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Published on: January 12, 2017
Long-term histologic changes in the dental pulp after posterior segmental osteotomies
J F Lownie1, P E Cleaton-Jones, H Coleman
1Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa.
Summary
Segmental osteotomy in baboons showed pulp healing over 18 months, with initial inflammation and necrosis resolving into fibrosis. Careful clinical follow-up is recommended, delaying endodontic treatment until necessary.
Area of Science:
- Oral surgery
- Dental pulp biology
- Histopathology
Background:
- Segmental osteotomy is a surgical procedure involving bone cutting and repositioning.
- Understanding the long-term effects of osteotomy on dental pulp is crucial for patient prognosis.
Purpose of the Study:
- To histologically evaluate dental pulp tissue changes for 18 months following segmental osteotomy in nonhuman primates.
Main Methods:
- Subapical posterior maxillary and mandibular osteotomies were performed on 26 baboons (Papio ursinus).
- Dental pulp tissues were examined via perfusion-fixation and longitudinal step-serial sections at immediate, 3, 6, 12, and 18 months post-surgery.
Main Results:
- Odontoblast layer loss and inflammatory cell infiltrate were observed as early as 3 months.
- Osteodentin and secondary dentin formation were evident by 6 months.
- Necrosis at 3-6 months evolved into pulp fibrosis by 12-18 months, with changes more pronounced in experimental teeth.
Conclusions:
- Histologic pulp changes after segmental osteotomy do not necessarily compromise tooth prognosis.
- Avoiding damage to root apices and conducting regular clinical/radiographic follow-ups are essential.
- Delaying endodontic treatment is advised due to spontaneous pulp healing observed in many cases.
