Focal osteosclerosis and apical periodontal pathoses in "European" and Cape coloured dental outpatients.

Standardized panoramic radiographs were used to determine and compare the prevalences of focal osteosclerosis (including condensing osteitis) and apical periodontal pathoses in a sequential presenting sample of 600 European and 600 Cape Coloured dental outpatients. Most cases of focal osteosclerosis were found in edentulous zones or associated with carious or inadequately restored teeth; however, some were subjacent to apparently sound teeth. Focal osteosclerosis of definite dental origin was just as common in participants aged 25 years and older as in younger individuals. While focal osteosclerosis occurred predominantly in the mandible, apical periodontal pathoses were distributed more evenly between both jaws.     

Effect of the quality of restorations and of dental prosthesis on the alveolar bone loss in patients with chronic destructive periodontitis

In recent years many risk factors have been implicated in the etiology of destructive periodontitis. The quality of the previous dental works might play a decisive role in the development of periodontal attachment loss. The main objective of the present clinical study was to evaluate the aggravating role of the subgingival restorations with questionable quality and the interproximal untreated carious lesions in the progression of periodontal attachment loss in a randomly selected group of patients with destructive periodontitis. The panoramic radiographs of 170 randomly selected patients suffering with destructive periodontitis were analyzed and the quality of the approxima restorations, the presence or absence of interproximal untreated carious lesions and the interdental bone loss were recorded. The level of interproximal bone around the teeth with restorations or with approxima carious lesions were compared with the sound contralateral counterparts and with the overall average alveolar bone level. Some more than 50% of 2175 approxima restorations were faulty. 280 untreated carious lesions were present in 170 subjects. The interproximal bone loss was always greater around teeth with untreated carious lesions or with faulty restoration. The differences between the control teeth and the carious teeth were statistically significant (P < 0.01) excepting the maxillary front and mandibular premolar region. The differences between the teeth with faulty restorations and the controls were statistically significant (P < 0.01) in the mandible and in the maxillary molar region. Although there were significant differences between teeth with untreated carious lesions or with faulty restoration and the controls in many regions of the dental arch, the differences clinically were not always necessarily significant, showing only less than 0.5 mm differences in bone levels, In conclusion the faulty restorations and untreated carious lesions do not seem to be decisive aggravating risk factors leading to bone loss in patients with chronic destructive periodontitis.     

Vanilloid receptor 1 expression in human tooth pulp in relation to caries and pain

AIMS: To investigate the presence of vanilloid receptor 1 (TRPV1) in human dental pulp and to correlate any expression with caries and pain. METHODS: Permanent mandibular first molars were collected and categorized as intact or grossly carious. Grossly carious teeth were further categorized as carious asymptomatic or carious painful samples. Coronal pulps were removed and processed for indirect immunofluorescence using antibodies raised against TRPV1 and a neuronal marker, either protein gene product 9.5 or alpha-smooth muscle actin, in conjunction with Ulex europaeus agglutinin 1 lectin to fully label the pulp vasculature. RESULTS: Analysis revealed that TRPV1 labeling was not confined to pulpal nerve fibers. TRPV1 was also consistently expressed within pulp microvasculature. Expression of neuronal TRPV1 was significantly increased throughout the pulp in grossly carious samples (P < .05). No significant differences were found between carious asymptomatic and carious painful samples. A significant increase in vascular TRPV1 expression was observed in arterioles present in the midcoronal pulp in carious painful compared with carious asymptomatic samples (mean area +/- SEM [%] of TRPV1 to vascular labeling; 6.48% +/- 4.5% for carious asymptomatic teeth, n = 9; 31.21% +/- 9.6% for carious painful teeth, n = 9; P = .02). CONCLUSION: Expression of TRPV1 in pulpal nerve fibers undergoes marked changes with caries. This may be of relevance in the development of pulpal inflammation, but its relationship to dental pain is still unclear. However, vascular TRPV1 expression does appear to be positively correlated with dental pain, thus providing new insights into symptomatic pulpitis.     

