Biological behavior of human dental pulp cells in response to carious stimuli analyzed by PCNA immunostaining and AgNOR staining.

The change in proliferative and metabolic activities of human dental pulp cells responding to carious stimuli was studied by means of immunohistochemical staining for proliferating cell nuclear antigen (PCNA) and silver-binding nucleolar organizer region (AgNOR) staining. We classified the pulp tissues into five groups according to the progression of dental caries, ranging from grade 0 (the pulp of noncarious teeth) to grade 4 (the pulp of perforated carious teeth). PCNA-positive pulp cells were detected only in advanced dental caries (grades 3 and 4), and the difference in immuno-positive rate was significant between the two grades (p <0.001). However, the mean number of AgNORs per nucleus increased even in the early phase of dental caries, significant differences being detected between grades 1 and 2 (p<0.005), 2 and 3 (p<0.005), and 3 and 4 (p<0.001). Our data suggested that the metabolic activity of dental pulp cells was enhanced in the early phase of dental caries. However, proliferation of pulp cells occurred later in small degrees during fully developed caries such as grades 3 and 4. The slow and weak response in cellular proliferation might contribute to the usual fragility of the pulp to various assaults including caries or pulpitis.