Clinical, radiological, and histological correlation in diagnosis of pulpitis

Abstract

Background: To establish an endodontic diagnosis, a clinician should consider a variety of factors.
Various studies have failed to demonstrate a strong correlation between histological findings with
clinical and radiographic assessments. This study sought to evaluate the histopathological features of
reversible and irreversible pulpitis diseases and their correlation with clinical diagnosis in extracted
human molar teeth.
Materials and Methods: In this experimental ex vivo study, 75 molars with caries and three intact
molars were used. According to the radiographic findings and clinical criteria and the need for root
canal therapy, samples were categorized as having normal/reversible pulpitis and irreversible pulpitis.
Immediately after extraction, an exposure was made at 2 mm below the cementoenamel junction.
Formalin‑fixed specimens were decalcified, sectioned and stained with hematoxylin and eosin for
histological examinations using light microscopy. Variables including the type and severity of the
inflammation, hyperemia, necrosis, fibrosis and the existence of an odontoblastic layer and dentin
bridge were evaluated. The Fisher’s exact test and the Chi‑squared test were used for statistical
analysis. P <0.05 was considered as significant.
Results: Acute inflammation, hyperemia and pulp exposure were significantly more common
among subjects with irreversible pulpitis (P < 0/005). However, fibrosis was significantly higher in
the reversible group (P < 0/005). There were no statistically significant differences between the
groups regarding the other variables.
Conclusion: Some discrepancies between clinical, radiographic and histological findings were
observed in our experimental study. Indeed, effective clinical practice requires consideration of all
discrepancies found.
Key Words: Diagnosis, histology, pulpitis, root canal therapy, signs and symptoms