Oral health status of institutionalized elderly Cape Coloreds from the Cape Peninsula of South Africa

A study has been conducted to assess the oral health status and need for dental treatment among elderly Cape Coloreds resident in homes for the aged in the Cape Peninsula of South Africa. This paper describes the prevalence of diseases of the mouth with special reference to denture-induced lesions and white lesions of the oral mucosa. Dental caries was the most prevalent oral lesion (27.2%). The most common conditions of the soft tissues were leukoedema (24.4%) and leukoplakia (4.4% for the tongue; 20.4% for the remainder of the oral mucosa). Leukoedema and leukoplakia showed statistically highly significant correlations with tobacco habits. Men more commonly had a tobacco habit than women (P less than 0.002) and leukoplakia, leukoedema and depigmented lesions of the lips were significantly more common in men than in women. No significant difference could be proven statistically when the frequency of irritative fibrous hyperplasia in females was compared with that in males.     

48例外胚层发育不良综合征患者颌面骨形态分析

目的:了解外胚层发育不良综合征(ectodermal dysplasia,ED)患者的颌面部发育状况,为临床治疗提供参考.方法:收集2013年6月-2016年10月收治的48例ED患者的临床信息和头颅侧位X线片.将患者分为2组:第1组23例,除缺牙外,累及≥2种外胚层组织;第2组25例,除缺牙外,仅累及1种外胚层组织.比较2组病例的缺牙数及颌面骨形态影像学参数的差异.采用SPSS 17.0软件包对数据进行单样本t检验和成组t检验.结果:第1组缺牙数显著多于第2组(22.3±5.8∶12±6.6,P＜0.05).在女性患者中,第1组滞留乳牙数显著多于第2组(8±4∶2.4±2.7,P＜0.05).2组患者的上颌骨长度减少(ANS-Ptm减小)且位置后缩(S-Ptm、SNA、NA-PA减小),下颌骨前突(NP-FH增大)、颏部前突(Y轴角减小),下颌骨长度(Co-Po)及位置(S-Co)相对正常,骨性Ⅲ类错(牙合)(ANB＜0),全面高降低(N-Me减小).在男性患者中,第1组较第2组的SNA、NA-PA、ANS-Ptm、S-Ptm、Y轴角显著减小(P＜0.05),NP-FH显著增大(P＜0.05).结论:ED患者颌面骨形态表现为上颌骨长度减少及位置后缩,下颌骨长度和位置相对正常,下颌骨前突、颏部前突、骨性Ⅲ类错(牙合)和全面高降低.ED患者颌面骨形态异常的严重程度与缺失的恒牙数呈正相关,滞留的乳牙可能会促进颌面骨发育.     

Parameters of resonance frequency measurement values: a retrospective study of 385 ITI dental implants

OBJECTIVES: There is no proven clinical tool to evaluate the amount of osseointegration and stability around dental implants. Therefore, the aim of this retrospective clinical study was to evaluate resonance frequency analysis values of 385 ITI solid screw implants. MATERIAL AND METHODS: Both at implant placement and after healing, implant stability quotients (ISQs) were determined. For statistical analysis, Pearson's correlation coefficients, Welch's two-sample t-tests and paired samples t-tests were computed at a level of significance of alpha=0.05. RESULTS: ISQ values ranged from 39 to 86 at implant placement and from 35 to 89 after healing, showing a significant increase. The highest ISQ values at both stages were obtained in the posterior mandible (P < or = 0.002). After healing, ISQ values in the anterior mandible were significantly higher than in the anterior maxilla (P=0.005). Implant length had a significant influence on ISQ in the anterior mandible (P=0) at insertion and in the anterior (P=0.005) and posterior mandible (P=0.036) after healing. Implant diameter and ISQ at insertion correlated in the anterior mandible (P=0.037). After healing, a significant influence was found for all regions, except the posterior maxilla (P=0.795). With the exception of the anterior maxilla (P=0.542), ISQ at placement had a significant influence on ISQ after healing. In the anterior maxilla (P=0.002) and in the posterior mandible (P=0.007), healing time significantly influenced ISQ after healing. CONCLUSIONS: It appears that only repeated ISQ measurements of a specific implant have some diagnostic benefit, although the parameters influencing the absolute values still remain unclear.     

