Dentin Bridge Research Articles

The Response of the Pulp-Dentine Complex, PDL, and Bone to Three Calcium Silicate-Based Cements: A Histological Study in an Animal Rat Model

Objective The aim of this study was to histologically examine the tissue reaction of three different calcium silicate cements in the closure of perforations in rat incisor teeth. Material and Methods. An experimental lateral root perforation with pulp exposure was performed in 32 lower incisors of 16 male Wistar albino rats. They were randomly assigned into three test groups (each including eight teeth) that were filled either by Biodentine (BD) or MicroMega mineral trioxide aggregate (MM-MTA) or EndoSequence root repair material putty (ESRRM putty), besides eight unperforated incisors from the other four rats (control group). The inflammatory response and healing process were evaluated histologically and scored after one and four weeks. Differences among groups were tested by Kruskal–Wallis tests at P ≤ 0.05. Results In the first week, BD produced more inflammatory response in the pulpal (score 3) than other materials (score 2). Only ESRRM putty showed odontoblast-like cells in 50%, 25% dentine-like deposit, 25% evidence of bone deposition in the drilling site (score 2), and minimum periodontal ligament (PDL) necrosis and disorganization (25%, score 2). After one month, all groups had healthy pulpal tissue, but 25% of ESRRM putty retained score 1 inflammatory response, and 50% of the BD case had an incomplete palisading odontoblast layer (score 3). A thick and regular dentine bridge deposition was seen in the ESRRM putty group in comparison with MM-MTA and BD cases. The cortical plate healing in all ESRRM putty samples was complete (score 3), while an incomplete closure was seen in MM-MTA and BD groups (score 2). Both the MM-MTA and ESRRM putty groups had fully organized PDL (score 2), while in 50% of BD cases, a necrotizing area and disorganized PDL with inflammatory cells infiltration were still present. Statistically significant differences in the scores of any histologic parameters among the three tested materials were observed neither in the 1st nor in the 4th weeks of the experimental period. Conclusion Better tissue compatibility and repair of pulpal and periodontal tissue have been detected after lateral perforation in the root of rat incisors when treated with ESRRM putty than MM-MTA and BD. However, the difference was not significant.

Histologic assessment of pulp response to strontium ranelate and bisphospho-nates when compared to calcium hydroxide as direct pulp capping materials. An animal study.

Aim: To compare strontium ranelate as a pulp capping agent to bisphosphonate and calcium hydroxide. Materials and methods: The pulps of 36 premolars from 4 dogs were exposed and capped with one of 3 test materials, namely strontium ranelate, bisphosphonate, and calcium hydroxide. Half of the specimens underwent histologic evaluation at 6 weeks and the remaining half were assessed at 12 weeks. Each slide was scored from 1 to 3 according to hard tissue formation, inflammation, and odontoblastic differentiation. The pH of the 3 materials was also measured. Data were inspected using SPSS software and the recorded scores were statistically analyzed at 6 and 12 weeks. Results:Calcium hydroxide was the only material that exhibited discontinuous dentin bridge at both evaluation periods. Strontium ranelate showed irregular hard tissue formation in few of the samples at 12 weeks; while bishphonate did not induce any hard tissue formation. All the materials exhibited severe to moderate inflammatory reaction at 6 weeks which subsided to mild inflammation at 12 weeks. Differentiation of odontoblasts was observed with all materials at both evaluation periods with no significant differences among them. The average pH obtained for Dycal base was 9, and 12 for the catalyst; for bisphosphonate the value was 6.8; and 8.6 for strontium ranelate. Conclusions: Strontium ranelate was not as effective as calcium hydroxide as a pulp capping agent, while bisphosphonate failed to show any potential for hard tissue formation up to 12 weeks. However, all the test materials allowed healing of the pulp tissues.

