Pulp Capping Materials Research Articles

Elective full pulpotomy in mature permanent teeth diagnosed with symptomatic irreversible pulpitis: a two years retrospective study

AimTo investigate the outcome of elective full pulpotomy, using calcium silicate-based cements (CSBC), after 2 years, in symptomatic mature permanent teeth with carious lesions, diagnosed as irreversible pulpitis, and analyse the capacity of Wolters et al. (2017) classification to predict the likelihood of treatment failure.MethodsThe treatment records of 56 patients with symptomatic mature teeth with carious lesions, diagnosed as irreversible pulpitis and treated by elective full pulpotomy, using CSBCs as pulp capping materials, were reviewed. Thirteen teeth were excluded. The remaining 43 teeth were evaluated retrospectively at 24 months. Fisher`s exact test with the Lancaster’s mid-P adjustment was used to assess different outcomes amongst the diagnostic categories.ResultsFour of the cases failed before 24 months and required root canal treatment (RCT). Overall success rate at 2 years was 90.7% (39 of 43). An inverse, but non-significant, correlation was observed between the severity of pulpitis according to the Wolters classification and the treatment success rate (p > 0.05). The type of CSBC used was associated to the success rate (OR = 10.5; 95% C.I. = 0.5 – 207.4; p = 0.027), being 82% with Endosequence and 100% with Biodentine. Postoperative pain associated significantly to lower success rate (66.7%) (Odds ratio = 8.0; 95% C.I. = 0.7 – 95.9; p = 0.047).ConclusionsElective full pulpotomy using a CSBC was a successful choice for the treatment of mature permanent teeth with symptoms indicative of irreversible pulpitis. There were no significant differences between the success rate of mild, moderate and severe pulpitis. Postoperative pain could be considered a risk marker for failure of full pulpotomy. The term “irreversible pulpitis” should be re-signified to indicate the need for access to the pulp chamber, rather than an indication for extraction or RCT.

Long-Term Evaluation of Pulp Vitality Preservation in Direct and Indirect Pulp Capping: A Retrospective Clinical Study.

Background: This retrospective clinical study aimed to assess dental pulp tissue reactions to direct and indirect pulp capping after 10 years of follow-up. Methods: A total of 276 permanent teeth with deep carious lesions were evaluated and divided into five groups: Group (1), direct pulp capping with Mineral Trioxide Aggregate cement; Group (2), direct pulp capping with a resin-based glass ionomer; Group (3), direct pulp capping with TheraCal; Group (4), indirect pulp capping with a three-step total-etch adhesive system; and Group (5), indirect pulp capping with a two-step self-etch adhesive system. Results: A 72.5% success rate was achieved overall. A statistically significant difference was found when comparing direct and indirect pulp capping with a success rate of 23.8% and 93.8%, respectively. For direct pulp-capping procedures, the area of pulp exposure was correlated with pulp necrosis (p = 0.035), while bleeding after exposure appeared independent (p = 0.053). Patient age was significantly related to the maintenance of pulp vitality (p = 0.013). A statistically significant correlation between the pulp-capping material and the occurrence of pulp necrosis was discovered (p = 0.017). For the indirect pulp-capping treatments, a significant correlation between patient age (p = 0.021) and the adhesive system (p = 0.019) with pulp necrosis was described. Conclusions: The pulp-capping material, patient age, and the width of the pulp exposure before the procedure should be carefully considered when performing direct pulp-capping treatments. The performance of the etch-and-rinse adhesive systems was superior to the self-etch system during the indirect pulp-capping procedures.

Histological response of inflamed pulp to hydraulic calcium silicate cements in direct pulp capping: Systematic review of pulpitis models.

