Dentin Bridge Research Articles

Clinical and radiographic evaluation of silver diamine fluoride versus mineral trioxide aggregate as indirect pulp capping agents in deeply carious first permanent molars a randomized clinical trial

AimClinical and radiographic evaluation of SDF versus MTA as indirect pulp capping agents in deeply carious first permanent molars.MethodologyThis study was conducted on (30) first permanent molars indicated for indirect pulp capping (IPC) randomly allocated to either SDF or MTA groups (n = 15). The molars were finally restored with glass hybrid glass ionomer restoration. Clinical assessment was conducted at 3, 6, 9 and 12 months, while radiographic assessment was performed at 6 and 12 months using predetermined criteria. Data was statistically analyzed.ResultsThere was no statistically significant difference between both groups for all assessed clinical and radiographic parameters, including dentin bridge formation, at all follow-up periods. There was no evidence of clinical or radiographic failure in either group.ConclusionsSDF showed a high success rate compared to MTA and can be considered a promising alternative IPC agent in permanent molars.

Comparative study of pulpal response following direct pulp capping using synthesized fluorapatite and hydroxyapatite nanoparticles

ObjectiveThis study aimed to investigate and compare the histological response of rabbit dental pulp after direct pulp capping with 3 different materials: mineral trioxide aggregate (MTA), nanoparticles of fluorapatite (Nano-FA), and nanoparticles of hydroxyapatite (Nano-HA) after 4 and 6-week time intervals.Material and methodsA total of 72 upper and lower incisor teeth from 18 rabbits were randomly categorized into 3 groups)24 incisors from six rabbits each. MTA Group: teeth were capped with MTA. Nano-FA Group: teeth were capped with fluorapatite nanoparticles. Nano-HA Group: teeth were capped with hydroxyapatite nanoparticles. Blood samples were collected to examine some antioxidant enzymes nitric oxide (NO), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione (GSH), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). After that, three rabbits from each group were euthanized after 4 and 6 weeks, respectively. Pulp tissues of all teeth in all groups were histologically observed.ResultsThe obtained results showed that both Nano-HA induced the formation of thick dentin bridges with irregular dentin patterns at 6 weeks, while MTA and Nano-FA induced no dentin bridge with no tubular dentin pattern. Blood examination at the two intervals revealed no significant increase or decrease in the values of NO, SOD, CAT, GPx, GSH, and TNF-α. However, there was a significant increase in p-values of IL-6 in the Nano-FA treated group compared to both MTA and Nano-HA treated groups at the two intervals. Regarding the inflammatory reaction of the dental pulp, the MTA and Nano-HA groups displayed moderate inflammation, followed by Nano-FA, which showed the highest prevalence of nonpathological inflammation. Histological results were consistent with the blood examination. After 4 weeks, the Nano-FA and Nano-HA groups showed pulp fibrosis at the operating site, but the MTA showed only granulation tissues. Plus, dilated blood vessels appeared in the Nano-FA group. After 6 weeks, MTA and Nano-FA groups showed pulp fibrosis at the operating site with the persistence of dilated blood vessels with Nano-FA. The nano-HA group showed dentin bridge formation at the operating site.ConclusionMTA and Nano-HA could be considered favorable materials for direct pulp capping, while Nano-FA produces nonpathological inflammatory cell reactions. Moreover, the Nano-HA was the best in dentin bridge formation. Although nano-FA increased the operating site closure, it was noticed that it significantly increased IL-6 compared to MTA at the two intervals and significantly increased IL-6 compared to Nano-HA at 6 weeks, which may be manifested as some nonpathological inflammations in the Nano-FA group compared to the other groups, but it was deemed acceptable to direct pulp capping procedures.