Impact of a New Silicate-Based Capping Material on Healing Potentiality of Traumatically Exposed Healthy Dog's Dental Pulp

The aim of the current study was to evaluate the impact of a new silicate-based capping material on healing potential of traumatically exposed healthy dog's dental pulp. Materials and Methods: Two pulp capping materials were evaluated in this study; Mineral trioxide aggregate (MTA), and Five mineral oxides (5MO). Glass ionomer as overlying restorative material. Six adult healthy dogs with intact permanent dentition were selected for the study. A total of sixteen anterior teeth were used in each dog. Both pulp capping materials were used in the same dog. Class V cavities were prepared on the teeth. After pulp exposure, the pulp capping materials were applied directly to the exposed pulp. All cavities were sealed with glass ionomer restorative material. The used six dogs were divided into two groups; three dogs each, according to the capping periods to 7 days and 90 days. At the end of each period the dogs were sacrificed by injecting an overdose of pentobarbital sodium. Teeth were separated from bone with immediate sectioning of their roots in the mid-way between cementoenamel junction and apex. The teeth were fixed in 10% neutral buffered formalin. Then the teeth were demineralized in Morse's solution (50% formic acid and 20% sodium citrate) for 3 months. In the last, the teeth were embedded in paraffin wax and serially sectioned buccolingually and stained with hematoxylin-eosin. The specimens were examined under optical light microscope to estimate the amount of pulp inflammation and dentin bridge formation at the interface of the capping materia

Evaluation of the Efficacy of Erbium, Chromium-doped Yttrium, Scandium, Gallium, and Garnet Laser in Partial Pulpotomy in Permanent Immature Molars: A Randomized Controlled Trial

IntroductionThe use of the erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser in vital pulp therapy contributes to the formation of dentin bridges and a sterile zone as well as the maintenance of the vitality of the pulp. However, no prior studies have used the Er,Cr:YSGG laser in partial pulpotomy of immature permanent teeth. The aim of this study was to compare the efficacy of partial pulpotomy treatment using mineral trioxide aggregate (MTA) alone and MTA with the Er,Cr:YSGG laser in permanent immature molars. MethodsA total of 90 caries-exposed permanent immature molar teeth were included and randomly divided into 2 groups: the MTA group (n = 45) and the laser + MTA group (n = 45). In the MTA group, MTA was applied to the exposed area on the pulp after bleeding control. In the same session, the tooth was restored with a composite resin. In the laser + MTA group, before MTA condensation, the Er,Cr:YSGG laser was applied to the exposure area. Patients were recalled at 1, 3, 6, and 12 months after treatment. The Mann-Whitney U and chi-Square tests were used for statistical analysis. ResultsThe success rate (95.5%) of the laser + MTA group was similar to that of the MTA group (88.8%). There was no significant difference between groups in terms of the frequency of at least 1 pathologic clinical or radiographic failure at 12 months (P > .05). ConclusionsPartial pulpotomy treatment showed a high success rate in immature permanent molars; however, the use of the laser did not contribute to the success rate compared with MTA alone.

Dentin Bridge Formation After Indirect Pulp Capping With Bioactive Glass Incorporated in Resin Composite and Its Adhesive in Comparison With Light Cured Calcium Hydroxide

Dentin Bridge Formation After Indirect Pulp Capping With Bioactive Glass Incorporated in Resin Composite and Its Adhesive in Comparison With Light Cured Calcium Hydroxide

Comparison of iRoot BP Plus and Calcium Hydroxide as Pulpotomy Materials in Permanent Incisors with Complicated Crown Fractures: A Retrospective Study

