Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/588018877f8c9d0a098b4cb3
Revista de Odontologia da UNESP
Original Article

Análise microscópica de polpas de dentes humanos permanentes traumatizados

Microscopic analysis of the human pulp of permanent traumatized teeth

Bruno, K.F.; Alencar, A.H.G.; Estrela, C.; Batista, A.C.; Pimenta, F.C.

Downloads: 3
Views: 955

Resumo

O presente estudo tem como objetivos analisar microscopicamente a polpa de 20 dentes humanos permanentes traumatizados com coroa intacta e diagnóstico clínico de necrose pulpar, e avaliar a confiabilidade desse diagnóstico mediante os achados histopatológicos. As amostras de polpas removidas foram coradas pelas técnicas de Hematoxilina e Eosina, para avaliar possíveis alterações morfológicas, e pelo método de Brown e Brenn, para verificação de microrganismos. As análises - subjetiva geral e estatística (análise de diagnóstico) - revelaram que 3 dentes (15%) não apresentaram tecido pulpar, sendo caracterizados como autólise total, e 17 (85%) tiveram suas amostras de polpas analisadas à microscopia, sendo que 3 (15%) apresentaram necrose parcial sem condições de reparo e 14 (70%), necrose total; em 12 (65%) das 17 amostras de polpas, pôde ser verificada, pelo método de Brown e Brenn, a presença de microrganismos e nenhum dos critérios clínicos empregados no diagnóstico de necrose pulpar em dentes traumatizados foi patognomônico. Diante dos resultados, as seguintes conclusões podem ser destacadas: a) mediante os achados microscópicos, 100% dos dentes traumatizados estavam necróticos e em 65% destes, constatou-se presença de microrganismos; b) os testes de vitalidade pulpar ao calor, ao frio e o teste de percussão vertical foram os mais confiáveis para o diagnóstico de necrose pulpar nos dentes traumatizados.

Palavras-chave

Traumatismo, necrose pulpar, microscopia

Abstract

This study microscopically analyzed the pulp of 20 human permanent traumatized teeth with intact crowns and clinical diagnosis of pulp necrosis, and evaluated this diagnosis concerning histopatologic findings. The removed pulp specimens were stained with hematoxylin and eosin, for evaluation of possible morphological alterations, and Brown e Brenn method, to verify microorganisms. General subjective analysis and statistical analyses (diagnostic analysis) revealed that 3 teeth (15%) did not present pulp tissue, being characterized as complete autolysis; analysis of pulp samples was performed on the other 17 (85%) cases, among which 3 (15%) exhibited partial necrosis without possibility of repair and 14 (70%) presented complete necrosis; in 12 (65%) out of 17 pulps the presence of microorganisms could be conformed by Brown and Brenn method and none of the clinical criteria employed for the diagnosis of pulp necrosis in traumatized teeth was pathognomonic. The present results allowed the following conclusions: concerning the microscopic findings, 100% of traumatized teeth presented pulp necrosis and 65% of them with microorganisms; the pulp vitality tests to heat, cold and vertical percussion test were the most reliable to diagnose pulp necrosis in traumatized teeth.

Keywords

Trauma, pulp necrosis, microscopy

References



1. Abou-Rass M, Bogen G. Microorganisms in closed periapical lesions. Int Endod J. 1998;31:39-47.

2. Andreasen FM. Transient apical breakdown and its relation to color and sensibility changes after luxation injuries to teeth. Endod Dent Traumatol. 1986;2:9-19.

3. Andreasen FM. Histological and bacteriological study of pulps extirpated after luxation injuries. Endod Dent Traumatol. 1988;4:170-81.

4. Andreasen FM. Pulpal healing after luxation injuries and root fractures in the permanent dentition. Endod Dent Traumatol. 1989;5:111-31.

5. Andreasen FM. Transient root resorption after dental trauma: the clinician’s dilemma. J Esthet Restor Dent. 2003;15:80-92.

6. Andreasen FM, Vestergaard-Pedersen B. Prognosis of luxated permanent teeth: the development of pulp necrosis. Endod Dent Traumatol.1985;1:207-20.

7. Andreasen JO. Challenges in clinical dental traumatology. Endod Dent Traumatol. 1985;1:45-55.

8. Andreasen JO, Andreasen FM. Texto e atlas colorido de traumatismo dental. Porto Alegre: Artmed; 2001.

9. Arwill T, Henschen B, Sundwall-Hagland I. The pulpal reaction in traumatized permanent incisors in children aged 9-18. Odont Tidskrift. 1967;1:130-47.

10. Bergenholtz G. Microorganisms from necrotic pulp of traumatized teeth. Odont Revy. 1974;25:347-58.

11. Cipriano TJ, Walton RE. The ischemic infarct pulp of traumatized teeth: a light and electron microscopy study. Endod Dent Traumatol. 1986;2:196-204.

12. Cohenca N, Karni S, Rotstein I. Transient apical breakdown following tooth luxation. Dent Traumatol. 2003;19:289-91.

13. Côrtes MIS, Bastos JV. Lesões traumáticas na dentição permanente. In: Estrela C. Ciência endodôntica. São Paulo: Artes Médicas; 2004. p. 799-918.

14. Dumsha T, Hovland EJ. Pulpal prognosis following extrusive luxation injuries in permanent teeth with closed apexis. J Endod. 1982;8: 410-2.

15. Hahn C, Falkler Jr WA, Siegel MA. A study of T and B cells in pulp pathosis. J Endod. 1989;15:20-5.

16. Jacobsen I. Criteria for diagnosis of pulp necrosis in traumatized permanent incisors. Scand J Dent Res. 1980;88:306-12.

17. Le Goff A, Bunetel L, Mouton C, Bonnaure-Mallet M. Evaluation of root canal bacteria and their antimicrobial susceptibility in teeth with necrotic pulp. Oral Microbial Immunol. 1997;12:318-22.

18. Mangkornkarn C, Steiner JC, Bohman R, Lindemann RA. Flow cytometric analysis of human dental pulp tissue. J Endod. 1991;17:49-53.

19. Nair PNR. Light and electron microscopic studies of root canal flora and periapical lesions. J Endod. 1987; 13:29-39.

20. Novoa MMH. Análise comparativa da sintomatologia clínica do dente e a histopatologia do tecido pulpar [ dissertação mestrado]. Bauru: Faculdade de Odontologia da USP; 2005.

21. Paul BF, Hutter JW. The endodontic-periodontal continum revisited: new insights into etiology, diagnosis and treatment. J Am Dent Assoc. 1997;128:1541-8.

22. Petersson K, Soderstrom C, Kiani-Anaraki M, Lévy G. Evaluation of the ability of thermal and electrical tests to register pulp vitality. Endod Dent Traumatol. 1999;15:127-31.

23. Taklan S. A bacteriological study of pulp of intact non- vital teeth. J Br Endod Soc. 1974;1:75-7.
588018877f8c9d0a098b4cb3 rou Articles
Links & Downloads

Rev. odontol. UNESP

Share this page
Page Sections