Analysis of pulp histological response to pulpotomy performed with white mineral trioxide aggregate mixed with 2.25% sodium hypochlorite gel in humans: a randomized controlled clinical trial

This study aimed to evaluate the histological success of pulpotomy in primary molars using white mineral trioxide aggregate (WMTA) mixed with 2.25% sodium hypochlorite (NaOCl) gel and to evaluate in vitro its physical and chemical properties. The study had a clinical stage and an in-vitro stage. The clinical study was conducted with 24 patients aged 8–10 years. It was a randomized controlled trial to perform a histologic evaluation of pulp response following pulpotomy. Primary first molars were randomly assigned in split mouth model to control group—WMTA + distilled water (DW) or experimental group – WMTA + NaOCl gel. Teeth were extracted after 7, 30 or 90 days and submitted to histological analysis. The second stage was an in-vitro study to evaluate the physical and chemical properties of the two materials tested. SEM and EDX analyses and pH level evaluations were performed after 24 h and 28 days. The histological findings revealed that while WMTA + NaOCl gel group showed better odontoblastic integrity (P < 0.05), WMTA + DW group had more favorable outcomes in dentin bridge formation and pulp calcification (P < 0.05). Pulp tissue hemorrhage and pulp fibrosis were similar between them (P > 0.05). Regarding materials’ in vitro evaluation, the pH level indicated a higher initial pH for the WMTA + NaOCl gel group, which equalized after 28 days. SEM analysis initially showed a less homogeneous surface for WMTA + NaOCl gel, but it became similar after 28 days. EDX analysis indicated higher calcium and silicon percentages in the WMTA + NaOCl gel group initially, which increased in both groups after 28 days. Adding 2.25% NaOCl gel to WMTA enhanced odontoblastic integrity in both the short and medium term. In addition, it had a similar chemical composition, surface morphology, and alkalinity when compared to WMTA + DW mixture.

Clinical outcomes of selective removal to soft dentin versus firm dentin for deep caries lesions: a randomized controlled trial up to 5 years.

This study aimed to compare the success of selective removal to soft dentine (SRSD) with or without calcium silicate (CS) and selective removal to firm dentine (SRFD) in permanent dentition. Between November 2018 and March 2020, 165 posterior deep caries lesions in 134 patients were included in the study and randomly assigned into test (n = 101) and control (n = 64) groups. The control group (n = 46) received the treatment of SRFD with CS, while the test group was further randomized into two groups to receive SRSD with CS (n = 45) and SRSD without CS (n = 45). An additional group (PE) consisted of teeth with exposed pulps during caries removal (n = 29). The primary outcome of the study was to assess the vitality of the teeth based on clinical and radiographic examination after five years. The secondary outcome of the study was to evaluate the influence of baseline variables and CS application on treatment outcome. The success rates of different treatment strategies were compared (Pearson chi-squared and Log-rank tests). The impact of baseline variables and treatment strategies on failure and dentin bridge formation was analyzed using binary logistic regression model. The success rate for SRSD with or without CS (94.1-100%) was significantly higher compared to SRFD (75.8%) and PE (81.8%) after five years (P = 0.012). Failure was less likely for premolars. Cavity type and depth had an influence on dentin bridge formation. A five-year follow-up in this study demonstrated better clinical outcome for SRSD with or without CS compared to SRFD technique, irrespective of age, pre-op sensitivity, cavity type, radiographic depth and activity of the caries. Application of CS after SRSD in deeper cavities provided better healing in terms of dentin bridge formation. SRSD might be more advantageous over SRFD for the management of deep caries lesions.

Investigation of the physical, chemical, and biological properties of the cockle shell-derived calcium silicate-based pulp capping material: a pilot study.

Hard-setting calcium hydroxide-based materials, e.g., Dycal and Life, have been widely used for direct pulp capping. However, various studies have shown undesirable effects such as high solubility and unpredictable dentine bridge formation. Bioceramic, mainly composed of tricalcium and dicalcium silicates, e.g., mineral trioxide aggregate and Biodentine, have provided more desirable physical and biological properties. This study aims to measure the physical properties, chemical properties, and biological response of human dental pulp cells (HDPCs) on three dental pulp-capping materials, Dycal, Life, and cockle shell-derived tricalcium silicate pulp capping material (C-Cap). C-Cap was prepared from cockle shells and rice husk ash. Its chemical composition was identified using X-ray diffractometry. The setting time, flow, solubility, and radiopacity tests were performed following the International Organization for Standardization 6876:2012. pH and calcium ion release were measured. The materials were subjected to an extraction medium at various concentrations and subsequently measured for cytotoxicity and migration on HDPCs, from three healthy, mature permanent teeth from different donors. Osteogenic differentiation was assessed by examining alkaline phosphatase enzyme activity and alizarin red staining assay. The data were tested for a normal distribution. The differences among groups were statistically analyzed using ANOVA and Tukey's multiple comparison test (p < 0.05). The setting time of each material was approximately 1-2 min. C-Cap showed the lowest solubility (10.27% ± 1.02%) compared to Dycal (12.67% ± 0.94%) and Life (12.74% ± 1.33%), with a significant difference (p < 0.05). All materials exhibited radiopacity ranging from 2.4 to 2.9 mm of aluminum. C-Cap had the highest flow, alkalinity, and calcium ion release. C-Cap was significantly less cytotoxic than Dycal and Life (p < 0.05). The migration of HDPCs cultured in C-Cap extraction medium (27.74% ± 0.12%) was comparable to that in serum-free medium (27.09% ± 0.08%) with a significant difference (p < 0.05). The mineralization by HDPCs maintained in C-Cap extraction medium was significantly higher than those in Dycal and Life extraction mediums with a significant difference (p < 0.05). C-Cap, a tricalcium silicate-based pulp capping material has potential for further development. C-Cap exhibited comparable physical properties and superior biological properties when compared to Dycal and Life.

