Direct Pulp-capping Agent Research Articles

Evaluation of the physical properties of bromelain-modified biodentine for direct pulp capping

BackgroundThis study aims to evaluate the compressive strength, solubility, radiopacity, and flow of Bromelain (BR)-modified Biodentine (BD) for direct pulp capping (DPC). This is suggested to determine the impact of BR on the physical properties of BD.MethodsEighty samples were prepared according to the ISO and ADA specifications and evaluated for compressive strength, solubility, radiopacity, and flow. The compressive strength was evaluated at 24 h and 21 days via a universal testing machine. The solubility was determined by weight loss after 24-hours immersion in deionized water. Radiopacity was assessed via X-ray with aluminum step-wedges, and flow was measured by the diameter of the discs under a standard weight. Independent sample t-tests were used to statistically assess the data. A significance level of 5% was considered.ResultsThe compressive strength was 41.08 ± 1.84 MPa for BD and 40.92 ± 1.80 MPa for BR + BD after 24 h, and 88.93 ± 3.39 MPa for BD and 87.92 ± 3.76 MPa for BR + BD after 21 days, with no significant differences. Solubility was slightly greater in the BR + BD (2.75 ± 0.10%) compared to BD (2.62 ± 0.25%), but not significantly different. The radiopacity was similar between BD (2.82 ± 0.11 mm) and BR + BD (2.73 ± 0.10 mm). BR + BD resulted in significantly greater flow (9.99 ± 0.18 mm) than did BD (9.65 ± 0.27 mm) (p ≤ 0.05).ConclusionBR-modified BD maintains BD’s physical properties, with improved flow, making it a promising DPC agent that warrants further study.

To Evaluate and Compare Platelet-rich Fibrin and Mineral Trioxide Aggregate as Direct Pulp Capping Agents in Primary Molars: A Randomized Prospective Clinical Study.

This study aimed to evaluate and compare the clinical and radiographic success of platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA) as direct pulp capping (DPC) agents in primary molars. In this study, 50 primary first and second molars from healthy children aged 5-9 years requiring pulp therapy were randomly allocated into two groups. In the PRF group, after coronal pulp removal and hemostasis, the remaining pulp tissue was covered with PRF preparation. In the MTA group, after coronal pulp removal and hemostasis, MTA was placed, followed by a zinc oxide eugenol (ZOE) base and glass ionomer cement (GIC) in both groups. Clinical and radiographic evaluations were undertaken at 1-, 3-, 6-, 9-, and 12-month intervals. By the end of the 12th month, the overall success rate was 82.6% in the PRF group, whereas it was 61.9% in the MTA group. Platelet-rich fibrin can be used successfully as an appropriate alternative material in DPC of primary teeth when compared with MTA. Tiwari T, Tyagi P, Tiwari S, et al. To Evaluate and Compare Platelet-rich Fibrin and Mineral Trioxide Aggregate as Direct Pulp Capping Agents in Primary Molars: A Randomized Prospective Clinical Study. Int J Clin Pediatr Dent 2024;17(S-1):S25-S29.

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.

Reparative Mineralized Tissue Characterization by Different Bioactive Direct Pulp-capping Agents

ABSTRACT The aim of direct pulp caping (DPC) is to support the formation of mineralized tissue and encourage pulp healing by placing a dental biomaterial directly over the exposed pulp. The era of vital pulp therapy has been influenced by the introduction of various pulp-capping materials. Emphasis has shifted from the “doomed” organ concept of an exposed pulp to one of hope and recovery; this comprehensive review thus discusses the ability of different direct pulp-capping materials to form a dentin bridge. Furthermore, this review will discuss the quality and quantity of dentinal bridge formation by different pulp-capping agents.

Radiographic Outcomes of Mineral Trioxide Aggregate (MTA) with and Without Platelet-Rich Fibrin (PRF) In Direct Pulp Capping: A Clinical Pilot Study

