Inflammatory Response and Odontogenic Differentiation of Inflamed Dental Pulp Treated with Different Pulp Capping Materials: An In Vivo Study.

Abstract

Previous studies have evaluated the pulpal responses to calcium silicate cements (CSCs) on normal dental pulp, but investigations on the effects of CSCs on inflamed pulp are limited. This study aimed to test the inflammatory response and odontogenic differentiation of inflamed rat dental pulp after direct pulp capping with CSCs. Wistar rat molars pulps were exposed for 48 hours to induce inflammation and then capped with ProRoot MTA (Dentsply, Tulsa, OK, USA), Biodentine (Septodont, Saint-Maur-des-Fossés, France), RetroMTA (Bio MTA, Seoul, Korea) and Dycal (Dentsply Caulk, Milford, DE, USA). The degree of pulpal inflammation and hard tissue formation was evaluated by histological analysis. Immunofluorescence staining for interleukin (IL)-6, osteocalcin (OCN), and runt-related transcription factor 2 (RUNX2) was also performed. After 4 weeks, complete recovery from inflammation was evident in 22%, 37.5%, 10%, and none of the ProRoot MTA, Biodentine, RetroMTA and Dycal samples, respectively. Heavy hard tissue deposition as a continuous hard tissue bridge was observed in 77.8%, 75%, 70%, and 60% of the ProRoot MTA, Biodentine, RetroMTA, and Dycal samples, respectively. IL-6, OCN, and RUNX2 were detected in all materials, mainly adjacent to areas of inflammation and reparative dentine formation. At 1, 2, and 4 weeks, significant differences were not observed between the inflammation and hard tissue formation scores of the four material groups (P > .05). In this study, pulpal inflammation was still present in most specimens at 4 weeks after pulp capping and a significant number of samples showed incomplete and discontinuous dentine bridge formation. The results of this study suggest that initial inflammatory conditions of the pulp may risk the prognosis of teeth treated with CSCs.