不同矢状骨面型后牙微种植体植入安全区研究

目的:CBCT探究不同矢状骨面型后牙区植入微种植体的安全区域特征.方法:纳入骨性Ⅰ、Ⅱ、Ⅲ类患者各20名的CBCT数据,运用InVivo 5.0软件重建,选择上下颌第一前磨牙远中至第二磨牙近中区域,分别测量距牙槽嵴顶2、4、6、8、10mm处的近远中向宽度,采用SPSS 19.0对测量结果进行统计学分析.结果:上颌距牙槽嵴高度4～8mm,下颌距牙槽嵴高度超过4 mm根尖间隔区域是安全适宜的微种植体植入部位.上颌第一前磨牙和第二前磨牙根间骨量在骨性Ⅰ、Ⅱ类组＞骨性Ⅲ类组(P＜0.05),其它测量部位各组间无统计学差异.下颌后牙区各根间骨量多数表现为骨性Ⅲ类组＞骨性Ⅰ、Ⅱ类组(P＜0.05).结论:上颌距牙槽嵴高度4～8 mm的第二前磨牙和第一磨牙间,下颌距牙槽嵴高度超过4 mm的第一和第二磨牙间的根尖间隔区域是相对安全的植入部位,不同骨面型存在一定差异.     

Vasoactive intestinal polypeptide (VIP) and VPAC1 receptor in adult human dental pulp in relation to caries

OBJECTIVE: To quantitatively measure VIP levels and to qualitatively study the distribution of VIP fibres and demonstrate the presence of the VPAC1 receptor in human dental pulp from carious and non-carious adult human teeth. DESIGN: Dental pulp samples were collected from non-carious, moderately carious and grossly carious adult human teeth. VIP levels were determined using radioimmunoassay. The distribution of VIP fibres was studied using immunohistochemistry. The VPAC1 receptor protein expression was determined by Western blotting. RESULTS: VIP levels were found to be significantly elevated in the dental pulp of moderately carious compared with non-carious (p=0.0032) or grossly carious teeth (p=0.0029). The distribution of VIP fibres was similar in non-carious and carious teeth, except that nerve bundles appeared thicker in the pulp samples from carious compared with non-carious teeth. Western blotting indicated that the VPAC1 receptor proteins were detected in similar levels in pooled dental pulp samples from both carious and non-carious teeth. CONCLUSION: It is concluded that quantitative changes in the levels of VIP in human dental pulp during the caries process and the expression of VPAC1 receptor proteins in membrane extracts from carious and non-carious teeth suggests a role for VIP in modulating pulpal health and disease.     

Substance P expression in human tooth pulp in relation to caries and pain experience

The neuropeptide substance P (SP) is found within a subpopulation of nociceptive afferent nerve fibres and has been shown to be upregulated in a variety of sites following peripheral inflammation. The aim of this study was to investigate the expression of SP within human teeth, both in health and disease, and to seek a correlation between reported pain history and SP expression within pulpal nerves. Coronal pulps were removed from 62 permanent mandibular molars with a known pain history. Teeth were categorised as intact, moderately or grossly carious. Using indirect immunofluorescence, sections were double-labelled for the general neuronal marker protein gene product 9.5 (PGP 9.5) and for SP. Image analysis was then used to quantify the percentage area of PGP 9.5-labelled tissue which was also labelled for SP. Throughout the pulp, the expression of SP was found to be significantly increased with the progression of caries. Furthermore, SP expression was significantly greater in grossly carious painful specimens than in grossly carious asymptomatic specimens. These data would suggest that the expression of SP within pulpal nerves undergoes dynamic changes following caries, which may have an important clinical significance in terms of inflammation and pain experience.     

Clinical and radiographic evaluations of implants as surveyed crowns for Class I removable partial dentures: A retrospective study

PURPOSEThe purpose of this study was to evaluate survival rates and marginal bone loss (MBL) of implants in IC-RPDs.MATERIALS AND METHODSSeventy implants were placed and used as surveyed crowns in 30 RPDs. The survival rates and MBL around implants based on multiple variables, e.g., position, sex, age, opposing dentitions, splinting, type of used retainer, and first year bone loss, were analyzed. Patient reported outcome measures (PROMs) regarding functional/esthetic improvement after IC-RPD treatment, and complications were also inspected.RESULTSThe 100% implant survival rates were observed, and 60 of those implants showed MBL levels less than 1.5 mm. No significant differences in MBL of implants were observed between implant positions (maxilla vs. mandible; P = .341) and type of used retainers (P = .630). The implant MBL of greater than 0.5 mm at 1 year showed significantly higher MBL after that (P < .001). Splinted implant surveyed crowns showed lower MBL in the maxilla (splinted vs. non-splinted; P = .037). There were significant esthetic/functional improvements observed after treatment, but there were no significant differences in esthetic results based on implant position (maxilla vs. mandible). Implants in mandible showed significantly greater improvement in function than implants in the maxilla (P = .002). Prosthetic complication of IC-RPD was not observed frequently. However, 2 abutment teeth among 60 were failed. The bone loss of abutment teeth was lower than MBL of implants in IC-RPDs (P = .001).CONCLUSIONClass I RPD connected to residual teeth and strategically positioned implants as surveyed crowns can be a viable treatment modality.     

