Abstract
Summary. The purpose of the present study was to test the hypotheses that calcium hydroxide enhances pulpal protection against irritating substances in and around dental restorations when topically applied to cut dentine, and to acquire further information regarding the possible mechanisms involved. Cavities in dentine were treated for 30 days with either a water slurry of calcium hydroxide or a hard‐setting calcium hydroxide containing base. Control cavities were treated with saline. The additional effect of dry cutting prior to the restoration was also included as a control. Pulpal responses after placement of a silicate cement restoration were evaluated after an additional period of 30 or 150 days. From histological sections the volumes of inflamed pulp and the volumes of irregular secondary dentine were calculated with a morphometric method of evaluation. Changes in dentine to the calcium hydroxide treatment were observed with scanning electron microscopy. Most pulps in teeth with cavities treated with saline and restored for 30 days with silicate cement exhibited inflammatory alterations. Calcium hydroxide treated teeth had a significantly lower volume of inflamed pulp compared with the saline controls. Dry preparation was also associated with reduced inflammatory reaction. Pulps in teeth with dentine treated by the calcium hydroxide containing hard‐ setting base displayed the same magnitude of pulpal inflammation as the saline treated controls. After restoration for 150 days the volumes of inflamed pulp tissue were reduced in all treatment groups, however the least pulpal responses were found in teeth treated with calcium hydroxide slurry. Data also showed that the calcium hydroxide treatment was associated with only small volumes of irregular secondary dentine, while in contrast dry cut teeth showed large volumes of irregular secondary dentine. Scanning electron microscopic evaluation of dentine treated with calcium hydroxide revealed reticular structures inside the dentinal tubules
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