IntroductionCalcium hydroxide has been used as a traditional pulpotomy agent for a long time but has some disadvantages. iRoot BP Plus (Innovative Bioceramix Inc, Vancouver, Canada) is a newly developed, ready-to-use calcium silicate–based bioactive ceramic with excellent bioactivity and sealing ability. However, whether iRoot BP Plus shows superiority over calcium hydroxide as a pulpotomy material on permanent incisors with complicated crown fractures remains unknown. MethodsThis research included 205 permanent incisors with complicated crown fractures. These teeth were treated with pulpotomy and divided into 2 groups according to the pulpotomy material (105 treated with iRoot BP Plus and 100 with calcium hydroxide). Clinical and radiographic information was collected during the 12- to 24-month follow-up period. The formation of reparative dentin bridges and pulp canal obliteration were analyzed using radiographs in both groups. ResultsThe success rates for recall in the average follow-up period of 17.5 ± 4.4 months (12–24 months) after pulpotomy treatment were significantly different between the 2 groups, with 99% for the iRoot BP Plus group and 93% for the calcium hydroxide group. Reparative dentin bridges were observed in 92.4% of the iRoot BP Plus group and 90% of the calcium hydroxide group, but the difference was not significant. Pulp canal obliteration was observed in 2 teeth (2%) in each group. ConclusionsThe success rates obtained in our study indicate that iRoot BP Plus as a pulpotomy agent can be a suitable alternative to calcium hydroxide to manage complicated crown fractures.

Histopathological pulp response of dog's teeth capped with biosealer and biodentine: An in vivo study

Introduction: The aim of this study was to evaluate the pulpal response after pulp capping using either biodentine (BD) or tech biosealer capping (TBC) in the dog model. Materials and Methods: Class V cavities were carried out on 45 teeth in three mongrel dogs. The dental pulp was exposed in 30 teeth (2 experimental groups) and left unexposed in 15 teeth (control group). The cavities of the experimental groups were capped with either BD (n = 15 teeth) or TBC (n = 15 teeth). All cavities in the experimental and control groups were restored with resin-modified glass ionomer. Dentin bridge formation, architecture of the odontoblastic layers, and signs of inflammation were assessed after 1, 2, and 3 months using the computer image analyzer. Results: The BD group exhibited a thick newly formed reparative dentin bridge completely closing the exposure site with cell inclusions and mineralization, variable numbers of odontoblast-like cells, preserved pulp tissue, marked numerous collagen fibers, and blood vessels. While the TBC group exhibited an incomplete newly formed reparative dentin bridge with tunnel defect, vacuolated odontoblasts, complete pulp degeneration with multiple edematous spaces, hyperemic blood vessels, extravasated red blood cells, multiple calcified structures scattered just beneath the dentin bridge and through the pulp tissue, and newly ill-defined odontoblasts. Conclusion: For pulp capping, BD has a better dentin bridge formation and pulp preservation than TBC in the dog model.

Two calcium silicate-based materials used in direct pulp capping (in-vivo study)

Aim The aim was to clinically and radiographically evaluate mineral trioxide aggregate (MTA) and TheraCal LC as direct pulp capping (DPC) materials. Materials and methods Twenty male patients aged 17–35 years with immediate mechanical pulp exposure in lower molars were randomly divided into two equal groups (n = 10). Group 1: pulp exposures were capped using MTA. Group 2: pulp exposures were capped using TheraCal LC. Immediately after DPC, a base-line digital bitewing and periapical radiographs were taken. Clinical evaluation was performed at 1, 4, 12, and 24 weeks after DPC for presence/absence of spontaneous pain, tenderness to percussion, draining sinuses and pulp response to thermal pulp vitality test. At 24 weeks after DPC, digital periapical, and bitewing radiographs were taken. Digitalized bitewing radiographs were submitted to image analysis software to measure dentin bridge thickness in comparison to the base-line bitewing radiographic image. Digitalized preoperative and postoperative periapical radiographs were submitted to the same software to evaluate changes in the width of periodontal ligament space. Results Clinically, all cases showed criteria of successful treatment except 3, four cases in groups 1 and 2, respectively. Statistical analysis revealed no statistically significant difference between both groups (P > 0.05). All of the thirteen cases that were available for evaluation after 6 months showed dentin bridge formation. In MTA group, the mean value of dentin bridge formed was higher than in TheraCal LC group with no statistically significant difference (P = 0.710). Changes in the width of periodontal ligament space were not significantly different between both groups recording (P > 0.05). Conclusion Clinically and radiographically, MTA and TheraCal LC are favorable materials for DPC inducing adequate dentin bridge formation and minimal widening of periodontal ligament space.

