Análise microscópica da polpa e microbiológica do canal radicular de dentes permanentes traumatizados

Abstract

The present study had the purpose of analising microscopically the pulp tissue of human traumatized teeth with clinical diagnosis of pulp necrosis, evaluating the presence of microorganisms in the root canal and correlating clinical and radiographic criteria with microscopic and microbiologic findings. Twenty teeth were selected with intact crown that had injury in the periodontal tissues and that during the follow-up of the pulp condition, by clinic and radiographic evaluations, the pulp necrosis was clinically diagnosed. Microbiologic collect was performed in the root canal and the pulp tissue extirpated was stained with hematoxylin and eosin for microscopical evaluation and the adjacent slide stained to the Brown and Brenn method. The statistic and descriptive analyses (Analyse of diagnosis, Wilcoxon`s Test and Linear Regression Test) enabled the following observations: from 20 traumatized teeth 3 did not present enough pulp tissue to have a microscopic evaluation performed and 17 showed pulp necrosis; in 12 out of 17 pulps the presence of microorganisms could be conformed by Brown and Brenn method; the microbiological evaluation presented microbial development in 17 root canals (85,0%), with predominance of facultative anaerobics; none of clinical criteria used were pathognomonic (100,0%) to the diagnosis of the pulp necrosis in the traumatized teeth. Testings that showed more sensibility were termic pulp testing relative to hot (90,0%), relative to cold (85,0%) and the vertical percussion testing (75,0%); this last one also showed high sensibility (80,0%) in observating present microorganisms in the root canal; either the apical periodontal space condition (normal or increased) or the period of time the injury until the endodontic intervention did not show statistically significant correlation to the number of present microorganisms in the root canal, except the buccal streptococcus, which number showed bigger as the time increased. It was conclude that among the 20 traumatized teeth with clinical diagnosis of pulp necrosis, 3 did not show pulp to allow a microscopic exam and 17 showed necrotic pulps in the microscopic exam; 85,0% showed microorganisms in the root canal and a positive correlation was observed between the clinic and radiographic criteria used to the pulp necrosis diagnosis with microscopic and microbiologic findings.