Dental Pulp Changes Observed in a Patient on Long-term Corticosteroids

Abstract

We encountered a patient on long-term oral corticosteroids for systemic lupus erythematosus, who did not complain of pain during caries treatment. Since the patient had no subjective sense of dental pain, all her remaining teeth became stumps, and total tooth extraction was conducted 25 years after presentation. We examined her premolar stumps histopathologically and obtained the following findings: 1. the dental pulp was narrowed in nearly all samples; 2. odontoblasts were not observable; 3. regions with dentinal tubules forming lamellae and regions with fibrotic dentinal tubules were observed. 4. fibrosis of the entire dentin was observed in some regions. 5. nerve fibers stained by anti-neurofilament protein antibody were observed in the dental pulp cavity, but the nerve fibers appeared degenerate and no nerve fiber endings were observed.