This systematic review aimed to compare the histological response of inflamed pulpodentinal complex to the hydraulic calcium silicate cements in experimental animal models of pulpitis. Articles that evaluated the histological response of inflamed pulp to mineral trioxide aggregate (MTA) in comparison with other restorative materials were selected and analysed in detail. The risk of bias assessment was conducted using SYRCLE's RoB tool. The GRADEpro tool was used to determine the overall quality of evidence. Out of the 2947 retrieved articles from databases, five articles fulfilled the inclusion criteria. MTA induced significantly more hard tissue formation compared to calcium hydroxide. The use of pulp-capping material containing fluocinolone acetonide and ASP/PLGA-ASP/ACP/PLLA-PLGA composite membrane was comparable. This systematic review could not demonstrate enhanced efficiency of capping materials compared to MTA. Future well-conducted animal studies are warranted for demonstrating the hard tissue formation abilities of pulp-capping materials with convenient inflammatory conditions.

Traditional Versus Advanced Pulp Capping Materials in Primary Teeth.

In situations where pulp degeneration and carious lesions may coexist, pulp therapy is a regularly employed method. Mineral trioxide aggregate, a material that is now utilized for indirect pulp treatment (IPT), is nontoxic and nonmutagenic. There is proof that the restoration margin can be sealed to manage the caries lesion. In terms of the clinical and radiological outcome, it has been demonstrated that IPT is more effective and secure than direct pulp capping and pulpotomy. The pulp capping treatment's goal is to protect the pulp from microorganisms as well as from thermal, electrical, chemical, and physical stimulation. There is evidence that suggests targeted caries clearance and composite restoration may stop caries lesions more effectively than full dentin removal. Various pulp capping materials that are available in the market were highlighted in this review, and the discussion of each material was expanded to demonstrate its clinical efficacy. Articles were specifically selected and discussed for the materials used for the IPT in the primary teeth as very few studies have been done so far in relation to this subject. A literature search in various libraries, including PubMed, Cochrane, ResearchGate, Scopus, ScienceDirect, and other libraries, was done for several available materials that have been used for the IPT procedure in primary dentition in the last 20 years.

Novel L-(CaP-ZnP)/SA Nanocomposite Hydrogel with Dual Anti-Inflammatory and Mineralization Effects for Efficient Vital Pulp Therapy.

Vital pulp therapy (VPT) is considered a conservative treatment for preserving pulp viability in caries and trauma-induced pulpitis. However, Mineral trioxide aggregate (MTA) as the most frequently used repair material, exhibits limited efficacy under inflammatory conditions. This study introduces an innovative nanocomposite hydrogel, tailored to simultaneously target anti-inflammation and dentin mineralization, aiming to efficiently preserve vital pulp tissue. The L-(CaP-ZnP)/SA nanocomposite hydrogel was designed by combining L-Arginine modified calcium phosphate/zinc phosphate nanoparticles (L-(CaP-ZnP) NPs) with sodium alginate (SA), and was characterized with TEM, SEM, FTIR, EDX, ICP-AES, and Zeta potential. In vitro, we evaluated the cytotoxicity and anti-inflammatory properties. Human dental pulp stem cells (hDPSCs) were cultured with lipopolysaccharide (LPS) to induce an inflammatory response, and the cell odontogenic differentiation was measured and possible signaling pathways were explored by alkaline phosphatase (ALP)/alizarin red S (ARS) staining, qRT-PCR, immunofluorescence staining, and Western blotting, respectively. In vivo, a pulpitis model was utilized to explore the potential of the L-(CaP-ZnP)/SA nanocomposite hydrogel in controlling pulp inflammation and enhancing dentin mineralization by Hematoxylin and eosin (HE) staining and immunohistochemistry staining. In vitro experiments revealed that the nanocomposite hydrogel was synthesized successfully and presented desirable biocompatibility. Under inflammatory conditions, compared to MTA, the L-(CaP-ZnP)/SA nanocomposite hydrogel demonstrated superior anti-inflammatory and pro-odontogenesis effects. Furthermore, the nanocomposite hydrogel significantly augmented p38 phosphorylation, implicating the involvement of the p38 signaling pathway in pulp repair. Significantly, in a rat pulpitis model, the L-(CaP-ZnP)/SA nanocomposite hydrogel downregulated inflammatory markers while upregulating mineralization-related markers, thereby stimulating the formation of robust reparative dentin. The L-(CaP-ZnP)/SA nanocomposite hydrogel with good biocompatibility efficiently promoted inflammation resolution and enhanced dentin mineralization by activating p38 signal pathway, as a pulp-capping material, offering a promising and advanced solution for treatment of pulpitis.

