J. (1983): Morphometric Analysis of Chronic Inflammatory Periapical Lesions in Root-filled Teeth, Oral Surg 55:295-301.

Bergenholtz, G. and Warfvinge, J. (1982): Migration of Leukocytes in the Dental Pulp in Response to Plaque Bacteria, Scand J Dent Res 90:354-362.

Browne, R.M. ; Plant, C.G. ; and Tobias, R.S. (1980): Quantification of the Histological Features of Pulpal Damage, Int Endodont J 13:104- 111.

Cox, C. and Bergenholtz, G. (1986): The Healing Sequence in Capped Inflamed Dental Pulps of Rhesus (Macaca mulatta) Monkeys, Int Endodont J (accepted).

Cruz-Orive, L.M. ; Hoppeler, H. ; Mathieu, O. ; and Weibel, E.R. (1985): Stereological Analysis of Anisotropic Structures Using Directional Statistics, J R Stat Soc (Series C, Appl Stat) 34:14-32.

Fitzgerald, M. (1979): Cellular Mechanisms of Dentin Bridge Repair Using 2H-thymidine, J Dent Res 50 (Sp Iss):2198-2206.

Gundersen, H.J. ; Boysen, M. ; and Reith, A. (1981): Comparison of Semiautomatic Digitizer-tablet and Simple Point Counting Performance in Morphometry, Virchows Arch Abt B Zellpath 37:317-325.

10.

Gundersen, H.J.G. and Sterby, R. (1981): Optimizing Sampling Efficiency of Stereological Studies in Biology: or 'Do more less well!', J Microsc 121:65-73.

11.

Langeland, K. (1957): Tissue Changes in the Dental Pulp. An Experimental Histological Study, Odont Tidskr 65:239-387.

12.

Mathieu, O. ; Cruz-Orive, L.M. ; Hoppeler, H. ; and Weibel, E.R. (1980): Measuring Error and Sampling Variation in Stereology: Comparison of the Efficiency of Various Methods for Planar Image Analysis , J Microsc 121:75-88.

13.

Mjor, LA and Tronstad, L. (1972): Experimentally Induced Pulpitis, Oral Surg 34:102-108.

14.

Schroeder, H.E. and Lindhe, J. (1975): Conversion of Stable Established Gingivitis in the Dog into Destructive Periodontitis, Arch Oral Biol 20:775- 782.

15.

Schroeder, H.E. and Münzel-Pedrazzoli, S. (1973): Correlated Morphometric and Biochemical Analysis of Gingival Tissue, J Microsc 99:301-329.

16.

Stanley, H.R. (1970): Methods and Criteria in Evaluation of Dentin and Pulp Response, Int Dent J 20:506-527.

17.

Stern, M.H. ; Dreizen, S. ; Mackler, B.F. ; Selbst, A.G. ; and Levy, B.M. (1981): Quantitative Analysis of Cellular Composition of Human Periapical Granuloma, J Endodont 7:117-122.

18.

Warfvinge, J. ; Dahlen, G. ; and Bergenholtz, G. (1985): Pulpal Reactions to Bacterial Cell Wall Material , J Dent Res 64:1046-1050.

19.

Weibel, E.R. (1979): Practical Methods for Biological Morphometry. In: Stereological Methods, Vol. 1, London: Academic Press.