Aim: The purpose of the current investigation was to determine by radiographic means if a calcific dentinal bridge had formed following direct pulp capping (DPC) with calcium hydroxide (CH), mineral trioxide aggregate (MTA), or a combination of platelet-rich fibrin (PRF) and MTA. Materials and Methods: In the beginning, 45 systemically healthy patients who needed DPC and had pulpal exposure were enrolled in the trial. They were then randomly assigned to one of three groups: CH (control, n = 15), MTA ( n = 15), or PRF + MTA ( n = 15). To determine the radiographic density of the dentin immediately underneath the location of pulpal exposure, pre-operative intraoral digital radiographs of the afflicted teeth were acquired. Through sequential imaging, the radiographic evaluation of dentinal bridge formation was performed. All images were studied carefully, keeping the reference point constant. Results: Out of the 45 patients, finally 10 per group were analysed. According to an analysis of variance, difference in mean density values among the various groups was found to be significant [( p = .001). On bi-group comparison (using post-Tukey HSD), difference between CH and PRF + MTA was significant ( p = .001), between MTA and PRF + MTA was significant ( p = .022), and between CH and MTA not significant ( p = .347)]. The PRF + MTA group showed the highest increase in mean density values. Conclusion: The results of the present study suggest that PRF and MTA when used in combination have better radiographic outcomes compared to MTA alone when used as DPC agents.

Histological evaluation of dental pulp response to Biodentine, enamel matrix derivative (Emdogain), and mineral trioxide aggregate as direct pulp-capping agents – A randomized clinical trial

ABSTRACT Aim: We aimed to study the response of pulp tissue to Biodentine, enamel matrix derivative (Emdogain), and mineral trioxide aggregate (MTA) as direct pulp-capping (DPC) agents. Materials and Methods: This study was performed on 78 maxillary/mandibular permanent teeth indicated for surgical extraction (periodontal/orthodontic). Exposure of 1.2 mm in diameter was made. Hemostasis was achieved. The tooth was randomly allocated to one of the three groups. In Group 1, pulp capping was done with Biodentine. In Group 2, Emdogain was used. In Group 3 (control), pulp capping was carried out with MTA. Final restoration was done with glass-ionomer cement. Teeth were extracted atraumatically after 6 weeks. Histologic examination was done and samples were evaluated. Differences in inflammatory response in the three groups were statistically evaluated using Chi-square test. Results: Grade 1 inflammatory response was observed in 57.7% of cases treated with Biodentine, 36% with Emdogain, and 65.4% with MTA. The difference was however not statistically significant (P = 0.427). Majority of cases in the MTA group (57.7%) showed presence of calcific bridge directly adjacent to the medicament interface as compared to Biodentine (46.1%) and Emdogain (0%), and the difference between the groups was statistically significant (P &lt; 0.05). The difference in formation of calcific bridge with MTA and Biodentine was not statistically significant (0.694). Conclusions: Within the limitations of this histological study, it can be concluded that MTA and Biodentine are well tolerated as DPC agents by pulp tissue as compared to Emdogain.

Evaluation of Mineral Trioxide Aggregate and Biodentine as Direct Pulp-capping Agents in Human Teeth: An Ex-Vivo Study

Introduction: Biodentine (Tricalcium Silicate based) is a modern bioactive cement that is comparable to the broadly utilized mineral trioxide aggregate (MTA). It has dentin-like mechanical properties, which can be considered appropriate material for diseased dentin-pulp complex recovery such as direct pulp capping. The present study was to compare the reaction of the pulp-dentin complex in human teeth after direct pulp capping with use of MTA and Biodentine. Objective: To assess the histomorphologic response of human dental pulps on direct pulp capping with MTA and Biodentine. Methods: Pulps of 34 maxillary permanent intact human third molars planned for extraction were mechanically exposed with sterile rotary round bur and allotted to one of the two exploratory groups, MTA or Biodentine. After four weeks, the teeth were extracted, stained with hematoxylin- eosin, and categorized by employing a preset histologic scoring framework. The histopathologic evaluations scored data were recorded and statically analyzed using SPSS where Mann-Whitney U test was used and p&lt;0.05 was considered statistically significant. Results: No inflammatory pulp reaction seen in 34 (100%) teeth whereas 19 (55.9 %) showed complete dentinal bridge arrangement. Layers of well-arranged odontoblast and odontoblast-like cells were found to make tubular dentin beneath the osteodentin. Inferential statistics using showed insignificance between the MTA and Biodentine test groups amid the perception period, showing similar outcomes. Conclusions: Biodentine had comparative adequacy in the clinical setting and may be considered an appropriate alternative to MTA as the pulp- capping agent.

