Influence of Pregnancy on the Inflammatory Process Following Direct Pulp Capping: a Preliminary Study in Rats.

Luiza Helena Silva Almeida,Katerine Jahnecke Pilownic,Ana Regina Romano,Fernanda Geraldo Pappen,Anelize Campello Felix,Sandra Beatriz Chaves Tarquínio

doi:10.1590/0103-6440201902093

Luiza Helena Silva Almeida, Katerine Jahnecke Pilownic + Show 4 more

Open Access

https://doi.org/10.1590/0103-6440201902093

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Abstract

The purpose of this study was to evaluate the inflammatory process following direct pulp capping during pregnancy. This experimental study involved 48 maxillary first molars of female Wistar rats. The procedures were performed in pregnant and non-pregnant animals (n =20 each). Direct pulp capping with mineral trioxide aggregate (MTA) and restoration with a light-cured resin composite was performed in half of exposed pulp specimens. In the other half of specimens, light-cured composite was placed directly on the exposed pulp. In the control groups (n=4 each), no intervention was performed. Animals were euthanized at 3 and 7 days. All sections (three per slide) were viewed under an optical microscope. One previously calibrated pathologist performed descriptive analysis and assigned scores for inflammatory response and tissue organization adjacent to the pulp exposure. The Kappa value for intra-examiner variability was 0.91. At 3 days, in animals treated with MTA, inflammatory infiltrate was absent in non-pregnant animals while mild inflammatory infiltrate was observed in some pregnant animals. The inflammatory response ranged from mild to severe in both groups treated with composite alone. At 7 days, the inflammatory response was more intense in pregnant than in non-pregnant animals treated with MTA; while this difference were not evident in animals treated with composite alone. In conclusion, pregnancy may not influence the inflammatory process following direct pulp capping with light-cured resin composite, which was always harmful to the pulp; while the tissue response after the direct pulp with MTA were more favorable in non-pregnant animals.

Highlights

During pregnancy, physical and hormonal changes influence women’s bodies and health significantly [1]
Increased levels of estrogen and progesterone are related to increased permeability of oral vasculatures and decreased host immunocompetence, which increase the tendency for and severity of oral inflammation in reaction to bacterial, physical, and chemical irritants [3]
The role of hormones in the periodontal inflammation is well documented, there is a lack related to the of inflammatory exacerbation or greater predisposition of pulp tissue to inflammation as a result of hormonal changes during pregnancy [3]

Summary

Introduction

Physical and hormonal changes influence women’s bodies and health significantly [1]. Pregnancy increases estrogen and progesterone levels by 30 and 10 times, respectively [2]. These high levels increase the permeability of the oral vasculature and reduce immunocompetence, increasing the tendency for and severity of periodontal tissue inflammation [3]. The dental pulp is comprised of loose connective tissue; it may be affected by hormonal changes [4]. The increased susceptibility of tissues to inflammation may explain why emergency dental services due to acute dental pain are frequently necessary during pregnancy [5]. Clinical survey data indicate that between 38.2% and 54.0% of pregnant women seek out to dental care during pregnancy having acute dental pain as the primary motivation [6,7,8], while the prevalence of dental pain is between 7.5–17.5% in the general population [9,10]

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