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.
Rev. odontol. UNESP, vol.38, n1, p.15-21, 2009
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
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