Histopathological Assessment of Tricalcium Aluminate-free Mineral Trioxide Aggregate and Two Antibacterial Enhanced Mineral Trioxide Aggregates As Pulpotomy Agents in Rat Model.

To evaluate the effect of a newly developed MTA-based material and two antibacterial-enhanced MTAs as pulp capping materials in immature permanent dental elements underwent full pulpotomy. The present animal study included 20 Wistar albino rats that, after full pulpotomy, were randomly divided into 4 groups receiving different MTA formulations as pulp capping materials: conventional MTA, Tricalcium aluminate (TCA)- free MTA, and MTA enhanced with metronidazole or doxycycline. Histopathological assessments were carried out at 7- and 28-days post-treatment to evaluate dentinal bridge formation, inflammatory reactions, pulp tissue necrosis and internal resorption. Seven days post-treatment, all groups exhibited inflammation and pulp necrosis, that were minimal in Groups III and IV than Group I. Group II showed a statistically significant difference only in terms of pulp necrosis (p<0.001). At 28-days all Groups showed slight inflammation and pulp necrosis, mainly in Groups I. Dentinal bridge formation was appreciated in all samples belonging to Groups II, III and IV and in 7/10 specimens of Group I, resulting in a statistically significant difference (p≤0.001). TCA-free MTA and antibiotic-enhanced MTAs showed superior performances in dentinal bridge formation and exhibited minimal pulpal necrosis than conventional MTA. The inclusion of antibiotics might contribute to create a more sterile environment that would improve the outcomes, favoring deposition of a mineralized matrix. However, further studies are needed to support these preliminary results. (EEJ-2024-10-157).

Comparing effectiveness of mineral trioxide aggregate, bioceramic putty and tannic acid in maintaining pulp vitality after experimental pulpotomy in rats

This study aimed to evaluate and compare the effectiveness of mineral trioxide aggregate (MTA), bioceramic putty (BP) and tannic acid (TA) for experimental pulpotomy. Our in-vivo experimental study involved sample of 45 rats that were randomly divided into 4 groups: Group 1 (subdivided into negative (1-A) and positive (1-B) subgroups), Group 2 (MTA treated), Group 3 (BP treated) and Group 4 (TA treated). 4 weeks post pulpotomy, specimens were analyzed histologically, immunohistochemically using dentin sialoprotein marker, and histomorphometrically by assessing the thickness of newly formed dentin bridge. Group 1-B showed pulp necrosis without hard tissue formation. Group 2 showed moderate dentin formation while group 3 presented a thick layer of calcific barrier. Group 4 showed dentin bridge formation, however, irregular pulp calcifications and radicular pulp necrosis were seen. The thickness of newly formed dentin bridge showed a significant difference between group 1-B and group 2, 3 &4. Significant difference was found between group 2&3 and group 3&4. Dentin sialoprotein immunohistochemical expression was negative in group 1-B, mild in group 2, strong in group 3 and moderate in group 4. MTA and BP proved to be effective pulpotomy agents with BP being superior. For TA, further studies are required to explain the recorded unfavorable effects in some specimens.

Histological Evaluation of Photobiomodulation and Calcium Aluminosilicate on Direct Pulp Capping of Dogs' Permanent Teeth.

