Determination of endotoxins in the vital pulp of human carious teeth: Association with pulpal pain

Abstract

Objectives: The aims of this investigation were to determine the presence or absence of endotoxins in the pulp of symptomatic and symptom-free human carious teeth, to quantify the amount of endotoxins present, and to associate the presence of endotoxins with the acute pulpal pain. Material And Methods: Pulpal tissue was sampled from 28 single-rooted carious teeth (15 symptomatic, 13 symptom-free) derived from 28 patients. Samples were also taken from the pulp of 5 noncarious control teeth. During sampling an effort was made to collect an equal weight of pulpal tissue in all cases (approximately 8 mg). The extraction of endotoxins was performed with the use of phenol-water. The assay and quantitative determination of endotoxins was performed with the use of a limulus lysate test. The data were analyzed statistically by using the independent t test. Results: Endotoxins were detected in pulpal tissues of all carious teeth in the symptomatic (mean average, 0.15773 ng/mL; SD = 0.045811) and symptom-free group (mean average, 0.10723 ng/mL; SD = 0.010925). In noncarious control teeth, endotoxins were not detected. The presence of endotoxins was significantly higher in the group of symptomatic teeth than in the group of symptom-free teeth (P < .001). Conclusions: The presence of endotoxins in the pulpal tissue of all the carious teeth indicates that they may play a major role in the pathogenesis of human pulpal diseases. Since a significantly higher level of endotoxins was detected in the pulp of symptomatic carious teeth than in that of symptom-free carious teeth, an association of endotoxins levels with severity of pulpal pain is probable. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:587-93)