Vitronectin-Derived Peptide Promotes Reparative Dentin Formation

Exposed dental pulp can maintain its vitality through a pulp-capping procedure with biocompatible materials, followed by reparative dentin formation. Our previous study demonstrated that a vitronectin-derived peptide (VnP-16) promotes osteoblast differentiation and concomitantly restrains osteoclast differentiation and resorptive function. In this study, we aimed to demonstrate that VnP-16 promotes odontoblast differentiation, mineralization, and reparative dentin formation in a pulp exposure model using a rat tooth. VnP-16 showed no cytotoxicity and promoted cellular behavior in human dental pulp cells, enhancing their differentiation into odontoblast-like cells and mineralization, effects that are comparable to those obtained with vitronectin. In a rat pulp exposure model, VnP-16 showed mild inflammatory responses at 2 and 4 wk or none. Mineral trioxide aggregate (MTA) demonstrated a tendency of early formation of reparative dentin at 2 wk when compared with recombinant human bone morphogenetic protein 2 (rhBMP-2) and VnP-16. However, VnP-16 induced reparative dentin formation similar to MTA and rhBMP-2 without inflammation at 4 wk. In addition, VnP-16 showed a thicker and homogeneous reparative dentin formation versus MTA and rhBMP-2. Collectively, these results suggest that VnP-16 can be a useful, direct pulp-capping agent for highly qualified reparative dentin formation by promoting cell behavior and odontoblastic differentiation of human dental pulp cells.

Biodentine or Mineral Trioxide Aggregate as Direct Pulp Capping Material in Mature Permanent Teeth with Carious Exposure? A Systematic Review and Meta-analysis.

To evaluate the success rate of direct pulp capping (DPC) with Biodentine in mature permanent teeth with carious vital pulp exposure compared to that of DPC with mineral trioxide aggregate (MTA) by means of a systematic review and meta-analysis. The two authors searched independently the literature published through July 31, 2020, in five electronic databases (PubMed, the Cochrane Central Register of Controlled Trials, Web of Science Core Collection, the Wiley Online Library, and the SCOPUS database). The research protocol was previously registered in the PROSPERO database (CRD42020192511). Clinical studies that met the inclusion criteria were chosen and independently screened by the authors. A custom-designed spreadsheet was used to extract the data. The quality of each study was evaluated by means of the revised Cochrane risk of bias (ROB) tool or the ROB of nonrandomized studies of interventions tool. Three randomized controlled trials and one retrospective study met the inclusion criteria. Only one study had a high risk of bias. The included studies reported data on a total of 95 participants with an age range of 8-51 years. No significant difference was observed in the overall treatment outcome when comparing Biodentine with MTA (Risk ratio=1.00, 95% confidence interval [0.93-1.07], p=1.00). Biodentine had comparable clinical and radiographic success to that of MTA when used as a DPC agent in mature permanent teeth with carious vital pulp exposure. Additional high-quality studies are needed.

Effectiveness of Calcium Hydroxide (CaOH) as agent for Direct Pulp Capping in the Mandibular Molars

Background: Direct Pulp Capping technique has been in use as a treatment therapy to sustain a vital pulp. The substitute procedure to the endodontic therapy or extraction is precise &amp; successful pulp capping. Calcium hydroxide (CaOH) is considered as gold standard agent for pulp capping because of antibacterial characteristics &amp; ability to form dentinal bridge. Calcium hydroxide has also shown great results on peri-apical healing process. Aim: To evaluate success rate of direct pulp capping when CaOH is used as a direct pulp capping agent Setting: Multan Dental College Multan Methodology: Sample size 60 cases. Patients of 15-40 years age group were selected with the exposure of the vital pulp by caries or Trauma in permanent lower molars clinically. Those cases with pinpoint (precise) exposure of pulp were selected. Flow of blood from site of exposure should be ceased inside two to three minutes after the applying the soaking cotton pallet with the saline. Results: 25 were woman (41.67%) and 35 were men (58.33%). Overall percentage of success is 80% which means that 48 patients had showed effectiveness, while twelve patients had shown failure of pulp capping Conclusion: We conclude that Calcium hydroxide is a choice for the direct pulpal capping. When a site of exposure is sealed/ wrapped by means of calcium hydroxide, the odds of the failure may decrease, and prognosis might be good. Keywords: Calcium hydroxide, Direct Pulp Capping, Postoperative X-ray, follow-up

Histological Analysis of Human Pulp by Comparing Propolis, Mineral Trioxide Aggregate and Calcium Enriched Mixture as a Direct Pulp Capping Agent in Primary Molars