Chemical modification of MTA and CEM cement to decrease setting time and improve bioactivity properties by adding alkaline salts.

Background. Mineral trioxide aggregate (MTA) and Calcium-enriched Mixture (CEM) cement are used for pulp capping since they induce the formation of a dentinal bridge. Long setting time is a shortcoming of these types of cement. This study aimed to assess the effect of the incorporation of some alkaline salts to MTA and CEM cement on their setting time, ion release profile, pH, and surface morphology. Methods. In this in vitro experimental study, 5% calcium chloride (CaCl2), calcium oxide (CaO), sodium fluoride (NaF), and calcium nitrate [Ca(NO3)2] were separately added to MTA and CEM cement. The primary and final setting times of the cements were measured using a Gillmore needle apparatus. The samples were immersed in simulated body fluid (SBF) for one, seven, and 14 days and subjected to x-ray diffraction (XRD) and scanning electron microscopy (SEM) for phase identification and surface morphology assessment. The change in the pH of solutions was studied, and the calcium ion release profile was determined using inductively coupled plasma atomic emission spectroscopy (ICP-AES). The data were analyzed with ANOVA, followed by post hoc tests. Results. CaCl2 and CaO decreased the setting time of MTA, and Ca(NO3)2 decreased the setting time of CEM cement. The incorporation of the salts increased the pH and calcium ion release from both cements, and hydroxyapatite deposits were noted to cover the surface of the samples (observed by SEM and confirmed by EDXA). Conclusion. The incorporation of CaCl2 and CaO into MTA and Ca(NO3)2 into CEM cement decreased their setting time and increased their pH and calcium ion release.

Comparison between Calcium Hydroxide (CH) and Mineral Trioxide Aggregate (MTA) as Pulp Capping Agent: A Systematic Review