Physicochemical and Biological Properties of Pulp Capping Agents: A Systematic Review of In Vitro Studies

Abstract Aim: The primary aim was to evaluate the physicochemical and biological characteristics of pulp capping materials. Materials and Methods: The systematic review report adhered to the latest Preferred Reporting Items for Systematic Reviews and Meta-Analysis statements, and the protocol was pre-registered (CRD42023471030) in the PROSPERO database before its commencement. To retrieve relevant literature, electronic searches were conducted using the Medline and Google Scholar databases from January 2000, up to August 2023. The records obtained through our electronic search were managed using a specialized web application for systematic review screening, and data were extracted using a standardized form. The evaluation of potential bias within the studies employed the modified Consolidated Standards of Reporting Trials (CONSORT) checklist specifically designed for reporting in vitro dental material research. Results: The results revealed that out of 255 identified records, 16 studies were included. An analysis based on the modified CONSORT checklist identified a moderate risk of bias in the included studies, with compliance scores ranging from 50% to 70%. Studies scoring below 50% were omitted from the discussion because of a higher risk of bias. Conclusion: This study concludes that the physicochemical properties of resin-incorporated materials are better than those of calcium silicate cement (CSCs). However, the biological properties of CSCs are superior to those of resin-incorporated materials.

Antimicrobial Efficacy of Carbonated Hydroxyapatite Against Streptococcus mutans, Enterococcus faecalis, and Candida albicans: An In Vitro Study

Background: Dental caries commonly lead to pulp infection, necessitating vital pulp therapy (VPT) to protect the health of the pulp tissue. Effective pulp-capping materials, including those with antimicrobial properties, are crucial for successful VPT. This study aimed to evaluate the antimicrobial efficacy of carbonated hydroxyapatite (CHA), a novel pulp-capping material, compared to frequently used materials, against Streptococcus mutans, Enterococcus faecalis, and Candida albicans. Methods: CHA was synthesized at three concentrations (0.05 M, 0.1 M, and 0.5 M) and compared with mineral trioxide aggregate (MTA). Antimicrobial efficacy was evaluated using the agar diffusion method. Zones of inhibition were evaluated after 24 hours of incubation. A one-way analysis of variance (ANOVA) and post hoc tests were used for the statistical analysis. Results: All materials exhibited antimicrobial activity against the tested microorganisms, with CHA at 0.1 M concentration demonstrating the highest efficacy against E. faecalis and C. albicans. MTA and CHA at 0.5 M concentrations showed strong activity against S. mutans. According to statistical analysis, significant differences were found in antibacterial activity among the tested materials (P<0.0001). Conclusion: CHA, particularly at 0.1 M concentration, demonstrated significant antimicrobial efficacy against S. mutans, E. faecalis, and C. albicans, suggesting its potential as a pulp-capping agent. Further research is warranted to explore its clinical applicability in VPT.

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 < 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.

Green synthesis of nanohydroxyapatite with Elaeagnus angustifolia L. extract as a metronidazole nanocarrier for in vitro pulpitis model treatment

