[Study on the diagnosis of the deciduous tooth pulpitis by the blood picture in the dental pulp].

Abstract

The purpose of this study was to investigate the method of diagnosis of deciduous tooth pulpitis to make sure of the extent of the inflammation for more appropriate pulp therapy. The subjects were 100 decayed deciduous teeth of the 81 normal healthy children aged from 2y9m to 11y2m, which justified the vital pulp amputation therapy according to Nagasaka's deciduous tooth pulpitis diagnosis criteria. The blood picture was compared with the histological structure of the coronal pulp and then observed after treatment. The diagnosis of the deciduous tooth pulpitis was considered by the blood picture in the dental pulp. The results were as follows. 1. As to the blood picture in the deciduous dental pulp, it was suggested that the lymphocyte ratio was able to be taken for the discrimination of the deciduous tooth pulpitis, because ratio of lymphocyte in the coronal pulp was higher than its normal values in the peripheral blood picture regardless of the age. 2. As to the histological structure of the removed coronal pulp, the inflammatory degree was divided into 4 types; (-) no evidence of inflammation, (+) slightly confined infiltration of the inflammatory cells, (++) slightly or moderately diffused infiltration, ( ) severely diffused infiltration, when the numbers of the case at each degree type were (-) 0, (+) 37, (++) 47 and ( ) 16 cases. 3. As to the ratio of the lymphocyte ratio over 60% against all at each degree type, (+) 86.5% and (++) 61.7% were much higher than ( ) 0%. 4. The ratio of cases in which it was difficult to control bleeding at ratios of the coronal pulp amputations were type (+) 32.4% and (++) 25.5% in type, however, type ( ) showed high rate (62.5%). 5. As a result of the clinical and X-ray examination after vital pulp amputation therapy, the number of poor case was 12 of 42 cases (28.6%) in type (+) (++) and 4 of 4 cases (100%) in type ( ). 6. This result suggests that the vital pulp amputation therapy is not adequate when it is hard to control bleeding and the lymphocyte ratio of blood picture in the coronal pulp shows under 57%.