CLINICAL, RADIOLOGICAL, AND IMMUNOLOGICAL FEATURES OF DENTAL PULP DAMAGE IN PATIENTS WITH CHRONIC PERIODONTITIS

Chronic generalized periodontitis is frequently accompanied by inflammatory and degenerative changes in the dental pulp due to the anatomical communication between periodontal tissues and the root canal system. Early identification of pulp involvement remains a diagnostic challenge because conventional clinical and radiographic methods often fail to detect initial pathological changes. The present prospective comparative study aimed to evaluate the clinical, radiological, functional, and immunological characteristics of dental pulp lesions in patients with chronic generalized periodontitis and to determine the diagnostic value of an integrated examination approach. A total of 154 participants were enrolled, including 124 patients with chronic generalized periodontitis complicated by pulp involvement and 30 periodontally healthy individuals serving as controls. Clinical periodontal indices, cone-beam computed tomography (CBCT), electroodontodiagnostics (EOD), and enzyme-linked immunosorbent assay (ELISA) were used to assess periodontal status, pulp vitality, radiological changes, and cytokine concentrations (IL-1β, IL-6, TNF-α, and IL-10). The results demonstrated that chronic fibrous pulpitis was the predominant form of pulp pathology, while CBCT detected extensive alveolar bone destruction and accessory canal involvement in the majority of patients. EOD revealed impaired pulp vitality closely associated with periodontal pocket depth and bone resorption. Immunological analysis showed significantly elevated levels of IL-1β, IL-6, and TNF-α together with reduced IL-10 concentrations, indicating a pronounced local inflammatory imbalance. The integrated application of CBCT, electroodontodiagnostics, and cytokine profiling significantly improved the early diagnosis of retrograde pulp involvement compared with conventional diagnostic methods. Comprehensive assessment of clinical, radiological, functional, and immunological parameters provides a reliable basis for selecting appropriate treatment strategies and improving the prognosis of patients with chronic periodontitis complicated by pulp lesions.