Stereological Analysis of the Dental Pulp in Patients with Advanced Periodontitis

Background : The adverse effects of periodontitis on dental pulp have long been argued. The purpose of this study was to investigate stereological indices of dental pulp in patients with advanced periodontitis compared with healthy people. 
Materials and Methods : In this case-control study, 15 single-rooted permanent teeth of patients with advanced periodontal diseases and that of people with healthy periodontium, as control group, were investigated. All teeth were intact, and without filling and decay. After tissue processing, longitudinal serial sections of the tooth were prepared and stained by Masson’s trichrome. A grid containing organized points superimposed on the images of each section randomly. Then, the points hit with each subject were counted. The volume of pulp and its components in both groups were estimated, using Cavalieri’s principle. Data were analyzed using Mann-Whitney U test. The significance level was considered as p<0.05.
Results : No significant difference was observed between the groups in terms of inflammation and calcification intensity (p<0.05). Microscopic evaluations of tissue sections showed significant increase in predentin thickness in periodontitis group than control group (p<0.05). In addition, statistically significant reduction was observed in periodontitis group with respect to pulp absolute volume, volume density, odontoblastic layer absolute volume, collagen fibers absolute volume, and absolute pulp blood vessels volume, compared with control group (p<0.05).
Conclusion : Results showed periodontal disease affects stereological parameters of pulp. Because of reduction of pulp volume and narrowing of root canal, precise diagnostic and therapeutic considerations are recommended during treatment of those teeth.