Introduction: Photobiomodulation (PBM) is beneficial to biological tissues; depending on the optical dose that is absorbed by tissues, it can function as a biostimulative, analgesic, and anti-inflammatory mediator. Thus, the current research aimed to assess the impacts of PBM and Calcium aluminosilicate-based material on direct pulp capping (DPC) of dogs' permanent teeth through histological analysis. Methods: To study DPC of dogs' teeth, we separated 24 canines and premolars obtained from mature, healthy mongrel dogs into four equal groups: group 1, which served as the control (exposed pulp was covered with a sterile polytetrafluoroethylene, Teflon tape); group 2, which received PBM treatment using a 980 nm diode laser with a 100 mw output power for one minute; group 3: Calcium aluminosilicate-based material; group 4: Calcium aluminosilicate+PBM. In accordance with the assessment period, each group was divided into three equal subcategories: (A) 1 week; (B) 2 months; (C) 3 months. The teeth were evaluated histologically for inflammatory response and dentine bridge formation. Results: Statistical analysis detected that there was a significant difference between PBM, Calcium aluminosilicate cement, and the combination group of PBM and Calcium aluminosilicate related to the control group in variant evaluation periods regarding the inflammatory response and dentine bridge thickness through the histological analysis. In relation to the inflammatory response after one week, the combined group (Calcium silicate cement+PBM) exhibited a significantly decreased intensity of inflammation compared to other groups at an identical time. As for dentin bridge creation, the PBM+calcium aluminosilicate group detected thicker dentine bridge creation at three months than other studied groups. Conclusion: Combined with calcium aluminosilicate-based material, PBM using a 980 nm diode laser with output power of 100 mw for one minute decreased the initial inflammatory response and enhanced a complete thick dentine bridge formation.

Comparative evaluation of silver diamine fluoride, glass ionomer cement, and calcium hydroxide for indirect pulp therapy in young permanent molars: A randomized controlled trial.

Comparative evaluation of indirect pulp therapy (IPT) with silver diamine fluoride (SDF), Type VII glass ionomer cement (GIC), and calcium hydroxide (Ca(OH)2) in young permanent molars. This was randomized controlled trial, in which 45 children with 60 young permanent first molars were allocated as; Group A: IPT with SDF, Group B: Type VII GIC, and Group C: Ca(OH)2. Clinical and radiographic evaluation and comparison was done at baseline, 3, 6, 12 months. Data analysis was done using Chi-square test, one way ANOVA, Tukey's post hoc analysis test. The level of significance was set at P < 0.05. On statistical analysis IPT with SDF showed 88.2%, Type VII GIC showed 94.1% and Ca(OH) 2 showed 88.2% success at 12 months' follow-up. However, intergroup comparison showed no statistical significant difference. The mean dentin bridge formation in SDF was 0.5467 ± 0.08338 mm, Type VII GIC (0.4813 ± 0.06551 mm) and Ca(OH)2 group (0.5 ± 0.07559 mm), which was statistically significant with a P = 0.049. On comparative evaluation, clinical and radiographic success for IPT with SDF, Type VII GIC and Ca (OH) 2 were comparable. This study also concluded SDF and Type VII GIC can be used as IPT agents in permanent teeth. Dentin bridge formation was more in SDF followed by Ca(OH)2 and Type VII GIC, respectively.

Evaluation of direct pulp capping with diode laser assistance influence on the development of dentin bridge against traditional approach using radiography and clinical data.

Evaluation of direct pulp capping with diode laser assistance influence on the development of dentin bridge against traditional approach using radiography and clinical data.

Microtomographic and histological evaluation of two bioceramics as pulp capping agents in vivo.