The aim of this study is to introduce a dental capping agent for the treatment of pulp inflammation (pulpitis). Nanohydroxyapatite with Elaeagnus angustifolia L. extract (nHAEA) loaded with metronidazole (nHAEA@MTZ) was synthesized and evaluated using a lipopolysaccharide (LPS) in vitro model of pulpitis. nHAEA was synthesized through sol–gel method and analyzed using Scanning Electron Microscopy, Transmission Electron Microscopy, and Brunauer Emmett Teller. Inflammation in human dental pulp stem cells (HDPSCs) induced by LPS. A scratch test assessed cell migration, RT PCR measured cytokines levels, and Alizarin red staining quantified odontogenesis. The nHAEA nanorods were 17–23 nm wide and 93–146 nm length, with an average pore diameter of 27/312 nm, and a surface area of 210.89 m2/g. MTZ loading content with controlled release, suggesting suitability for therapeutic applications. nHAEA@MTZ did not affect the odontogenic abilities of HDPSCs more than nHAEA. However, it was observed that nHAEA@MTZ demonstrated a more pronounced anti-inflammatory effect. HDPSCs treated with nanoparticles exhibited improved migration compared to other groups. These findings demonstrated that nHAEA@MTZ could be an effective material for pulp capping and may be more effective than nHAEA in reducing inflammation and activating HDPSCs to enhance pulp repair after pulp damage.

Comparative Evaluation of Effectiveness of Calcium Hydroxide, MTA, and TheraCal LC in Indirect Pulp Capping in Primary Molars: In Vivo Study.

This investigation aimed to observe the effects of Dycal, mineral trioxide aggregate (MTA), and TheraCal LC, as indirect pulp-capping materials in primary molars. About 75 children with lower primary molars aged between 4 and 7 years suggested for IPC were selected and randomly allocated into: Group I - Dycal, group II - MTA, and group III - TheraCal LC. An immediate postoperative radiograph was taken after the procedure. Recall examination was done after 3 and 6 months for clinical and radiographic assessment. The radiographs were digitized, and the amount of thickness of dentin was assessed using Corel Draw software. The values were tabulated and subjected to paired t-tests and independent t-tests for intra and intergroup analysis, respectively. The p-value < 0.05 was considered statistically significant. There was a statistically significant increase in dentin thickness in the first 3 months compared to the 6-month follow-up. At the end of the research phase, TheraCal LC had more tertiary dentin deposited than MTA, followed by Dycal. TheraCal LC can be a reliable indirect pulp-capping agent in primary teeth. Indirect pulp capping (IPC) is a very extensively employed treatment regimen to manage extensive caries. For many decades, calcium hydroxide has been regarded as the benchmark of pulp capping materials. With several advancements in materials for restoration, TheraCal LC a resin-modified, light-cured calcium silicate-filled liner serves as a pulp-capping agent and dentin protector, promoting pulp healing and preserving vitality as an obstacle cum protector of the dental pulp complex. How to cite this article: Thomas NA, Jobe J, Thimmaiah C, et al. Comparative Evaluation of Effectiveness of Calcium Hydroxide, MTA, and TheraCal LC in Indirect Pulp Capping in Primary Molars: In Vivo Study. J Contemp Dent Pract 2024;25(4):365-371.

Color Matching of Single-Shade Composite Resin by Various Pulp Capping Materials in Anterior Teeth

This study aimed to compare color matching between single-shade composite resin-restored teeth with various pulp capping materials and the dentin surrounding the restoration through instrumental analysis and visual evaluation of the color difference. Fifty maxillary right central incisor acrylic resin teeth were prepared with standardized Class III cavities on the proximal surfaces. These teeth were divided into five groups: restored with single-shade composite resin only; Ultra-Blend™ plus followed by single-shade composite resin; TheraCal PT™ followed by single-shade composite resin; Endocem&lt;sup&gt;®&lt;/sup&gt; MTA premixed followed by single-shade composite resin; and Well-root PT™ followed by single-shade composite resin. The color difference (ΔE&lt;sub&gt;ab&lt;/sub&gt;&lt;sup&gt;*&lt;/sup&gt;) between the restored area and the center of the resin teeth was measured using a spectrophotometer. No significant color difference was observed in groups restored with only single-shade composite resin, Ultra-Blend™ plus, and TheraCal PT™. The visual evaluation revealed that Ultra-Blend™ plus exhibited the best color matching score, whereas the Endocem® MTA premixed and Well-root PT™ groups showed significantly lower color matching scores than the single-shade composite resin-only group. When opting for single-shade composite resin usage for anterior tooth restorations with the aim of reducing chair time, pulp capping materials UltraBlend™ plus and TheraCal PT™ provide esthetically pleasing results.