Congenital absence of the permanent canines: a clinico-statistical study

We report here a clinico-statistical study of congenital absence of the permanent canines (CAPC). Sixty-five cases (22 men and 43 women) of CAPC were found in the files of 35,927 outpatients, an incidence of 0.18%. Thirty-seven cases had single absence of the canine and 28 cases had multiple absences. There were 42 cases in the maxilla, 17 in the mandible, and 6 in both the maxilla and the mandible. In the single absence cases, there was a tendency of occurrence at the left side in the maxilla, and the right side in the mandible. There were 39 CAPC cases without absence of other permanent teeth. Several complicated dental anomalies were seen such as persistence of deciduous teeth, congenital absence of other permanent teeth, microdontia, malposition, and complete or incomplete impaction (excluding the third molars). The complication rate of other permanent tooth absences was higher in the cases with CACP in the maxilla than in the mandible.     

Do tooth gaps matter? Evaluation of self‐assessments: a pilot study

This study aimed to test the hypothesis stating no difference in number of teeth or tooth gaps counted by the dentist or the patient. The sample consisted of 49 randomly selected regular patients and their dentists (response rate 10%, 53% males). Mean age of the patients was 53.6 +/- 11.9 years. The mean number of teeth was 26.5, 20/49 reported tooth gaps (excluding second and third molars) and 12/20 had visible gaps. The calculation of patients' detection of gaps showed a sensitivity = 79%, specificity = 96% and a positive predictive value of 95%. The patients reported more teeth in the maxilla and fewer teeth in the mandible compared with their dentists. More teeth were misdiagnosed as the number of teeth increased in the mandible. Patients reported more gaps than dentists in both jaws (NS); an average of 0.04, 0.18 and 0.22 misdiagnosed gaps in the maxilla, mandible and for both jaws respectively. Agreement on tooth present/missing in the maxilla was 91.3% (+/-9.82) and in the mandible 88.2% (+/-10.44). Correlation between self-report and dentist's report of the number of teeth present and the number of gaps in the maxilla was (Pearson's r) 0.94 and 0.83. One person with self-perceived visible gaps and five persons with non-visible gaps were recommended treatment; two persons agreed about a treatment need. Self-assessments of tooth gaps show limited but acceptable sensitivity and excellent specificity. No significant differences in tooth counting were found when comparing self-reports and dentists' reports. The study should be tried on a larger scale.     

Effect of maxillary edentulousness on mandibular residual ridges

Bone mineral density (BMD) was measured in five different regions of the mandible of 77 postmenopausal women. These women were also classified according to the remaining, clinically determined alveolar height in the edentulous distal regions of the mandible. The duration of edentulousness in the maxilla and in the mandible was determined anamnestically. All subjects were edentulous in the maxilla, and 42 were also edentulous in the mandible. The other 35 women had teeth only in region d35-d45. This study shows that after extraction of the last teeth in the mandible, the BMD of the cortical bone is not lowered, but that the BMD of the trabecular portion is lowered more by mechanical stress caused by the remaining natural teeth than by maxillary dentures. This feature becomes apparent when duration of edentulousness in the maxilla is compared with the BMD values of different regions in the mandible.     

Evaluation of proximal tooth contact tightness at rest and during clenching

The aims of this study were to develop a device for measuring the tightness of proximal tooth contact and to evaluate the proximal contact tightness using this device at rest and during clenching. Twenty young adult volunteers with healthy dentition participated in this experiment. The tightness of proximal tooth contact between the second premolar and the first molar of both the maxilla and the mandible was measured by pulling a stainless steel strip between them at rest, and at 20 and 50% clenching levels of maximum voluntary contraction of masseter muscles at intercuspal position. Proximal contact tightness increased as the clenching levels of both the maxilla and the mandible increased. At rest, proximal contact tightness was less in the maxilla than in the mandible, whereas during clenching it was less in the mandible. These results indicate that during clenching, the teeth are displaced and they contact appropriately with adjacent teeth, making it possible to exert sufficient occlusal force while maintaining the integrity of dental arches.     

