Clinical and histopathological evaluation of the dental pulp and its relationship with pain in patients with total biopulpectomy treatments

Human dental pulp consists of specialized loose connective tissue that is part of the dentin-pulp complex. During an inflammatory process, pulp tissue produces an increase in internal pressure that causes acute pain and histological changes: irreversible pulpitis (IP) can be symptomatic or asymptoma...

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Autores principales: Galiana, Mariel Beatriz, Galiana, Andrea Verónica, Lugo de Langhe, Carlos Daniel, Montiel, Natalia Belén, Zacarías, Rocío, Gualdoni, Graciela Mónica
Formato: Artículo revista
Lenguaje:Español
Publicado: Facultad de Odontología de la Universidad Nacional del Nordeste (FOUNNE) 2025
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Acceso en línea:https://revistas.unne.edu.ar/index.php/rfo/article/view/9029
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Sumario:Human dental pulp consists of specialized loose connective tissue that is part of the dentin-pulp complex. During an inflammatory process, pulp tissue produces an increase in internal pressure that causes acute pain and histological changes: irreversible pulpitis (IP) can be symptomatic or asymptomatic, and its histopathological characterization allows establishing different inflammatory stages. The objective was to establish the correlation between pre- and postoperative pain and histopathological findings in pulps extracted from patients with a clinical diagnosis of IP. An observational, cross-sectional study was conducted in patients with IP treated at the Endodontic Clinic of FOUNNE. Pain intensity was measured using the Visual Analogue Scale (VAS) before treatment, 1 to 5 days after treatment, and more than 5 days after treatment, through telephone survey. Pulps were processed and categorized by the Histopathology Service (FOUNNE). The degree of inflammation assessed was: Grade 0 (absent), Grade 1 (1–2 histological characteristics [HC]), Grade 2 (3–4 HC), and Grade 3 (5 or more HC). Of the patients treated, 51% presented Grade 2 pulp inflammation, 28% Grade 3, and 20% Grade 1. The most frequent alterations were fibrosis, hyalinization, mild inflammatory infiltrate, calcific nodules and spicules, and atrophy. Preoperative pain between 6 and 9 on the VAS was reported by 47% of patients. At postoperative follow-up, 73% did not present pain, while the remaining 27% did, in mild (2–3) and severe (8–9) ranges, the latter requiring analgesic prescription. The most frequent histopathological characteristics in the pulp tissues studied were fibrosis, hyalinization, and pulp calcifications. The predominant inflammatory grade was Grade 2. A positive correlation was observed between pre- and postoperative pain. Clinical and histopathological findings did not always show a direct correlation.