Maintaining pulp vitality and function is a priority of the medicaments employed in pulp therapy to preserve tooth integrity. Aim: This study evaluated inflammatory response and reparative dentin bridge formation after direct pulp capping with two different bioceramics. Materials and Method: This was an in vivo controlled experimental study on 12 male Wistar rats. Pulpotomies were performed and the exposed pulps were capped with Biodentine or Neo MTA. After 15, 45 and 90 days, maxillary segments were obtained and prepared for histologic analysis and Micro-CT. Hounsfield Units (HU) were quantified. Results: Micro-CT analysis showed greater mineralization at 90 days with Neo MTA than with Biodentine. HU did not differ significantly (p >0.05) between molars treated with Biodentine and Neo MTA at 15 and 45 days, but at 90 days, there was statistically significant difference (p <0.05) between them. Reparative dentin was observed near the pulp exposure and canal orifice with both bioceramics. At 45 and 90 days, molars treated with Neo MTA showed mineralized tissue filling the canal orifice. Molars treated with Biodentine showed mineralized tissue and dentin bridge at the site of exposure at 45 days, and total pulp exposure coverage and mineralized entin matrix at 90 days. Conclusions: Biodentine and Neo MTA induce the formation of reparative dentin bridge after 45 days with inflammatory cell infiltrate.

Effect of four direct pulp capping agents on human dental pulp tissue.

Direct pulp capping (DPC) is a vital pulp therapy, wherein accidental or carious pulp exposures can be capped with various materials to induce reparative dentine formation. One of the major factors that determine the success of direct pulp capping procedures is the material used. Therefore, it is of interest to evaluate and compare the efficacy of a new material, Tristrontium aluminate in comparison with the widely used materials such as ProRoot MTA, Biodentine & TheraCal LC. Hence, 40 premolars scheduled for extraction for orthodontic treatment, were equally divided into 4 groups and iatrogenic DPC was done using one of the study materials. The premolars were then extracted after 90 days & assessed for the formation of Dentine Bridge and pulpal response elicited by the materials using CBCT and histopathological analysis. All the materials tested in the study were successful in inducing dentine bridge formation & maintaining pulp vitality. Thus, the novelty of Tristrontium aluminate for potential applications in future is eminent.

Neohesperidin exerts subtle yet comprehensive regulation of mouse dental papilla cell-23 in vitro

ObjectiveThe molecular regulation of odontoblasts in dentin formation remains largely uncharacterized. Using neohesperidin (NEO), a well-documented osteoblast regulator, we investigated whether and how NEO participates in odontoblast regulation through longitudinal treatments using various doses of NEO. DesignMouse dental papilla cell-23 (MDPC-23) served as a model for odontoblasts. MDPC-23 were treated with various doses of NEO (0, 1, 5, 10, 15, 20 μmol/L). Proliferation was assessed using the Cell counting kit-8 assay. Survival/apoptosis was assayed by live/dead ratio. Migration capability was assessed using scratch healing and Transwell migration assays. Mineralization was assessed using alkaline phosphatase staining and alizarin red staining. The expression levels of four key genes (Runx2, osteocalcin [OCN], β-catenin, and bone morphogenetic protein [BMP]−2) representing NEO-induced differentiation of MDPC-23 were measured by quantitative reverse transcription polymerase chain reaction. ResultsThe proliferation trajectories of MDPC-23 treated with the five doses of NEO demonstrated similar curves, with a rapid increase in the 10 μmol/L NEO condition after 48 h of treatment. Similar dose-dependent trajectories were observed for survival/apoptosis. All four key genes representing odontogenic differentiation were upregulated in MDPC-23 induced by NEO treatments at two optimal doses (5 μmol/L and 10 μmol/L). Optimal migration and mobility trajectories were observed in MDPC-23 treated with 10 μmol/L NEO. Optimal mineralization was observed in MDPC-23 treated with 5 μmol/L NEO. ConclusionNEO can subtly regulate odontoblast proliferation, differentiation, migration, and mineralization in vitro. NEO at 5–10 μmol/L offers a safe and effective perspective for clinical promotion of dentin bridge formation in teenagers.

Comparative Clinical and Radiographic Success Rate of Bioceramic Premix vs Biosilicate-based Medicament as Indirect Pulp Treatment Materials in Primary Molars: A Double-blind Randomized Trial with a Follow-up of 12 Months.

