Histological evaluation of dental pulp response to Biodentine, enamel matrix derivative (Emdogain), and mineral trioxide aggregate as direct pulp-capping agents – A randomized clinical trial

Abstract

ABSTRACT Aim: We aimed to study the response of pulp tissue to Biodentine, enamel matrix derivative (Emdogain), and mineral trioxide aggregate (MTA) as direct pulp-capping (DPC) agents. Materials and Methods: This study was performed on 78 maxillary/mandibular permanent teeth indicated for surgical extraction (periodontal/orthodontic). Exposure of 1.2 mm in diameter was made. Hemostasis was achieved. The tooth was randomly allocated to one of the three groups. In Group 1, pulp capping was done with Biodentine. In Group 2, Emdogain was used. In Group 3 (control), pulp capping was carried out with MTA. Final restoration was done with glass-ionomer cement. Teeth were extracted atraumatically after 6 weeks. Histologic examination was done and samples were evaluated. Differences in inflammatory response in the three groups were statistically evaluated using Chi-square test. Results: Grade 1 inflammatory response was observed in 57.7% of cases treated with Biodentine, 36% with Emdogain, and 65.4% with MTA. The difference was however not statistically significant (P = 0.427). Majority of cases in the MTA group (57.7%) showed presence of calcific bridge directly adjacent to the medicament interface as compared to Biodentine (46.1%) and Emdogain (0%), and the difference between the groups was statistically significant (P < 0.05). The difference in formation of calcific bridge with MTA and Biodentine was not statistically significant (0.694). Conclusions: Within the limitations of this histological study, it can be concluded that MTA and Biodentine are well tolerated as DPC agents by pulp tissue as compared to Emdogain.