I present the case of a 46-year-old man with a history of Perthes disease, which he had had 12 years prior, and reported asymptomatic swelling of his right fourth molar (Figure?(Figure3)). He was otherwise healthy and had no significant medical history, including no signs of infection. The patient reported chewing hard substances and stated that he had recently bitten his finger. When the oral examination was performed, the gingiva around the molar was reddened. The right fourth molar was severely carious and tooth extraction was performed (Figure?(Figure4)). A clinical and radiographic examination of the pulp chamber revealed a deep dentin lesion without communication to the pulp. The tooth was extracted, and the extracted tooth was submitted for histopathologic examination.
The patient's tooth was excised, and the pulp chamber was removed in one piece and submitted for histopathologic examination. The tooth was cut longitudinally through the pulp chamber on the mesial aspect.
The tooth was then longitudinally sectioned at 4 mm on the buccal, lingual, mesial, and distal aspects. The buccal and lingual sections were stained with hematoxylin and eosin and examined for the presence of inflammation.
The sections were placed in 10% buffered formalin for 48 hours and then transferred to 70% ethanol for storage. Paraffin-embedded blocks were sectioned at 5 µm and stained with hematoxylin and eosin. The resulting sections were examined and photographed using a microscope with bright field and standard 10X and 40X objectives.
The section from the buccal aspect (Figure?(Figure5)) had mild apical resorption, with necrosis of the pulpal and apical tissue. The apical resorption was characterized by the presence of a necrotic pulpal tissue, a pulpal cap, and a thin layer of new cementum formation at the tip of the root. The resorption was seen from the middle of the pulp chamber up to 2.5 mm of the root.
The section from the lingual aspect (Figure?(Figure6)) had a similar appearance, with mild resorption of the pulpal and apical tissue and a thick layer of dentin at the tip of the root.
The section from the mesial aspect (Figure?(Figure7)) showed a thin layer of new cementum formation and a pulp chamber filled with necrotic pulp tissue.
The section from the distal aspect (Figure?(Figure8)) had mild apical resorption, with necrosis of the pulp and apical tissue. The resorption was characterized by the presence of pulp and apical tissue necrosis 0b46394aab