Biological evaluation of novel phosphorylated pullulan-based calcium hydroxide formulations as direct pulp capping materials: An invivo study on a rat model.

Calcium hydroxide (CH) has been considered as a direct pulp capping materials (DPC) for the last decades despite having some limitations. Phosphorylate pullulan (PPL) incorporated with CH (CHPPL) is a novel biomaterial that was introduced as a promising DPC material. Thus, the aim of the study was to evaluate the inflammatory response and mineralized tissue formation (MTF) ability of PPL-based CH formulations on rat molars after DPC. This study consisted of six groups: CH with 1% PPL (CHPPL-1); 3% PPL (CHPPL-3); 5% PPL (CHPPL-5); Dycal and NEX MTA Cement (N-MTA) as the positive control, and no capping materials (NC). One hundred twenty maxillary first molar cavities were prepared on Wistar rats. After capping, all the cavities were restored with 4-META/MMA-TBB resin and pulpal responses were evaluated at days 1, 7, and 28. Kruskal-Wallis followed by Mann-Whitney U-test was performed with a significance level of 0.05. Immunohistochemical expression of IL-6, Nestin, and DMP-1 was observed. At day 1, CHPPL-1, N-MTA, and Dycal exhibited no to mild inflammation, whilst CHPPL-3, CHPPL-5, and NC showed mild to moderate inflammation, and the results were significantly different (p < .05). At day 7, mild to moderate inflammation was observed in CHPPL-1, N-MTA, and Dycal, whereas CHPPL-3, CHPPL-5, and NC exhibited moderate to severe inflammation. Significant differences were observed between CHPPL-1 and N-MTA with NC (p < .05), CHPPL-1 and CHPPL-3 with CHPPL-5 and Dycal (p < .05), and CHPPL-3 with N-MTA (p < .05). A thin layer of mineralized tissue formation (MTF) was observed in all groups. At day 28, CHPPL-1, Dycal, and N-MTA showed no to mild inflammation, whilst CHPPL-3, CHPPL-5, and NC exhibited mild to severe inflammation, and statistically significant difference was detected (p < .05). CHPPL-1, Dycal, and N-MTA exhibited continuous MTF, whilst CHPPL-3, CHPPL-5, and NC had thicker and interrupted MTF. Significant differences were observed between CHPPL-1, CHPPL-3, and N-MTA with NC group (p < .05). Variable expressions of IL-6, Nestin, and DMP-1 indicated differences in the materials' impact on odontoblast-like cell formation and tissue mineralization. These findings suggest that CHPPL-1 has the potential to minimize pulpal inflammation and promote MTF and had similar efficacy as MTA cement.

Silver Diamine Fluoride as a Medicament for the Indirect Pulp Therapy in Primary Teeth: A Review of the Literature.

Silver diamine fluoride (SDF) has been demonstrated to be effective in arresting caries lesions and, recently, clinical trials have assessed the effectiveness of SDF as amedicament for indirect pulp therapy(IPT) in primary teeth. This review aims to summarize the literature related to the use of SDF and find out if SDF can be used as an effective material for IPT.A literature search was undertaken on electronic databases includingPubMed, MEDLINE, ScienceDirect, and Google Scholar, which elicited 50 studies employing different materials in the IPT of primary molars; however, of them, only four clinical trials used SDF as indirect pulp capping (IPC) material. SDF has the potential to be a useful material for IPT in primary teeth. It is a handy choice for pediatric dentists due to its minimum invasiveness, ease of application, and ability to stop the progression of caries.However, more studies are needed to determine whether SDF can be used routinely for IPT and whether it can even replace the currently available materials, as well as to fully realize its potential and establish criteria for its ideal application in IPT procedures.