To evaluate and compare the clinical and radiographic success of NeoPUTTY® and Biodentine™ as indirect pulp treatment (IPT) materials in primary molars. This clinical trial was conducted on children aged 5-9 years. Class I carious lesions in primary molars indicated for IPT were divided into two groups-group I, NeoPUTTY®, and group II, Biodentine™. IPC was performed as per the standard protocols. The treated teeth were evaluated for clinical and radiographic success, along with the presence of a dentinal bridge at 6 and 12 months, by three blind examiners independently. All the data were tabulated, and statistical analysis was performed using the Mann-Whitney U test. Interexaminer reliability was analyzed using Fleiss κ statistics, and it showed "good" agreement. Clinical success was 100% in both groups at 6- and 12-month follow-up, while radiographic success was also 100% at 6-month follow-up for both groups. However, at 12-month follow-up, it was 93.33% for group I and 100% for group II. The difference was statistically nonsignificant. The presence of a dentinal bridge at 12-month follow-up was seen in 86.66% of cases in group I and 100% of cases in group II, but there was no statistical difference observed between them with a p-value of 0.555. Within the limitations of the study, we conclude that NeoPUTTY® and Biodentine™ are equally effective as IPT agents in primary teeth. Kothari P, Mathur A, Tirupathi S, et al. Comparative Clinical and Radiographic Success Rate of Bioceramic Premix vs Biosilicate-based Medicament as Indirect Pulp Treatment Materials in Primary Molars: A Double-blind Randomized Trial with a Follow-up of 12 Months. Int J Clin Pediatr Dent 2024;17(7):748-753.

Histopathological Evaluation of Human Placental Extract as a Direct Pulp-Capping Material in Dogs' Teeth

Abstract Objective The current research aimed to evaluate the histopathological pulpal alterations in dogs' teeth following direct pulp capping using either mineral trioxide aggregate (MTA) or human placenta extract (HPE). Materials and Methods Forty-eight incisors with mature apices from four dogs were involved. The teeth were randomly allocated to three groups (n = 16) based on the material utilized for direct pulp capping: MTA, HPE, and Teflon as the negative control group. All involved teeth were capped and restored at the same session. Each group was subsequently divided into two subgroups (n = 8) based on the post treatment evaluation period: 2 and 4 weeks. The histopathologic changes in each specimen's pulp tissues, including pulp inflammation, hyperemia, necrosis, and dentin bridge development, were assessed. Then, all the data were statistically analyzed using chi-square, t-test, and one-way analysis of variance (p &lt; 0.05). Results At 2 weeks, chronic inflammation was observed in 100% of MTA and 50% of HPE subgroups with a significant difference between them whereas the remaining 50% exhibited no inflammation. In contrast to Teflon that showed acute inflammation, remission of inflammation was time-dependent at both MTA and HPE subgroups as there was a substantial difference between the 2- and 4-weeks evaluation periods within the same group. However, throughout the initially observed 2 weeks, all subgroups exhibited essentially no complete calcified bridge; at 4 weeks, all MTA and HPE subgroups developed dentin bridge formation, with a significant difference between them regarding its thickness. Conclusion HPE is a promising pulp-capping material inducing less intense chronic inflammation accompanied with thicker dentine bridge formation in comparison to MTA.

Practical Tips for Successful Bitewing Radiographs in Children

Bitewings are a fundamental tool for treatment decision-making in young patients as they provide essential information on caries depth, the presence of a dentine bridge and pulp retraction, radiographic signs of pulp necrosis and presence of a permanent successor. The article updates the practitioner on the use of bitewing radiographs for primary molars and provides hints and tips for maximizing success in children. CPD/Clinical Relevance: The correct use of bitewing radiographs is essential for clinical decision-making in children.

Efficacy of TheraCal LC and Biodentine as Direct Pulp Capping Agents - An Clinico-Histological Study.

To assess clinically and histologically the efficacy of TheraCal LC and Biodentine as Direct Pulp Capping agents. Sixty caries-free maxillary first premolar teeth which were scheduled for orthodontic extraction were selected for the study and were divided equally into Group 1 (Theracal LC) and Group 2 (Biodentine). Thermal and electric pulp testing was performed on the teeth to assess pulp vitality followed by tooth preparation to expose pulp horns under local anesthesia. After achieving hemostasis, the direct pulp capping agent was placed and composite restoration was done. All the teeth were evaluated and compared in terms of clinical and histological findings after 6 weeks. The statistical analysis used was the Kruskal-Wallis test. Teeth with Theracal LC showed no sensitivity to heat, cold, or percussion, whereas sensitivity to heat, cold, or percussion was noted with Biodentine. Histological evaluation revealed that TheraCal LC has higher efficiency in complete dentin bridge formation, had maximum dentin thickness, and showed minimal or no pulpal disorganization and pulpal inflammation as compared to Biodentine. TheraCal LC proves to be a promising future as a direct pulp capping agent.

