Correlation between Clinical and Histologic Pulp Diagnoses; Ricucci et al.


Introduction: Clinicians routinely face conditions in which they have to decide whether the dental pulp can be saved or not. This study evaluated how reliable the clinical diagnosis of normal pulp/reversible pulpitis (savable pulp) or irreversible pulpitis (nonsavable pulp) is when compared with the histologic diagnosis. Methods: The study material consisted of 95 teeth collected consecutively in a general practice over a 5- year period and extracted for reasons not related to this study. Based on clinical criteria, teeth were catego- rized as having normal pulps, reversible pulpitis, or irre- versible pulpitis. The former 2 were grouped together because they represent similar conditions in terms of prognosis. Teeth were processed for histologic and his- tobacteriologic analyses, and pulps were categorized as healthy, reversibly inflamed, or irreversibly inflamed according to defined criteria. The number of matching clinical/histologic diagnosis was recorded. Results: The clinical diagnosis of normal pulp/reversible pulpitis matched the histologic diagnosis in 57 of 59 (96.6%) teeth. Correspondence of the clinical and histologic diagnosis of irreversible pulpitis occurred in 27 of 32 (84.4%) cases. Infection advancing to the pulp tissue was a common finding in teeth with irreversible pulpitis but was never observed in normal/reversibly inflamed pulps. Conclusions: Findings using defined criteria for clinical and histologic classification of pulp conditions revealed a good agreement, especially for cases with no disease or reversible disease. This means that the classification of pulp conditions as normal pulps, revers- ible pulpitis, and irreversible pulpitis has high chances of guiding the correct therapy in the large majority of cases. However, there is still a need for refined and improved means for reliable pulp diagnosis. (J Endod 2014;40:1932–1939)

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Thanks to Domenico Ricucci, MD, DDS,* Simona Loghin, DDS,* and Jose F. Siqueira, Jr, DDS, MSc, PhD†
© Journal of Endodontics

Journal of Endodontics, 40 (2014) 1932-1939. doi:10.1016/j.joen.2014.08.010
Jan Berghmans

Jan Berghmans

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