Induction of reparative dentin by calcium silicate-based material as direct pulp capping agent

Mahmood Sajedeen,Mozammal Hossain,Yukio Nakamura

doi:10.3329/bsmmuj.v12i4.43857

Abstract

This study was performed to examine whether calcium silicate could induce reparative dentin formation without eliciting any adverse effect in direct pulp capping of premolar teeth. Twenty participants who need extraction of their 4 healthy permanent premolar teeth for orthodontic reasons were included in this study. Following the surgical procedure, the exposed pulp tissue was treated either with calcium silicate or covered with calcium hydroxide paste. On day 3, 7, 14 and 28, the experimental teeth was extracted and examined using light microscopy and histometric analysis to observe the inflammatory changes and the amount of reparative dentin formation. The results showed that in the calcium silicate treated teeth, substantial amounts of dentine-like tissue was formed on day 14 and mostly located on the exposure site. It was also observed in the calcium hydroxide treated teeth but dentin-like tissue located at a distance from the exposure site. The total amount of reparative dentine formed in the calcium silicate-treated teeth was significantly higher (p<0.005) than in the calcium hydroxide-treated specimens. In conclusion that the calcium silicate indices pulpal wound healing and reparative formation in the exposed teeth without affecting the normal function of the remaining pulp.

Highlights

The treatment of deep carious lesion is still a controversial issue in the operative dentistry because of the traditional concept of complete carious tissue removal in a deep preparation has been challenged
Complete carious dentin removal is not always essential to arrest the carious progression because the bacteria in the dentin may cause pulpal inflammation but there is a chance of pulp regeneration too.[1]
On day 14 and 28, partly calcified fibrous tissue lined by odontoblastic cells was seen below the calcium silicate-based material

Summary

Introduction

The treatment of deep carious lesion is still a controversial issue in the operative dentistry because of the traditional concept of complete carious tissue removal in a deep preparation has been challenged. Complete carious dentin removal is not always essential to arrest the carious progression because the bacteria in the dentin may cause pulpal inflammation but there is a chance of pulp regeneration too.[1] preservation of the pulp vitality in the treatment of deep carious lesion is considered as beneficial as that of endodontic treatment. If the pulp has become exposed during caries removal, the successful outcome could be significantly reduced. Direct pulp capping is a procedure, where an exposed pulp is covered by a dressing in an attempt to preserve the pulp vitality. The success of treatment depends on the materials used which are known as pulp capping material

Results

Discussion

Conclusion