Pulp capping treatment aims to maintain the vitality of the pulp so that dental function is maintained. Calcium hydroxide (CH) and Mineral Trioxide Aggregate (MTA) were used to maintain pulp vitality by forming a dentinal bridge formation without toxic effects. This study aimed to evaluate the effect of CH as pulp capping material in comparison with MTA. Clinical trials conducted searches in PubMed journals and Wiley for articles published in the last ten years to evaluate the effects of pulp capping material CH and MTA. Journals that met the inclusion criteria received, and the information does not need to put in exclusion criteria - Journal of the difference effectiveness of the material included in the systematic review. Three studies that did not meet the inclusion criteria and journals that could not be opened were excluded from the research study. The MTA treatment group showed a much higher success rate than the calcium hydroxide group. From this review, it was concluded that MTA is superior to CH in the absence of an inflammatory response and dentinal bridge formation. How to Cite this Article Pubmed Style Aries Chandra Trilaksana, Harmiyati Gappar. between Calcium Hydroxide (CH) and Mineral Trioxide Aggregate (MTA) as Pulp Capping Agent: A Systematic Review. SRP. 2020; 11(10): 45-48. doi:10.31838/srp.2020.10.9 Web Style Aries Chandra Trilaksana, Harmiyati Gappar. between Calcium Hydroxide (CH) and Mineral Trioxide Aggregate (MTA) as Pulp Capping Agent: A Systematic Review. http://www.sysrevpharm.org/?mno=127071 [Access: March 28, 2021]. doi:10.31838/srp.2020.10.9 AMA (American Medical Association) Style Aries Chandra Trilaksana, Harmiyati Gappar. between Calcium Hydroxide (CH) and Mineral Trioxide Aggregate (MTA) as Pulp Capping Agent: A Systematic Review. SRP. 2020; 11(10): 45-48. doi:10.31838/srp.2020.10.9 Vancouver/ICMJE Style Aries Chandra Trilaksana, Harmiyati Gappar. between Calcium Hydroxide (CH) and Mineral Trioxide Aggregate (MTA) as Pulp Capping Agent: A Systematic Review. SRP. (2020), [cited March 28, 2021]; 11(10): 45-48. doi:10.31838/srp.2020.10.9 Harvard Style Aries Chandra Trilaksana, Harmiyati Gappar (2020) between Calcium Hydroxide (CH) and Mineral Trioxide Aggregate (MTA) as Pulp Capping Agent: A Systematic Review. SRP, 11 (10), 45-48. doi:10.31838/srp.2020.10.9 Turabian Style Aries Chandra Trilaksana, Harmiyati Gappar. 2020. between Calcium Hydroxide (CH) and Mineral Trioxide Aggregate (MTA) as Pulp Capping Agent: A Systematic Reviews in Pharmacy, 11 (10), 45-48. doi:10.31838/srp.2020.10.9 Chicago Style Aries Chandra Trilaksana, Harmiyati Gappar. Comparison between Calcium Hydroxide (CH) and Mineral Trioxide Aggregate (MTA) as Pulp Capping Agent: A Systematic Review. Systematic Reviews in Pharmacy 11 (2020), 45-48. doi:10.31838/srp.2020.10.9 MLA (The Modern Language Association) Style Aries Chandra Trilaksana, Harmiyati Gappar. Comparison between Calcium Hydroxide (CH) and Mineral Trioxide Aggregate (MTA) as Pulp Capping Agent: A Systematic Review. Systematic Reviews in Pharmacy 11.10 (2020), 45-48. Print. doi:10.31838/srp.2020.10.9 APA (American Psychological Association) Style Aries Chandra Trilaksana, Harmiyati Gappar (2020) between Calcium Hydroxide (CH) and Mineral Trioxide Aggregate (MTA) as Pulp Capping Agent: A Systematic Reviews in Pharmacy, 11 (10), 45-48. doi:10.31838/srp.2020.10.9

Comparing Quality and Quantity of Dentin Bridge Formed Using Mineral Trioxide Aggregate, Biodentine, and Propolis: A Double-blinded Randomized Controlled Clinical Trial

Comparing Quality and Quantity of Dentin Bridge Formed Using Mineral Trioxide Aggregate, Biodentine, and Propolis: A Double-blinded Randomized Controlled Clinical Trial

Glucose Transporter 2 and 4 Are Involved in Glucose Supply during Pulpal Wound Healing after Pulpotomy with Mineral Trioxide Aggregate in Rat Molars

IntroductionPulp capping materials allow healing of injured pulp with a layer of reparative dentin. Glucose is needed to cure the injured area. Glucose is transported by glucose transporter (Glut) 2 and Glut4, which are transmembrane proteins that act as gatekeepers. We hypothesized that the transport of glucose via Glut2/Glut4 might contribute to the production of a dentin bridge during wound healing. Therefore, we explored Glut2 and Glut4 expression during reparative dentinogenesis after mineral trioxide aggregate capping. MethodsThe upper left first molar of 8-week-old Wistar rats underwent pulpotomy with mineral trioxide aggregate. At 1, 3, 5, 7, and 14 days after treatment, localization and colocalization of Glut2, Glut4, nestin (odontoblast marker), and antiendothelial cell antigen 1 (RECA-1; endothelial cell marker) were analyzed with immunohistochemical staining. Messenger RNA expression levels of Slc2a2 (encoding Glut2), Slc2a4 (encoding Glut4), Igf-1r (encoding insulinlike growth factor 1 receptor), and nestin were analyzed in the extracted teeth using real-time polymerase chain reaction. ResultsGlut2 and Glut4 were localized within odontoblasts and endothelial cells in normal control teeth. Three days after pulpotomy, Glut2- and Glut4-positive cells were detected; 7 days after pulpotomy, immunoreactivity for Glut2 and Glut4 was confined to newly differentiated odontoblastlike cells arranged beneath reparative dentin. Messenger RNA expression levels of Slc2a2 and Slc2a4 were significantly up-regulated after pulpotomy. ConclusionsGlut2 and Glut4 regulate glucose transport during wound healing beneath the injured area. This may contribute to the development of new vital pulp therapy for patients with deep caries.

