A clinical classification of the status of the pulp and the root canal system

School of Dentistry, The University of Western Australia, Nedlands.
Australian Dental Journal (Impact Factor: 1.1). 04/2007; 52(1 Suppl):S17-31. DOI: 10.1111/j.1834-7819.2007.tb00522.x
Source: PubMed


Many different classification systems have been advocated for pulp diseases. However, most of them are based on histopathological findings rather than clinical findings which leads to confusion since there is little correlation between them. Most classifications mix clinical and histological terms resulting in misleading terminology and diagnoses. This in turn leads to further confusion and uncertainty in clinical practice when a rational treatment plan needs to be established in order to manage a specific pathological entity. A simple, yet practical classification of pulp diseases which uses terminology related to clinical findings is proposed. This classification will help clinicians understand the progressive nature of the pulp disease processes and direct them to the most appropriate and conservative treatment strategy for each condition. With a comprehensive knowledge of the pathophysiology of pain and inflammation in the pulp tissues, clinicians may accomplish this task with confidence.

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    • "The mainstream publications report rather few studies focused on the relationship between the pathological and clinical status in dental pulp diseases [1, 8–14]. These studies draw the attention to the lack of concurrence between the clinical and pathological pictures, which therefore is deemed as a major impediment for the diagnosis accuracy, with a significant impact in endodontic practice [1] [10] [11] [14]. "
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    ABSTRACT: 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.
    Full-text · Article · Jun 2015
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    • "Pulp stones occur most frequently in the posterior teeth of both permanent and deciduous dentations (e.g., Langeland et al., 1974; Abbot and Yu, 2007; Goga et al., 2008; Sener et al., 2009; C ¸olak et al., 2012). Small pulp stones do not cause any pain, but as they increase in size they may apply pressure to the sensory nerve and cause pain (Abbot and Yo, 2007). The etiology of pulp stones is controversial. "
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    ABSTRACT: There are many reports in the literature concerning pulp stones in contemporary living populations, but there are no descriptions of cases of pulp stones and their prevalence in populations of the past. Here we present a study of pulp stones in a series of archaeologically derived samples from the Middle Euphrates Valley (Syria) obtained from two sites: Terqa and Tell Masaikh. The specimens were assigned to five periods: Early Bronze (2650-2350 BC); Middle Bronze (2200-1700 BC); late Roman (AD 200-400); Islamic (AD 600-1200); and Modern Islamic (AD 1850-1950). A total of 529 teeth representing 117 adult individuals of both sexes were examined. Pulp stones were identified by X-ray and 10 selected specimens were sectioned for histological study. Pulp stones were found in 99 of 117 individuals (85%) and in 271 of 529 (51%) teeth. Pulp stone prevalence was found to increase with age, for individuals of older age classes have more pulp stones than younger individuals. Intriguingly, the prevalence of single pulp stones was higher among older individuals (36-45, >46), while younger individuals (17-25, 26-35) more often possessed multiple stones. Individuals with moderate to highly advanced dental wear have pulp stones significantly more often than individuals whose tooth wear is limited to invisible or very small facets. Though there is no statistical significance in the prevalence of pulp stones across chronological periods, it appears that a high level of calcium in the diet is accompanied by a greater prevalence of pulp stones. Am J Phys Anthropol 153:103-115, 2014. © 2013 Wiley Periodicals, Inc.
    Full-text · Article · Jan 2014 · American Journal of Physical Anthropology
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    • "As pulp necrosis causes loss of the tooth's sensory apparatus, the dental pain associated with the initial inflammation completely subsides. Many patients at this point will assume the problem has improved or healed itself, but infection of the dental pulp may continue to spread through the apex of the pulp canal/s into the supporting structures, causing periapical periodontitis (Abbott & Yu, 2007). This may result in severe pain and often systemic effects (e.g. "

    Full-text · Chapter · Feb 2012
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