Biocompatibility and Cytotoxicity of Pulp-Capping Materials on DPSCs, With Marker mRNA Expressions

ObjectivesThe present study aimed to (i) investigate biocompatibility and cytotoxicity of pulp capping materials on viability of hDPSCs, (ii) determine angiogenic, odontogenic, and osteogenic marker mRNA expressions, and (iii) observe changes in surface morphology of the hDPSCs using SEM. MethodsImpacted third molars were used to isolate the hDPSCs, which were treated with extract release fluids of the pulp capping materials (Harvard BioCal–Cap, NeoPutty MTA, TheraCal LC, and Dycal). Effects of the capping materials on cell viability were assessed using MTS assay and the apoptotic/necrotic cell ratios and ROS levels from a flow cytometry. Marker expressions (ALP, OCN, Col1A, SPARC (ON) and VEGF) were determined by RT-qPCR. Changes in surface morphology of the hDPSCs were visualized by SEM. ResultsThe MTS assay results at days 1, 3, 5 and 7 indicated that Harvard BioCal–Cap, NeoPutty MTA and TheraCal LC did not adversely affect cell viability when compared to the control group. According to the MTS assay results at day 14, no significant difference was found among Dycal, Harvard BioCal–Cap, NeoPutty MTA and TheraCal LC affecting the cell viability. Dycal was the only capping material that increases the ROS level. High levels of VEGF expression were observed in Harvard BioCal-Cap, TheraCal LC, and NeoPutty MTA. NeoPutty MTA and Dycal up-regulated OCN expression, whereas TheraCal LC up-regulated Col1A and SPARC expression. Only Dycal increased ALP expression. The hDPSCs were visualized in characteristic spindle morphology by SEM due to TheraCal LC and Harvard BioCal–Cap. ConclusionsNeoPutty MTA and Harvard BioCal–Cap showed suitable biocompatibility values, and in particular, these pulp capping materials were observed to support the angiogenic marker. Clinical SignificanceSince it was thought that cytotoxicity and biocompatibility values would contribute significantly to future studies, a new pulp capping material, NeoPutty MTA and Harvard BioCal-Cap, were used in this study.

Mixing ratio of nano hydroxyapatite and Epigallocatechin-3-gallate (EGCG) towards viscosity and antibacterial effect as a potential pulp capping Material: An experimental study

BackgroundFinding a new natural scaffold is challenging due to crucial impact on long-term treatment outcomes in pulp capping. In this context, nano hydroxyapatite (nano-HA) is a potential candidate having similar properties to bone tissue in the body. The compound is often synthesized with Epigallocatechin-3-gallate (EGCG) which offers anti-inflammatory and antibacterial properties. Therefore, this study aims to contribute novel insights into the development of effective pulp capping materials by determining the viscosity ratio of the combination of nano-HA and EGCG applied to the cavity according to standard pulp capping material, as well as proving the antibacterial effect against Lactobacillus acidophilus. MethodsThe combination of nano-HA – EGCG is divided into three treatment groups, (G1) 1:1 ratio, (G2) 1:1.5 ratio, (G3) 1:2 ratio, as well as control group G4 (Ca(OH)2 and aquadest) with a ratio of 1:1. Meanwhile, each group is tested for viscosity using a Brookfield viscometer. The well diffusion method is used to determine the antibacterial activity by measuring the diameter of the inhibition zone for each treatment, with C1 (Ca(OH)2 and aquadest) as control group at a ratio of 1:1, and three treatment groups (nano-HA – EGCG), (C2) 0.5:1 ratio, (C3) 1:1 ratio, and (C4) 2:1 ratio. ResultsThe results show that there is a difference in the viscosity of each group with G3 having a viscosity of 12.0183 cP, which is closest to control. Furthermore, significant differences are also reported in antibacterial activity between control and treatment groups. ConclusionThe ratio of 1:2 (G3) has a viscosity that closely matches the standard of pulp capping materials. The combinations of nano-HA and EGCG are proven to have antibacterial power against Lactobacillus acidophilus.