Direct Pulp Capping: Which is the Most Effective Biomaterial? A Retrospective Clinical Study.

(1) Background: Recently, tricalcium silicate cements, such as Biodentine™, have emerged. This biomaterial has a calcium hydroxide base and characteristics like mineral aggregate trioxide cements, but has tightening times that are substantially more suitable for their application and other clinical advantages. (2) Methods: A retrospective clinical study was conducted with 20 patients, which included a clinical evaluation of the presence or absence of pulp inflammation compatible symptoms, radiographic evaluation of the periapical tissues, and structural alterations of the coronary restoration that supports pulp capping therapies with Biodentine™ and WhiteProRoot®MTA. (3) Results: This clinical study revealed similar success rates between mineral trioxide cement and tricalcium silicates cements at 6 months, with 100% and 95% success rates, respectively. There were no statistically significant differences between both biomaterials and between these and the various clinical circumstances, namely the absolute isolation of the operating field, exposure size, the aetiology of exposure, and even the type of restorative material used. (4) Conclusions: Biodentine™ demonstrated a therapeutic effect on the formation of a dentin bridge accompanied by slight inflammatory signs, with a high clinical success rate, indicating the possibility of its effective and safe use in dental pulp direct capping in humans, similar to the gold standard material.

Clinical, Radiographical and Histopathological Evaluation of Biodentine Versus Formocresol In Primary Teeth Pulpotomy

Aim: The present study was conducted to compare effects of biodentine and formocresol as pulp-dressing agents clinically, radiographically and histopatholically in primary teeth.Materials and Methods: Thirty healthy children aged from four to eight years, they were selected from patients attending outpatient clinic of Pediatric Dentistry Department. Each child had at least bilateral deep carious lower primary molar indicated for pulpotomy. Pulpotomy was done in both groups; where group I treated by biodentine while formocresol used in group II. The study cases were recalled after three, six, nine and twelve months for clinical and radiographic evaluation. For histopathological study sixteen lower primary first molars planned for serial extraction were selected, biodentine and formocresol pulpotomies were done, extraction of the treated teeth from each group was done after one and three-month intervals. Results: the overall clinical success rate of biodentine group was 90%, while formocresol group was 80%. The two groups were clinically successful with no statistically significant difference between them (P= 0.278). The radiographic success rate of biodentine group was 86.6%, while for formocresol group was 73.3%. There was no statistically significant difference between the two groups (P = 0.197). Biodentine showed significantly better histopathological results compared to formacresol after three-month interval. Biodentine favored the formation of partial dentine bridge with normal pulpal architecture. The pulp tissue in formocresol group showed necrosis with no evidence of dentine bridge formation Conclusion: the biodentine showed higher clinical, radiographic and histopathologic success rate compared to formocresol as a pulpotomy agent in primary molars. It can be considered as a biomaterial for vital pulp therapy of deep caries in primary teeth.