Aim: To evaluate the histological pulp response to three direct pulp capping agents (Propolis, Mineral Trioxide Aggregate and Calcium Enriched Mixture) in primary molars. Study design: Comparative study Place and duration of study: Pediatric Dentistry department and Oral Pathology department at de’Montmorency College of Dentistry, Lahore from 1st May 2016 to 31st December 2016. Methodology: Fifty-seven human vital primary first molars were selected from patients aged 8 years. They were divided into three groups of nineteen each. Propolis, mineral trioxide aggregate (MTA) and calcium enriched mixture (CEM) were used as direct pulp capping (DPC) agents in primary molars. After pinpoint exposure, the teeth were directly pulp capped with above mentioned materials. Teeth were extracted after fifteen days for histological examination of inflammatory pulpal cell response. Results: In Propolis group (15 days duration), 15 teeth (78.9%) were in grade 1inflammation, 1 tooth (5%) was in grade 2 inflammation and 3 teeth (15.7%) were in grade 3 inflammation. In Mineral Trioxide Aggregate group 14 teeth (73.7%) were in grade 1 inflammation, 3 teeth (15.7%) were in grade 2 inflammation and 2 teeth (10.5%) were in grade 3 inflammation. In Calcium Enriched Mixture group 15 teeth (78.9%) were in grade 1 inflammation, 3 teeth (15.7%) were in grade 2 inflammation and 1 tooth (5.3%) were in grade 3 inflammation. Conclusion: The effects of Propolis, Mineral Trioxide Aggregate (MTA) and Calcium Enriched Mixture (CEM) on pulpal tissue are comparable to each other. Propolis is a cheaper material as compared to other direct pulp capping agents and easily available. Therefore, it may be used as an alternative pulp capping agent however, further investigation is required to analyze human pulpal response. Keywords: Direct pulp capping. Propolis, Mineral trioxide aggregate, Calcium enriched mixture, Primary molars

Radiological Appraisal of Biodentine and Pulpotec Individually or in Combination with Photo-activated Disinfection as Pulp-capping Cements in Mature Teeth

The aim of the study was to evaluate and compare radiographically, Pulpotec cement and Biodentine as direct pulp-capping agents in mature teeth, individually and in combination with photo-activated disinfection (PAD). In the present study, 80 mature teeth with deep occlusal caries were selected for direct pulp-capping procedure and randomly assigned to one of the four groups [Pulpotec (I), Biodentine (II), Pulpotec + PAD (III), and Biodentine + PAD (IV)] allocating 20 teeth to each group. Direct pulp capping and cavity disinfection were performed based on the group allotted followed by permanent restoration with composite. The teeth were evaluated radiographically (densitometric analysis) at intervals of 3, 6, and 12 months. The radiographic gray values obtained at follow-up periods for each group were subjected to two-way analysis of variance (ANOVA) with repeated measures. There was a significant improvement (p <0.0001) in the scores of all the groups at follow-ups as compared to the baseline. There was a significant difference between group I/group II with groups III and IV (p = 0.000) with group IV scoring highest at all follow-ups. However, the difference between groups I/II and groups III/IV was nonsignificant. Both, Biodentine and Pulpotec can be used for direct pulp capping of mature teeth. Furthermore, PAD prior to material application significantly improved the radiographical success of Biodentine and Pulpotec, with Biodentine showing better results than Pulpotec. Biodentine and Pulpotec demonstrated comparable success as a pulp-capping agent and PAD application exhibited a synergistic effect when used in conjunction with these materials.

Histological analysis of human pulp following direct pulp capping with different materials: An ex vivo study

Background:The predictability of direct pulp capping (DPC) depends on the quality of the dentin bridge formation and the inflammatory response to the capping material. Various materials are available with variable success.Aim:The aim of this study is to evaluate histologically the effectiveness of calcium hydroxide, mineral aggregate, and dentin bonding agent when used as DPC in mechanically exposed adult pulp tissue.Materials and Methods:Pulpal exposures were made in 45 intact human premolars, scheduled for extraction for orthodontic purposes. Teeth were capped with hard setting calcium hydroxide (Dycal), mineral trioxide aggregate (ProRoot MTA), and dentin bonding agent (adper Single Bond). The final restoration was done with posterior composites using resin-modified glass-ionomer cement as a base. Pulps of teeth were evaluated histologically at the 15th and 45th day for inflammatory cell response and dentin bridge formation according to the criteria described by Cox et al. The statistical analysis of data was done using Chi-square test and P ≤ 0.05 was considered statsiticlly significant.Results:MTA as DPC agent showed milder inflammatory response compared to Dycal and Single Bond. The quality of bridge formation by MTA was similar to Dycal, which took the least time. Adper Single Bond Plus and Dycal showed a significantly higher degree of pulpal inflammation. Among all materials used, Adper Single Bond Plus took the longest time for both the resolution of pulpal inflammation and improvement of the quality of bridge formation.Conclusion:Based on the result, it can be concluded that Dycal and MTA produce similar types of dentin bridge formation when used a DPC agent. Adper Single Bond has the potential to be used as DPC agents, but it takes a longer time for the resolution of inflammation and dentin bridge formation.

