Determination of endotoxins in caries: association with pulpal pain

Aim The aims of this study were: (i) to determine the presence or absence o f endotoxins in the superficial and deep layers of carious lesions of sympt omatic and asymptomatic teeth with vital pulps; (ii) to quantify the amount of endotoxin present; and (iii) to associate the presence of endotoxins wi th the acute pulpal pain derived from the irreversible pulpitis. Methodology Two specimens of carious dentine were taken under aseptic condi tions from symptomatic teeth with irreversible pulpitis (n = 9) and asympto matic teeth with reversible pulpitis (n = 11). The first; specimen was take n from a layer of superficial caries and the second from a deeper one. Soun d dentine was also collected from intact teeth without restoration and used as a noncarious control group (n = 4), During the patient: sampling proced ure an effort was made to collect an equal quantity of caries and sound den tine in all cases (approximately 6 mg). The extraction of endotoxins was pe rformed using the Phenol-water method. The assay and quantitative determina tion of endotoxins was performed by the Quantitative Chromogenic test using Limulus Lysate. Data were analysed statistically using either independent or paired t-tests, Results The results indicated that endotoxins were: present in the superfic ial and deep layers of cartes of all symptomatic teeth with irreversible pu lpitis (0.15078 and 0.12111 ng mL(-1), respectively), with significantly gr eater amount (P < 0.01) in the superficial compared to the deep layer. Endo toxins were found in superficial and deep layer of caries of all asymptomat ic teeth with reversible pulpitis (0.12091 anti 0.07163 ng mL(-1), respecti vely), with significantly greater amounts (P < 0.001) in the superficial co mpared to the deep layer, The results also demonstrated that: significantly greater concentrations (P < 0.005) of endotoxins were present in the super ficial carious layer of symptomatic compared with asymptomatic teeth (;0.15 078 and 0.12091 ng mL(-1), respectively), Likewise, significantly greater a mounts (P < 0.001) of endotoxins were present in the deep carious layer of symptomatic compared with asymptomatic teeth (0.12111 and 0.07163 ng mL(-1) , respectively). In sound dentine no endotoxins were detected. Conclusions This study demonstrates that endotoxins are present in carious lesions of symptomatic and asymptomatic teeth, The amount of endotoxin was significantly greater in the superficial compared to the deep layer of cari ous dentine. More endotoxins are present in caries of painful teeth compare d with those without symptoms.