Dental Pulp Hemogram

¹ Indiana University School of Dentistry, Indianapolis, Indiana

Fifty-three deciduous and young permanent teeth with carious pulp exposures were evaluated according to the amount of pulpal hemorrhage upon removal of the caries, response to electric and thermal pulp tests, response to percussion, the history of pain, and the degree of mobility. Fourteen teeth with normal pulps served as controls.

The first drop of blood from the exposure site was used to prepare a blood smear. The white cell differential count (hemogram) was then made from the stained smear. The pulp hemogram was compared with a peripheral hemogram taken from the finger.

No clear-cut relationship was found between the dental pulp hemogram and the extent of pulp pathosis. However, some degree of relationship was observed between the pulp hemogram with an elevated neutrophil count from teeth with extensive inflammation of the pulp as determined microscopically.

The presence of neutrophils exhibiting degeneration and karyolysis was found to be indicative of a pulp with extensive inflammation, as was the presence of profuse bleeding at the exposure site. Pulp testing by heat, cold, or electricity was found to be unreliable in determining the degree of pulpal inflammation. The degree of mobility or tenderness to percussion was of no particular value in determining the degree of pulpitis.

A history of spontaneous pain was a more reliable characteristic of extensive pulpitis than was a history of pain occurring while eating. Teeth with a history of pain at night were found to have a considerable degree of pulpal inflammation. Internal resorption was found exclusively in teeth with extensive inflammation.