Histopathology of the pulp in primary incisors with deep dentinal caries

Resident’s Name: Derek Banks Date: October 31, 2008
Article title: Histopathology of the pulp in primary incisors with deep dentinal caries
Author(s): E Eidelman, M Ulmansky, Y Michaeli
Journal: Pediatric Dentistry
Volume (number): 14:6
Month, Year: Nov/Dec 1992
Major topic: ECC
Minor topic(s): Pulpal involvement of ECC
Type of Article: Histological analysis of extracted teeth
Main Purpose: Assess the rationale behind current treatment modalities by observing histologic change in carious teeth.
Overview of method of research: 53 extracted primary incisors from 22 children analyzed histologically. 24 had pulp exposures and 29 had no pulp exposures.
Findings: 69% of the teeth with no exposures showed normal pulps compared to 33% of those with exposures. Microabscesses were found in 33% of teeth with pulp exposures, and only 10% of those without exposures. 46 out of the 53 teeth showed vital pulps.
Key points/Summary: Some of the discussion was interesting. It talks about how pulpal involvement in teeth without exposures may be accounted for. A few of the hypotheses are: trauma can lead to pulpal involvement and necrosis, microscopic pulpal exposures undetectable to the explorer, and increased permeability of deep dentin due to greater number of tubules and increased tubular diameter (however dentin under a carious lesion is less permeable due to the production of dentinal sclerosis and reparative dentin.
Assessment of article: Very interesting. Good rationale for treating primary incisors rather than extract them.