Histopathological Evaluation of the Impact of Periodontitis on Dental Pulp Condition: A Systematic Literature Review

Abstract

Comprehensive treatment of periodontitis requires to assess the need of endodontic intervention. Histopathological examination is crucial to assess link between periodontitis and pulp condition. The current systematic review aimed to answer the focus question: ‘In patients with periodontitis, does periodontitis have any impact on the condition of dental pulp based on histopathological findings?’. The literature search in PubMed, ScienceDirect, Google Scholar and Cochrane Library included nine analytical cross-sectional studies. Results showed, periodontitis may lead to pulp inflammation, fibrosis, calcification and necrosis. Inflammatory cell infiltration ranged from 34.29% to 93.7%, with higher prevalence in severe periodontitis and gingival recession. Pulp necrosis was more common in the apical (21.7%) and middle thirds (34.8%) of the root, reaching 90% with gingival recession. One study reported inconsistencies between pulp sensibility tests and histological findings. Variability in histopathological alterations suggests additional factors, such as gingival recession, influencing pulp condition in periodontitis patients.