Evaluation of Medicinal Plant Extract Versus Traditional Medicament Used for Vital Pulpotomy of Primary Molars

Purpose: To evaluate clinically, radiographically and histologically the postoperative success of Ankaferd Blood Stopper (ABS) and formocreosl (FC) in pulpotomy procedures for primary teeth. Materials and Method: 70 Primary molars found in 27 patients were selected according to inclusion criteria. In the first part of the study pulpotomy was accomplished in 22 patients having 60 teeth (30 each group) and depending on the type of radicular pulp medicament, the teeth were divided randomly and equally into 2 groups: Group I(FC) and Group II (ABS). Clinical follow up was done after 1,3,6 and 9 months.Periapical radiographs were taken at 3 ,6 and 9 months follow up visits . In the second part of the study 10 primary molars were found in 5 patients planned for extraction due to orthodontic purpose were treated by pulpotomy procedure. Teeth were divided into2 groups(5 each group) and the teeth were extracted after 2 months for observation under light microscope. Results: No statistically significant difference between groups in the overall cumulative clinical or radiographic success at follow up periods. Histopathological examination revealed dentin bridge formation and continuous regular arrangement of odontoblastic layer at the pulp dentin junction along the root length in primary molars treated with ABS while FC specimens revealed Severe pulp hyperemia with thrombus formation at the entrance of pulp canal. Conclusion: ABS can be considered as good natural alternative to FC in primary molars pulpotomy.

Comparative Histological Study of Two Different Pulp Capping Agents in Rabbits Teeth

Objective: Evaluation of the histological pulp response following direct pulp capping with Galla Chinensis Extract (GCE) in comparison to Mineral Trioxide Aggregate (MTA) in rabbits’ teeth. Methodology: Intentional pulp exposure on the labial surfaces of permanent central incisors of twenty male rabbits was done. Split mouth technique was utilized for applying the capping material where MTA was used for capping upper and lower right central incisors while, GCE was used for capping upper and lower left central incisors. The teeth were restored by glass inonomer cement (GIC) as permanent restorations. Rabbits were divided randomly into two groups 10 rabbits each according to pulp capping period (two and four weeks). After animal scarification teeth were dissected and prepared for histological evaluation using Hematoxylin Eosin (HE) stains.Results: GCE group showed significantly higher mean dentin bridge thickness than MTA group at four weeks, also it showed significantly higher median inflammatory cell scores than MTA group at both time intervals. Conclusions: GCE is a promising direct pulp capping material with less biological pulp response in comparison to MTA.

Reparative Mineralized Tissue Characterization after Direct Pulp Capping with Calcium-Silicate-Based Cements.

Nowadays, the preservation of dental pulp vitality is an integral part of our daily therapies. The success of these treatments depends on the clinical situation as well as the biomaterials used. Mineral Trioxide aggregate and BiodentineTM are commonly used as pulp capping materials. One objective of vital pulp therapy is the repair/regeneration of the pulp. In addition to the initial inflammatory status of the pulp, the nature and quality of the new mineralized tissue obtained after pulp capping directly influence the success of the treatment. In order to characterize the reparative dentin, in the current study, the chemical composition and microstructure of the dentin bridge after direct pulp capping using Biodentine™ and mineral trioxide aggregate (MTA) was studied by using Raman microspectroscopy and scanning electron microscopy, respectively. The results showed that the reparative dentin bridge observed in both groups presented dentin tubules and chemical composition similar to primary dentin. With the limitations of this study, the calcium-silicate-based cements used as pulp capping materials provide an optimal environment for pulp healing, resulting in a reparative dentin resembling on certain points of the primary dentin and the regeneration of the pulp.

Analysis of hard tissue regeneration and Wnt signalling in dental pulp tissues after direct pulp capping with different materials.