The effects of Fr?nkel II treatment on arch width and arch perimeter

Changes in dental arch width and total arch perimeter in 24 Class II, Division 1 patients treated with the Fr?nkel II appliance were compared with changes in an untreated control group. Measurements were made on pretreatment and posttreatment plaster casts at three points on each of four maxillary and four mandibular teeth. Increases in width were computed at the occlusal point and compared for the two samples. A significant increase in occlusal arch width for all measures was suggestive of both a minor tipping movement of the maxillary teeth and a bodily movement of the mandibular teeth. Width development in the maxilla was greater than in the mandible. Occlusal arch width increased more in the molar and premolar regions in the maxilla and in the premolar region in the mandible. Wide arches were found to have as much increase as narrow arches. The total arch perimeter decreased significantly less in the treatment sample than in the control sample. The documented gains in arch width and arch perimeter would not be sufficient to relieve severe crowding, but could be useful in avoiding removal of teeth in borderline extraction cases.     

Radiographic observations on root resorption in the primary dentition.

In order to construct standardized charts for root resorption in the primary dentition of Japanese children, we investigated the stages of resorption (1/4, 1/2 and 3/4 of the root) based on the criterion of Fanning, et al. using 11,167 panoramic radiographs (5,759 of boys and 5,408 of girls). The following information was obtained. 1) The root resorption for a tooth on one side was the same as for its counterpart on the other side regardless of differences in sex or arch. 2) The average age for each root resorption stage was lower in girls than in boys regardless of differences in sex or arch. 3) The average age for each root resorption stage was lower in the mandible than in the maxilla for every tooth. 4) In the maxilla, the period between 1/4 to 3/4 resorption of the root was greater in the primary molars than in the primary anterior teeth. However, the opposite was true in the mandible. 5) Although no difference was observed between the maxilla and the mandible in the resorption period for the primary incisors and canines, the resorption time for the primary molars was greater in the maxilla than in the mandible. 6) When the relationship was observed between the resorption stages for each tooth and the calcification stages for the corresponding successional permanent tooth. a) With the exception of the maxillary and mandibular canines, the average age for 1/4 resorption of the primary root corresponded to the period between completion of the permanent crown and initial root formation of the successional permanent tooth. b) With the exception of the maxillary and mandibular canines, and the mandibular second premolars, the average age for 3/4 resorption of the primary root corresponded to the period between 1/4 and 1/2 formation of the root of the successional permanent tooth. From these results, standardized charts were constructed for the resorption of the roots of primary teeth in Japanese children. These standardized charts are useful in daily clinical practice in such areas as endodontic treatment of primary teeth and orthodontics.     

A clinical study of the width of the attached gingiva in the deciduous, transitional and permanent dentitions

This study involved 331 individuals who were without clinical evidence of gingival inflammation. The width of the keratinized gingiva and the depth of the gingival sulcus were measured on the mid-facial aspect of all teeth in each patient, using a calibrated, flat periodontal probe. The mean width of the attached gingiva did not show an increase from the deciduous to the permanent dentition. However, the width of the attached gingiva in the case of newly erupted permanent teeth was narrower than in the corresponding primary teeth. The widest zone of attached gingiva was found over the central and lateral incisors. The width of the attached gingiva decreased over the canine and the first premolar (and first primary molar). It then increased over the second premolar (and second primary molar) and the first molar. These variations were approximately the same in both the maxilla and the mandible, although there was a greater over-all width of attached gingiva in the maxilla than in the mandible. The tendency, in the permanent dentition, for the attached gingiva to increase in width with age was related to a concomitant decrease in sulcus depth.     

Dental abnormalities and bone lesions associated with familial adenomatous polyposis: report of cases

Dental abnormalities and bone lesions of the maxilla and mandible are found in more than 70% of patients with familial adenomatous polyposis (FAP). Dental abnormalities include impacted teeth (other than third molars), supernumerary teeth, congenitally missing teeth, and fused roots of molars. Bone lesions consist of osteomas--isolated or in clusters--in the maxilla and mandible. In this study of 24 patients, 75% had demonstrable dental abnormalities, and 79% had osteomas of the maxilla and mandible. Because dental abnormalities and bone lesions are present early in life, these features may be helpful in diagnosing this syndrome.     

