Pulpal Response to the Combined Use of Mineral Trioxide Aggregate and Iloprost for Direct Pulp Capping

Alanoud Almeshari,Wael Mahdi,Shilpa Bhandi,Sara Alsubait,Fahd Aljarbou,Rita Khounganian

doi:10.3390/app11083702

Alanoud Almeshari, Wael Mahdi + Show 4 more

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https://doi.org/10.3390/app11083702

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Journal: Applied Sciences	Publication Date: Apr 20, 2021
Citations: 1	License type: CC BY 4.0

Affiliation: King Saud University, Jazan University

Abstract

Purpose: The present study aims to assess the combined effects of mineral trioxide aggregate (MTA) and iloprost when used as a pulp capping material on pulpal inflammation and tertiary dentin formation compared with MTA and iloprost alone in rat molar teeth. Methods: Eighty maxillary first molar rat teeth were exposed and capped with iloprost solution, MTA, or MTA mixed with iloprost (MTA-iloprost). The cavities were then filled with resin-modified glass ionomer. The cavity was restored with glass ionomer without the use of pulp capping agent in the control group. The rats were sacrificed after one and four weeks. Block sections of the molar specimens were prepared and subjected to hematoxylin and eosin staining for evaluation. Statistical analysis was done using the Kruskal–Wallis test, followed by Dunnett’s test. Results: At week one, the control group showed significantly more severe pulpal inflammatory reactions than the iloprost (p = 0.00), MTA (p = 0.04), and MTA-iloprost (p = 0.00) groups. Hard tissue formation was commonly found in the iloprost, MTA, and MTA-iloprost groups. After four weeks, pulpal tissue degeneration was observed in the control group. Complete hard tissue barriers were found in 50%, 72.7%, and 77.8% of the specimens in iloprost, MTA, and MTA-iloprost groups, respectively, with no significant differences among the experimental groups. The dentinal tubule patterns were mostly regular in the MTA-iloprost group and irregular in the iloprost and MTA groups. Conclusions: The application of iloprost, MTA, and MTA-iloprost as a pulp capping material resulted in similar pulpal responses in the mechanically exposed pulp of rat molars. Therefore, mixing MTA with iloprost might not be clinically significant.

Highlights

Dental pulp is a richly vascularized connective tissue that is surrounded by a mineralized tooth structure
Based on previous in vitro findings, the current study was conducted to assess the combined effects of mineral trioxide aggregate (MTA) and iloprost when used as a pulp capping material on pulpal inflammation and tertiary dentin formation compared with MTA and iloprost alone in an in vivo experiment in rat molar teeth
Among the 80 molars, 11 teeth were not included in the analysis, comprising four from the control group, one from the iloprost group, three from the MTA group, and three from the MTA-iloprost group

Summary

Introduction

Dental pulp is a richly vascularized connective tissue that is surrounded by a mineralized tooth structure. Vital pulp therapy (VPT) intends to preserve and maintain the vitality and function of compromised dental pulp by facilitating reparative dentin formation [1]. The success of this therapy depends on the oxygen and nutrition supply and on the recruitment of progenitor cells to dental pulp in a process called angiogenesis [2]. Angiogenesis is the process by which new blood vessels form from pre-existing capillaries This vascular formation is pivotal in the healing sequence of dental pulp that requires hard tissue formation [3]; bioactive molecules that upregulate angiogenesis could accelerate tertiary dentin bridge formation. It is commonly used in the treatment of pulmonary arterial hypertension [5] and Raynaud’s disease [6]

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