Histological Evaluation of Pulpal Response and Dentin Bridge Formation After Direct Pulp Capping Using Recombinant Amelogenin and Mineral Trioxide Aggregate (MTA).

The purpose of the study was to compare and histologically investigate pulpal response and dentin bridge formation after direct pulp capping using recombinant amelogenin and mineral trioxide aggregate (MTA). Recombinant amelogenin protein and MTA were used as pulp capping materials in 120 teeth from eight mongrel dogs. Dogs were sacrificed at two different evaluation times. Regenerative changes were evaluated histologically. At two weeks, in contrast to the MTA group, most of the amelogenin group showed moderately formed hard tissue formation and the pulp tissue was completely filling the entire pulp chamber. These results were statistically significant. At two months, all the samples of the amelogenin group showed complete dentin bridge formation and the pulp chamber was filled entirely with tissue-mimicking the authentic pulp in all the specimens of the amelogenin group. These results were statistically significant. In conclusion, direct pulp capping by recombinant amelogenin protein resulted in significantly better regeneration of the dentin-pulp complex than MTA.

An animal study on the effectiveness of platelet-rich plasma as a direct pulp capping agent

Direct pulp capping (DPC) is a conservative approach for preserving tooth vitality without requiring more invasive procedures by enhancing pulp healing and mineralized tissue barrier formation. We investigated the effectiveness of Platelet Rich Plasma (PRP) vs. Mineral Trioxide Aggregate (MTA) as a DPC agent. Forty-two teeth from three mongrel dogs were divided into two equal groups. After three months, the animals were sacrificed to evaluate teeth radiographically using cone-beam computerized tomography, histopathologically, and real-time PCR for dentin sialophosphoprotein (DSPP), matrix extracellular phosphoglycoprotein (MEPE), and nestin (NES) mRNA expression. Radiographically, hard tissue formation was evident in both groups without significant differences (p = 0.440). Histopathologic findings confirmed the dentin bridge formation in both groups; however, such mineralized tissues were homogenous without cellular inclusions in the PRP group, while was osteodentin type in the MTA group. There was no significant difference in dentin bridge thickness between the PRP-capped and MTA-capped teeth (p = 0.732). The PRP group had significantly higher DSPP, MEPE, and NES mRNA gene expression than the MTA group (p < 0.05). In conclusion, PRP enables mineralized tissue formation following DPC similar to MTA, and could generate better cellular dentinogenic responses and restore dentin with homogenous architecture than MTA, making PRP a promising alternative DPC agent.

Effect of polydatin on the viability and odontogenic differentiation of human dental pulp stem cells: An in-vitro study

Background/purposeVarious materials have been used to promote human dental pulp stem cells (hDPSCs) differentiation to produce dentin bridge formation with less-than-optimal results. Polydatin (PD), a naturally present material with osteogenic properties can be a promising material in the pulp regeneration/repair process. The aim of this study was to evaluate the effect of (PD) on the viability and differentiation of human dental pulp stem cells. Materials and methodsPD effect on hDPSCs in terms of cellular viability, alkaline phosphatase (ALP) production, and messenger RNAs (mRNA) of odontogenic markers production using quantitative reverse transcription polymerase chain reaction (RT-qPCR) were evaluated. In addition, mineral deposits were detected with Alizarin red stain. ResultsThe viable hDPSCs in the presence of 0.01 μM and 0.1 μM PD were significantly higher than the control on days 3 and 7, respectively. In addition, ALP activity of hDPSCs was significantly increased with 0.01, 0.1, and 1 μM of PD. In addition, increased expression mRNAs of ALP, osteocalcin (OC), osteonectin (ON), osteopontin (OP), Runt-related transcription factor-2 (RUNX-2), dentin sialophosphoprotein (DSPP), and dentin matrix protein-1 (DMP-1) was observed after PD treatment, however, the difference was not statistically significant. Furthermore, increased size of mineral deposits was observed with PD. ConclusionPD promoted the expression of markers associated with odontogenic differentiation and mineralized tissue deposition in hDPSCs.