Comparative evaluation of different direct pulp capping agents in carious tooth: An in vivo study.

Background:The success of direct pulp capping (DPC) depends on the preoperative assessment of pulpal status, intraoperative judgment after pulp exposure, and the biomaterials used to cap the pulp.Aim:The study aims to compare the clinical and radiographic responses of the pulp–dentin complex after DPC with TheraCal LC, Biodentine, and current gold standard mineral trioxide aggregate (MTA) Plus.Materials and Methods:Ninety vital permanent teeth with Class I deep carious lesions were randomly divided into three different groups. After the caries excavation, hemostasis was established using sodium hypochlorite at the site of pulp exposure on which the material was placed. Clinical and radiographic follow-ups were performed at 1-, 3-, and 6-month intervals.Results:Overall success rates of MTA Plus, Biodentine, and TheraCal LC were statistically insignificant.Conclusions:TheraCal LC and Biodentine showed similar success rates when compared to MTA Plus and can be used as an agent in DPC.

Concentrated Growth Factor, Platelet-rich Fibrin, Mineral Trioxide Aggregate as Direct Pulp-capping Agents: Case Reports

Concentrated Growth Factor, Platelet-rich Fibrin, Mineral Trioxide Aggregate as Direct Pulp-capping Agents: Case Reports

Histopathological Evaluation of Primary Teeth after Pulp Capping with Calcium-Enriched Mixture and Bioactive Glass.

Direct pulp capping (DPC) is a conservative vital pulp therapy, which has some limitations in primary dentition. The aim of this study was to evaluate pulpal response of primary teeth after DPC with two biocompatible materials naming calcium-enriched mixture (CEM) and bioactive glass (BAG). This study was designed as a randomized clinical trial. After obtaining informed consent, 20 sound primary canines scheduled for orthodontic extraction, were selected. Following mechanical pulp exposure, the exposed site was capped with either CEM cement or BAG and then restored with amalgam. Teeth were extracted after two months and examined histopathologically. Parameters of hard tissue bridge (HTB) formation, its type and pulpal inflammation scores, were compared between the two groups. Data were analysed using the Fisher's exact test. All CEM specimens showed inflammation scores of 0 (less than 10%). In the BAG group, inflammation scores of 0, 1 and 2 were observed in 7, 2 and 1 specimens, respectively. Fisher's exact test showed no significant differences (P>0.05). All CEM specimens (100%) formed HTB, which was irregular in all cases. In 7 of 10 teeth in BAG, HTB formed and was irregular. Fisher's exact test revealed no significant differences between the two groups in this regard (P<0.001). Both CEM and BAG are suitable DPC agents in terms of HTB formation and pulp inflammation scores.

THE INFLAMMATORY REACTION OF PULP TISSUE WITH CALCIUM HYDROXIDE, MTA AND PORTLAND CEMENT (In Vivo)

Background : Perforation in normal pulp could be happened anytime. In sterile condition, direct pulp capping was the right therapy to maintain the vitality and pulp function. Direct pulp capping agent must contact with the pulp tissue. Generally, body had an immunologic respond with foreign body that contact with tissue. The respond could be inflammatory reaction. The used direct pulp capping agents were calcium hydroxide, and Mineral Trioxide Aggregate (MTA) which known as better agent but relatively expensive and difficult to obtain. So that, the alternative of MTA, Portland cement which was the same essential of MTA, was being developed. The aim of this study, to analized inflammatory reaction of the pulp tissue with direct pulpcapping agents calcium hydroxide, MTA, and Portland cement.Methods: Free caries M. Nemestrina’s posterior teeth were prepared to formpin point perforations on buccal surface of the crowns. The teeth were appliedwith one of the three capping agents. Teeth were filled and extracted. Theextracted teeth were proceed into histopatological preparation slides to evaluatethe inflammatic reaction.Results: The result showed no statistically significant differences of pulp inflammatory reaction between calcium hydroxide, MTA and Portland cement in7, 14, 42, and 90 days.Conclusion: The inflammatory reaction of pulp tissue of the three pulp cappingagent (calcium hydroxide, MTA, and PC) were insignificant different.