In Vitro Evaluation of Sealing Ability of Biodentine and TheraCal PT in Primary Molars.

A major objective in the management of deep carious lesions involving proximal surfaces of primary molars is to control marginal leakage. This could occur due to dimensional changes or failure in the adaptation of pulp capping materials to the prepared cavity. Evaluation of microleakage is important for assessing the success of newer pulp capping materials. Biodentine exhibits good sealing ability but possesses longer setting times and handling difficulties, which might delay the placement of the final restoration. The sealing ability of newer dual-cure calcium silicate-based material in TheraCal PT in class II cavities of primary molars is not known. Hence, the current study aimed to evaluate and compare the microleakage of Biodentine and TheraCal PT in primary molars. Extracted, noncarious primary molars (n = 28) were collected, and standardized class II cavities were prepared and restored with Biodentine (group I) and TheraCal PT (group II). Following this type, IX glass ionomer cement (GIC) was placed and polished. Microleakage was assessed using the dye penetration method, and data obtained through stereomicroscopic analysis were statistically analyzed. The mean microleakage score observed in group I was 2.0 ± 1.3 MPa, and in group II was 1.0 ± 1.1 MPa. Comparable sealing ability was observed between both groups (p = 0.061). TheraCal PT could be used as a suitable alternative to Biodentine for use in vital pulp therapeutic procedures in children to reduce the treatment time and improve sealing ability. Anusha B, Shivashankarappa PG, Mohandoss S, et al. In Vitro Evaluation of Sealing Ability of Biodentine and TheraCal PT in Primary Molars. Int J Clin Pediatr Dent 2024;17(2):158-161.

Antibacterial, biocompatible, and mineralization-inducing properties of calcium silicate-based cements.

Different pulp capping materials have different origins and compositions, require different preparations, and may vary in their bioactive properties. The purpose of this study was to evaluate the antibacterial activity, biocompatibility, and mineralization-inducing potential of calcium silicate-based pulp capping materials. Six contemporary calcium silicate-based cements, ProRoot MTA, MTA Angelus, Biodentine, EndoSequence, NeoMTA 2, and NeoPutty, were evaluated. The antibacterial effects of these materials against Streptococcus mutans UA159 and Enterococcus faecalis ATCC 29212 were determined by the agar diffusion assay and the direct culture test. The biocompatibility and mineralization-inducing potential of these materials in preodontoblastic 17IIA11 cells were evaluated by the MTT assay and by Alizarin Red S staining, respectively. In agar diffusion test, only Biodentine showed distinct antibacterial effects against S. mutans. All the tested materials, however, showed antibacterial effects against S. mutans and E. faecalis in the direct culture test, with Biodentine showing the strongest growth inhibition against both S. mutans and E. faecalis. All the tested materials showed acceptable biocompatibility and mineralization-supporting potential in our experimental conditions. In summary, ProRoot MTA, MTA Angelus, Biodentine, EndoSequence, NeoMTA 2, and NeoPutty demonstrated acceptable invitro antimicrobial, biocompatible, and mineralization-supporting properties.

Treatment outcome of coronal pulpotomy and indirect pulp capping in mature permanent molars with symptoms of moderate pulpitis: A randomized clinical trial.

