Association between Clinical Symptoms and Histological Features of Molars with Acute Pulpitis.

Introduction: Diagnosis of dental pulp status on the basis of clinical signs in many cases helps clinicians to better resolve patient problems. Various studies have shown no correlation between clinical and histologic findings. The aim of the present study was to evaluate the associations between clinical findings and histological features in extracted decayed teeth with acute pulpitis. Materials and Methods: One hundred permanent cavitated human teeth with mature apices and pulpitis, which were extracted for reasons not related to the present study, were evaluated. Demographic, clinical, and radiographic data were collected using pre-designed questionnaires. After tooth extraction, 5 micron-thick slices were prepared for microscopic assessment. General pathologist evaluated reactions to stimuli in all areas of the pulp tissue under a light microscope. When present, inflammation was classified according to the type and spread of cell detected and other histological findings, such as abscess formation, pulp stones, and pulpal fibrosis, were also recorded. Results: We found significant associations between pain characteristics, such as pain type and duration, and histological status. Acute inflammation, severe chronic inflammation, and liquefactive necrosis increased with pain severity. Various histological sections showed the absence of pulpal inflammation. Conclusions: We found a good agreement of patients' pain histories and pain characteristics with histological pulp status. Thus, the use of specified CHARTs and SCALEs that help patients provide the most accurate responses to questions about pain would aid the diagnosis of pulp status. In cases with an accurate pulpal diagnosis, the clinicians can manage pulpal protection when it is possible.

Residual dentin thickness of bifurcated maxillary premolars following two post space preparation methods.

INTRODUCTION: The aim of this in vitro study was to compare the effect of Gates-Glidden and Peeso reamer drills on residual dentin thickness during post space preparation in order to discover which method has minimum root structure damage. MATERIALS AND METHODS: Thirty extracted human maxillary premolars with bifurcations at root middle were horizontally cut 15 mm coronal to the apical end after root canal treatment. The samples were scannedby Cone Beam Computed Tomography (CBCT) before and after preparing the post space. Residual dentin thicknesses were measured at 4-, 6-, and 8-mm levels from the apex. Data were analyzed using repeated measured ANOVA. RESULTS: Endodontic therapy and post space preparations removed more dentin within the bifurcation of both roots compared to outer dentin. The difference in residual dentin thickness was highly significant regarding stage (before and after post space preparation) in all levels and stage × device in coronal and middle levels (P<.05). This in vitro study emphasizes the minimal dentin width in the buccal root of maxillary premolars, especially near the bifurcation. CONCLUSION: Lack of adequate residual dentin thickness after post space preparation implies that the use of posts in maxillary first premolars should be limited. When mandatory, it is recommended that post space be prepared with Gates-Glidden drill in the palatal root of maxillary first premolars and use of Peeso reamer be avoided.