Implant stability and histomorphometry: a correlation study in human cadavers using stepped cylinder implants

The aim of the present study was to determine the correlation between the primary stability of dental implants placed in edentulous maxillae and mandibles, the bone mineral density and different histomorphometric parameters. After assessing the bone mineral density of the implant sites by computed tomography, 48 stepped cylinder screw implants were installed in four unfixed human maxillae and mandibles of recently deceased people who had bequeathed their bodies to the Anatomic Institute I of the University of Erlangen-Nuremberg for medical-scientific research. Peak insertion torque, Periotest values and resonance frequency analysis were assessed. Subsequently, histologic specimens were prepared, and bone-to-implant contact, the trabecular bone pattern factor (TBPf), the density of trabecular bone (BV/TV) and the height of the cortical passage of the implants were determined. The correlation between the different parameters was calculated statistically. The mean resonance frequency analysis values (maxilla 6130.4+/-363.2 Hz, mandible 6424.5+/-236.2 Hz) did not correlate with the Periotest measurements (maxilla 13.1+/-7.2, mandible -7.9+/-2.1) and peak insertion torque values (maxilla 23.8+/-2.2 N cm, mandible 45.0+/-7.9 N cm) (P=0.280 and 0.193, respectively). Again, no correlations could be found between the resonance frequency analysis, the bone mineral density (maxilla 259.2+/-124.8 mg/cm(3), mandible 349.8+/-113.3 mg/cm3), BV/TV (maxilla 19.7+/-8.8%, mandible 34.3+/-6.0%) and the TBPf (maxilla 2.39+/-1.46 mm-1, mandible -0.84+/-3.27 mm-1) (P=0.140 and 0.602, respectively). However, the resonance frequency analysis values did correlate with bone-to-implant contact of the oral aspect of the specimens (maxilla 12.6+/-6.0%, mandible 35.1+/-5.1%) and with the height of the crestal cortical bone penetrated by the implants in the oral aspect of the implant sites (maxilla 2.1+/-0.7 mm, mandible 5.1+/-3.7 mm) (P=0.024 and 0.002, respectively). The Periotest values showed a correlation with the height of the crestal cortical bone penetrated by the implants in the buccal aspect of the implant sites (maxilla 2.5+/-1.2 mm, mandible 5.4+/-1.2 mm) (P=0.015). The resonance frequency analysis revealed more correlations to the histomorphometric parameters than the Periotest measurements. However, it seems that the noninvasive determination of implant stability has to be improved in order to give a more comprehensive prediction of the bone characteristics of the implant site.     

Determination of endotoxins in caries: association with pulpal pain

AIM: The aims of this study were: (i) to determine the presence or absence of endotoxins in the superficial and deep layers of carious lesions of symptomatic and asymptomatic teeth with vital pulps; (ii) to quantify the amount of endotoxin present; and (iii) to associate the presence of endotoxins with the acute pulpal pain derived from the irreversible pulpitis. METHODOLOGY: Two specimens of carious dentine were taken under aseptic conditions from symptomatic teeth with irreversible pulpitis (n = 9) and asymptomatic teeth with reversible pulpitis (n = 11). The first specimen was taken from a layer of superficial caries and the second from a deeper one. Sound dentine was also collected from intact teeth without restoration and used as a noncarious control group (n = 4). During the patient sampling procedure an effort was made to collect an equal quantity of caries and sound dentine in all cases (approximately 6 mg). The extraction of endotoxins was performed using the Phenol-water method. The assay and quantitative determination 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 superficial and deep layers of caries of all symptomatic teeth with irreversible pulpitis (0.15078 and 0.12111 ng mL-1, respectively), with significantly greater amount (P < 0.01) in the superficial compared to the deep layer. Endotoxins were found in superficial and deep layer of caries of all asymptomatic teeth with reversible pulpitis (0.12091 and 0.07163 ng mL-1, respectively), with significantly greater amounts (P < 0.001) in the superficial compared to the deep layer. The results also demonstrated that significantly greater concentrations (P < 0.005) of endotoxins were present in the superficial carious layer of symptomatic compared with asymptomatic teeth (0.15078 and 0.12091 ng mL-1, respectively). Likewise, significantly greater amounts (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 carious dentine. More endotoxins are present in caries of painful teeth compared with those without symptoms.