To investigate the involvement of Wnt signalling and cell cycle regulation in hard tissue formation after pulp capping with several materials in a rat molar pinpoint exposure model. Thirty-two rat molar pulps were mechanically exposed and assigned to 4 groups according to the pulp capping materials used Ca(OH)2 , mineral trioxide aggregate (MTA), Biodentine™ and an untreated control group. After 4weeks, the teeth were collected for microcomputed tomography to quantify reparative dentine formation. Histological analysis was then performed to evaluate the quality of the reparative dentine and the dental pulp tissue inflammatory reaction. Cyclin D1 and β-catenin expression was examined using immunofluorescence staining. The Kruskal-Wallis followed by Dunn's multiple comparison test was performed to determine significant differences. The exposed dental pulps treated with Ca(OH)2 , MTA and Biodentine™ exhibited reparative dentine formation near the exposure site. Fibrous tissues adjacent to the exposure site were observed in the untreated group. The microcomputed tomography evaluation of MTA and Biodentine™ groups revealed significantly greater reparative dentine formation compared with the control group (P=0.0032 in the MTA group and P=0.05 in the BiodentineTM group). From histological evaluations, the BiodentineTM group exhibited significantly greater reparative dentine formation grading compared with the control group (P=0.0152). The pulp tissues treated with Ca(OH)2 and Biodentine™ exhibited a lower inflammatory score compared with those of the untreated control (P=0.0291 in the Ca(OH)2 and P=0.0110 in the BiodentineTM group). Ca(OH)2 , MTA and Biodentine™ induced cyclin D1 expression in the dental pulp tissues adjacent to the reparative dentine. Moreover, the Biodentine™-treated defects demonstrated β-catenin expression in the pulp tissue adjacent to the newly formed reparative dentine, which was not observed with the other materials. All test materials promoted dentine bridge formation and stimulated cyclin D1 expression. The favourable outcome after direct pulp capping with Biodentine™ involved Wnt/β-catenin signalling. However, Wnt/β-catenin signalling did not participate in the mechanism by which Ca(OH)2 and MTA promoted reparative dentine formation.

Application of hydroxyapatite nanoparticle-assembled powder using basic fibroblast growth factor as a pulp-capping agent.

We have previously fabricated hydroxyapatite (HAP) nanoparticle-assembled powder (nano-HAP) plates and granules by assembling low-crystallinity HAP nanoparticles without template/binder molecules or high-temperature/pressure treatments. In this study, we combined the nano-HAP with fibroblast growth factor (FGF) 2, which promotes odontoblast differentiation, and used this as a pulpcapping agent for dentin defects created in rat molars. The tissue response was then radiologically and histologically assessed at 1 and 2 weeks after capping, to assess the biocompatibility and ability of this material to promote hard tissue formation. The application of nano-HAP/FGF2 induced the invasion of dental pulp cells and vessels, and was consistently found to stimulate formation of a dentinal bridge containing numerous dentinal tubules. We thus succeeded in treating the pulp exposure by using a physiological approach to promote tissue regeneration. Further investigations should be performed to explain exactly how the nano-HAP/FGF2 combination contributes to calcified tissue formation.

Pulpal repair after direct pulp capping with new bioceramic materials: A comparative histological study

AimTo histopathologically evaluate the pulpal healing after direct pulp capping with TotalFill and compared it with Neo MTA Plus in human tooth cultures. MethodsForty sound human premolars freshly extracted for orthodontic reasons were randomly assigned to two experimental groups; group I: TotalFill and group II: Neo MTA Plus. Standardized Class V cavities were prepared on the buccal surface of each tooth where the pulp exposure was performed with a dental explorer. The pulp-exposed teeth were immediately capped with one of the tested materials. The prepared cavities were then finally restored with glass-ionomer cement. Teeth were cultured for three weeks and three months. Then, the cultured teeth were demineralized, sectioned and stained for histopathological evaluation. Data collected and statistically analyzed by using Fisher's exact test. The significance level was set at P ≤ 0.05. ResultsHistopathological analysis showed complete dentin bridge formation and an absence of inflammatory pulp response. Statistical analysis showed no significant differences between the TotalFill and Neo MTA Plus groups during the observation periods. However, a significantly higher thickness of the dentin bridge was found in the group of teeth treated with TotalFill at three months. ConclusionsTotalFill produced similar favorable pulp healing and repair, and were comparable to Neo MTA Plus. Furthermore, TotalFill can form a thicker dentin bridge compared with Neo MTA Plus.