Journal of Dental Research

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Movement of Dentinal and Pulpal Fluid Caused by Clinical Procedures

Martin Brannstrom, Lars-A'ke Linden and Gunilla Johnson
J DENT RES 1968 47: 679
DOI: 10.1177/00220345680470050201

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Movement of Dentinal and Pulpal Fluid
Caused by Clinical Procedures
MARTIN BRANNSTROM, LARS-AKE LINDLN, and GUNILLA JOHNSON
Departments of Oral Histopathology and Cariology, Karolinska Institutet,
School of Dentistry, Stockholm, Sweden

The effects of some clinical procedures on tip was cut away to remove the periodontal
the fluid contents of the dentin and pulp ligament, which might have blocked the
were studied in vitro. The method involved aperture of the root canal. The pulp was
measurement of the movement of the menis- left intact in the tooth. In the middle of the
cus in a tube and glass capillary filled with root, a narrow groove was made with a
physiologic saline solution and attached to the cylindrical bur; a polyvinyl tube was at-
root pulp of the extracted tooth. Drilling was tached to the root and fixed with a wire. A
found to produce expansion and an outward length of the tube was chosen so that 10 mm
movement of fluid from the apex to the extended beyond the apex of the tooth. The
tooth. tube was filled with saline solution by means
of a syringe to remove any air bubbles. Into
It has been demonstrated that the sensory this solution-filled tube, a glass capillary (8
mechanism of the dentin may be related to cm long and about 0.25 mm in inner diam-
the hydrodynamics of the dentinal and pulpal eter) was inserted. It also was filled with
fluid.' It also has been noticed in an in vivo saline solution. The neck of the tooth was
study that some clinical procedures may in- then clamped firmly (Fig 1), and the crown
crease the pressure inside the pulp.2 At the was isolated with a rubber dam. A millimeter
meeting of the European Organization for scale was placed beneath the glass capillary,
Research on Dental Caries and Fluorine in and the movement of the saline meniscus was
1966, an in vitro study was presented that observed with a microscope. A movement of
involved a method previously applied only 1/4 mm was easily detectable. A description of
in studies of the fluid movement through the movements of the meniscus in the glass
enamel and dentin.'4 Similar studies have capillary was tape recorded together with the
demonstrated that pressure changes and fluid time, which was registered from a metro-
movements in the dentin and pulp could be nome. An analysis of the fluid movement in
produced by alterations in temperature and relation to time was made separately from the
air drying of the dentin.5 With the same tape.
method, it has been observed that the appli- With a cylindrical diamond stone, 1 mm
cation of various dehydrating agents such in diameter, and a carbide steel bur, the
as sugar, calcium chloride, and alcohol may tooth was prepared for a jacket crown. The
produce an immediate outward flow in the drilling was performed in different ways to
dentinal tubules.6 study the effect of variations such as drill
This method might be applied also in speed and cooling. The tooth preparation
studies of the immediate effect of various was made with an air turbine* and a dental
clinical procedures such as drilling and fill- air machines with maximum speeds of 400,-
ing cavities. The present experiments were 000 and 100,000 rpm, respectively. A tach-
done to investigate this possibility. ometer was used in connection with the
dental air machine.
Materials and Methods The effects of applying heated temporary
Six permanent single-rooted teeth from restoration material to the buccal surface of
children were used. About 1 mm of the root the intact crown and of air drying and im-
* Midwest American, Melrose Park, 111.
Received for publication April 24, 1967. t Dental-Air, Atlas Copco, Sweden.
679

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680 BRANNSTROM, LINDEN, AND JOHNSON J Dent Res September-Oclober 1968

FIG 1. Apparatus with the tooth and the capillary fixed with a clamp.

pression taking with a heated compound* spray or air during preparation greatly re-
after crown preparation also were studied. duced this movement. The effect of varia-
tions in drilling and the movement of the
Results fluid caused by air drying. impression taking,
Continuous cavity preparation at 80,000 and temporary capping are shown (Fig 3, 4).
rpm for :12 seconds with a diamond cylinder,
the bur penetrating the enamel and the Discussion
outer part of the dentin, produced a 12-mm The results indicate that this method
outward flow of the fluid in the glass capil- might be of value in demonstrations of the
lary (Fig 2). Cooling the tooth with water hydrodynamics of the tooth. Also, the meth-
od might be useful in comparative studies of
* Kerr Manufacturinr' Co., Ictreit, Mich. the total heating effect of different methods

distal movement
12 mm in 12 sec
FIG 2.-Diagram of the arrangement for measuring the movement of the fluid in the capillary.

