The endodontal infection is influenced by the probing pocket depth

Objective: It was the aim of this study to examine the influence of the probing pocket depth (PPD) on the pulp sensitivity, the histological findings and the bacterial infection of root canals in non-carious teeth. Methods: 24 subjects (age 29-71 yr.) were included in this study. 45 periodontal and pulpal samples were investigated in three different groups (each group n=15); test group1: PPD 5,5-8mm, probing attachment level (PAL)>8mm; test group2: PPD>8mm, PAL>12mm; controls: PPD 3-5mm, PAL>8mm. Sensitivity was tested with CO2-snow. Periodontal biopsies were taken at the deepest point of the pocket. Root canal samples were gained for immunohistological analysis (CD3/T cells, CD4/T helper cells, CD8/T suppressor cells) and microbiological analysis (PCR, A. actinomycetemcomitans, B. forsythus, P. gingivalis). Results: In group1, 66% of the teeth were not sensitive to CO2-snow (33% pus from pocket), 82% (73%) in group2, and 27% (0%) in the controls (p<0,05, u-test). With increasing PPD, an increase of lymphocyte subpopulation could be observed in the periodontal and pulpal samples. The lymphocytic median values' sum of the periodontal and pulpal samples resulted for group2 in a significant higher value (4,4/1,6) compared to the controls (2,6/0,8), (p<0,05). When P. gingivalis was found in periodontal pockets, it was observed endodontically in 65% (group1) and 78% (group2). Conclusion: It can be summarized, that the clinical, histological and microbiological inflammatory pulp status depends on the probing pocket depth.