Pulpo-dentinal complex revisited

The value of the concept of a pulpo-dentinal complex was assessed on human teeth treated according to the ISO test on biological evaluation. The teeth were extracted after 1 or 3 months and examined histologically. Biochemical and biological data available from the dental literature were also re-examined.

During the early development of the tooth, pulp and dentine establish close links and form an undivided organ. However, examination of the tissues at later stages of development casts doubt on the validity of such a concept. Major differences are reviewed in this report between the cells (odontoblasts and heterogeneous pulpal cells) and extracellular matrix (collagens, non-collagenic proteins and phospholipids) located either in the odontoblast-dentine area or in the pulp. It seems also that clear-cut differences are detected during inflammatory and repair processes.

It is concluded that, although the existence of a dentino-pulpal reaction cannot be denied, the concept of a pulpo-dentinal complex is an oversimplification and should be revisited. This may have implications in the evaluation of restorative treatments and in the design of a tissue repair strategy.