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 I mm

'i 10
0

5.

.0 n
Carbide steel
H

Diamond cyl.;
H
Diamond cyl.;
H
-- I I

Diamond cyl.;
--- n
Diamond cyl.;
.

Diamond cyl.;
fissure bur; 300,000 rpm; 80,000 rpm; 80,000 rpm; 80,000 rpm; 80,000 rpm;
4, intermittent continuous intermittent intermittent
80,000 rpm; intermittent
intermittent 1-min prep. 1-min prep. 1-min prep. 1-min prep. 12-sec prep.
1-min prep. Spray cooling. Spray cooling. Spray cooling. Air cooling. No cooling.
$4
Spray cooling.
la3
P-4
P4,-

v
FIG 3.-Movement of the fluid in the capillary produced by various burs and stones used in
cavity preparation (dental air machine, 80,000 rpm; air turbine, 300,000 rpm.)

mm

, 101

Heated Air drying a impression of

tempera ry preparation a jacket crown
restoration for jacket crown with heated
material 8 sec compound
0.
25 sec Cooling after
10 sec
06
CIL

FIG 4.-Movement of the fluid in the capillary produced by some clinical

procedures.
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682 BRA NNSTR6M, LINDPN, AND JOHNSON J Dent Res September-October 1968
of drilling and may be more reliable in this applied to an intact crown. An air blast to
respect than thermocouples. This method the prepared crown had the opposite effect,
might be used also in studying the effects producing fluid evaporation from the tubules
on the fluid contents of the dentin that are and causing a pulpward flow of saline solu-
produced by various filling materials. tion in the glass capillary. It is suggested
The coefficient of expansion of the fluid that this method might be valuable in dem-
in the dentinal tubules may be about ten onstrations of the hydrodynamics of the
times greater than that of the tubular wall, pulp and dentinal tubules and in studying
so heat will produce a pulpward movement the effect of various clinical procedures on
of fluid in the tubules and an outward flow the fluid contents of the dentin.
at the apex. Fluid also may flow outward
from tubules opened during the drilling, References
owing to both expansion and evaporation. 1. BRXNNSTR6M, M.: Sensitivity of Dentin,
The effect of an air blast was obviously Oral Surg 21:517-526, 1966.
from the evaporation and the outward flow 2. BEVERIDGE, E.E., and BROWN, A.C.: The
from the tubules caused by capillary forces, Measurement of Human Dental Intrapulpal
as has been demonstrated previously.' The Pressure and Its Response to Clinical Vari-
significance of fluid movements in the den- ables, Oral Surg 19:655-668, 1965.
tinal tubules in relation to dentinal sensi- 3. ATKINSON, H.F.: An Investigation into the
tivity has been discussed previously.5 Permeability of Enamel Using Osmotic
Methods, Brit Dent 1 83:205-214, 1947.
Conclusions 4. BERGMAN, G., and SILJESTRAND, B.: Water
Evaporation In Vitro from Human Dental
By applying a glass capillary filled with Enamel, Arch Oral Biol 8:37-38. 1963.
physiologic saline solution to the root pulp 5. BRXNNSTR6M, M., LINDEN, L.A., and As-
of the extracted tooth, it was possible to TROM, A.: The Hydrodynamics of the Dental
study the effect of some clinical procedures Tubule and of Pulp Fluid: Its Significance in
on the fluid contents of the dentin and pulp. Relation to Dentinal Sensitivity, Caries Res
Drilling was found to produce expansion 1:310-317. 1967.
and outward movement of fluid from the 6. LINDEN, L.A., and BRANNSTR6M, M.: Fluid
apex of the tooth. The same effect was ob- Movements in Dentin and Pulp: An In
tained when an impression of the prepared Vitro Study of Flow Produced by Chemical
crown was made with a heated compound Solutions on Exposed Dentin, Odont Reiy
and when heated temporary cement was 18:227-236, 1967.

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