Comparative Analysis of 2 Calcium Silicate–based Cements (Biodentine and Mineral Trioxide Aggregate) as Direct Pulp-capping Agent in Young Permanent Molars: A Split Mouth Study

IntroductionThe purpose of this study was to compare Biodentine and mineral trioxide aggregate (MTA) for direct pulp capping in young permanent molars by clinical and radiographic evaluation in 7- to 9-year-old children. MethodsIn 50 patients, 29 patients with bilateral asymptomatic first permanent molars with carious involvement were selected. According to split mouth design, these patients were then divided into 2 groups, Biodentine group (right side) and MTA group (left side). The pulp-capping procedure was performed by using Biodentine and MTA in 58 asymptomatic bilateral permanent molars with pulp exposure. At each recall (baseline, 6 and 12 months), treatment outcome was assessed clinically through pulpal sensitivity tests as well as radiographically to evaluate dentin bridge formation. ResultsThe study reported 100% success rate with both Biodentine and MTA at baseline and 6- and 12-month follow-up on the basis of clinical and radiographic parameters. These findings were statistically non-significant (P < .05) between both groups (Biodentine and MTA). Radiographically, dentin bridge formation was not evident with both groups at baseline, but it was evident after 6- and 12-month follow-up. These findings were statistically non-significant (P < .05) in both Biodentine and MTA groups. ConclusionsThis study reported 100% success rate with both MTA and Biodentine when used as direct pulp-capping agent in first permanent molars in 7- to 9-year-old children. The major limitations of the study were smaller sample size and short follow-up period.

Clinical evaluation of mineral trioxide aggregate and biodentine as direct pulp capping agents in carious teeth.

Background:Root canal treatment has been a routine treatment option for carious exposure of the dental pulp. In the context of minimally invasive dentistry, direct pulp capping (DPC) procedure with a reliable biomaterial may be considered as an alternative provided the pulp status is favorable. Mineral trioxide aggregate (MTA), a bioactive cement with excellent sealing ability and biocompatibility is capable of regenerating relatively damaged pulp and formation of dentin bridge when used as DPC agent. Biodentine is comparatively a new biomaterial claimed to possess properties similar to MTA and is currently explored for vital pulp therapy procedures.Aim:The aim of the present study was to evaluate the clinical response of pulp-dentin complex after DPC with MTA and biodentine in carious teeth.Subjects and Methods:Twenty-four permanent molars with carious exposure having no signs and symptoms of irreversible pulpitis were selected and assigned to one of the two groups, Group I - MTA and Group II - biodentine. Patients were recalled at 3 weeks, 3 months, and 6 months for clinical and radiographic evaluation. Fisher's exact test was used along with Chi-square test for statistical analysis.Results:Over a period of 6 months, MTA and biodentine showed 91.7% and 83.3% success rate, respectively, based on the subjective symptoms, pulp sensibility tests, and radiographic appearance.Conclusion:MTA and biodentine may be used as DPC agents when the pulpal diagnosis is not more than reversible pulpitis.

A comparison of human dental pulp response to calcium hydroxide and Biodentine as direct pulp-capping agents.

Context:Direct pulp capping involves the placement of a biocompatible agent on pulp tissue that has been inadvertently exposed from traumatic injury or by iatrogenic means.Aim:To compare the human pulp response to calcium hydroxide and Biodentine as direct pulp-capping agents.Materials and Methods:Pulp exposures were performed on the pulpal floor of forty human permanent premolars. The exposure sites were dressed with either Dycal or Biodentine as pulp-capping materials. After 45 days, teeth were extracted and processed for histological examination.Statistical Analysis:The histological data were subjected to Wilcoxon rank-sum test.Results:The dentinal bridges in teeth that were capped with Biodentine were significantly thicker (P < 0.0001) and more continuous (P = 0.0001) with less pulpal inflammation (P = 0.0044) in comparison to Dycal.Conclusion:Based on the result of this study, Biodentine can be suggested as the material of choice for direct pulp capping procedure instead of Dycal. However, further long-term follow-up in vivo human studies using Biodentine on cariously exposed pulpal teeth are warranted to derive a definite conclusion.