This clinical trial aimed to compare the clinical success of coronal pulpotomy and indirect pulp capping (IPC) in managing symptomatic deep proximal caries in molars with moderate pulpitis over a 12-month period. A total of 108 vital mature permanent molars with moderate pulpitis were randomly allocated to the IPC (n = 54) or coronal pulpotomy group (n = 54). Dycal and Biodentine were used as pulp-capping materials, followed by composite restoration. The absence of periapical infection and asymptomatic teeth that positively responded to the cold pulp sensitivity test (only in IPC) was considered posttreatment success at 12 months. Data from the study were analyzed using the Chi-square test and Kaplan-Meier survival analysis. There was a statistically significant difference between preoperative symptoms and the cold pulp sensibility test response (P = 0.000), indicating an association between symptoms and pulp sensibility. The average remaining dentine thickness (RDT) value was 0.48 ± 0.5 mm, with no statistically significant difference found between the location of caries and RDT (P = 0.084, P > 0.05). Compared to the IPC group, the pulpotomy group had a greater number of patients at 12 months after treatment that required no intervention. The Kaplan-Meier survival analysis revealed that the mean survival duration for pulpotomy was 48 weeks, and for IPC, it was 42.3 ± 2.35 weeks. Coronal pulpotomy with Biodentine proved more effective in reducing symptoms, achieving radiographic success, and ensuring tooth survival compared to IPC with calcium hydroxide.

Single visit indirect pulp capping with Biodentine: clinical case report

Introduction. Dental caries is the most widespread dental disease worldwide; it affects population of different ages. If not treated promptly or addressed improperly, dental caries progresses in a deep cavity, with potential signs of pulp inflammation. The minimal invasive principles of treatment of deep carious lesions provide guidelines for the preservation of the dental pulp, techniques known as vital pulp therapies. Among these techniques, indirect pulp capping is a method that has shown high clinical rates of success over time, if performed properly. The applied bioactive dental material plays an important role. The aim of this clinical case report is to describe a clinical case of single-visit indirect pulp capping with Biodentine, along with the algorithm of diagnosis of the pulp health status and treatment used in deep caries lesion in a permanent tooth. Materials and methods. Description of a clinical case of a permanent upper molar with a deep carious lesion, treated by single-visit indirect pulp capping with Biodentine. Clinical and radiological methods of investigations were used; the patient was assessed after 3 and 6 months after the applied treatment. Results. The main complaint of sensitivity to sweet stimuli presented by the patient attenuated shortly after receiving the treatment. After 3 and 6 months, the tooth is asymptomatic; the clinical and radiological findings show no evidence of pulp inflammation. Conclusions. Biodentine showed successful results when used as a bioactive dental material for indirect pulp capping.

COMPRESSIVE STRENGTH OF Ca(OH)2 COMBINED WITH MUSA ACUMINATA AS A PULP CAPPING MATERIAL

Background: The weakness of Ca(OH)2 is its low compressive strength and mechanical properties which can affect the stability of the material to the liquid in the tooth root canal so that it can dissolve the root canal medicament material. Due to the various weaknesses of Ca(OH)2, the researchers are interested in combining Ca(OH)2 with natural ingredients extracted from Musa acuminata (Mauli Banana) stem. Musa acuminata stem extract (MaSE) contains bioactive compounds such as tannins, saponins, alkaloids, flavonoids and lycopene which have antioxidant, anti-inflammatory, antibacterial and anti-viral properties. One of the requirements for pulp capping material is to have sufficient compressive strength, therefore, it is necessary to conduct research to test the value of the compressive strength of the combination of Ca(OH)2 with Musa acuminata stem extract. Purpose: To analyze the compressive strength of the pulp capping material from the combination of calcium hydroxide and Musa acuminata stem extract, with a ratio of 1:1; 1:1.5 ; and 1.5:1. Method: This research is a pure experimental study with a posttest-only design with a control group design, consisting of 4 treatment groups, including: group 1 the combination of Ca(OH)2 with Musa acuminata stem extract at 1:1, group 2 1:1.5, group 3 1.5:1, and group 4 as a positive control. Results: One Way Anova test (p&lt;0.05) which means there is a significant difference. Data analysis was continued with the LSD Post Hoc test (p&lt;0.05) which showed that there were significant differences between groups, between each treatment group. Conclusion: The combination of Ca(OH)2 with 50% MaSE and PG ratio of 1.5 : 1 : 0.375, has the highest compressive strength (1.40 MPa), so it can be concluded that the more Musa acuminata stem extract in the combination, the lower the compressive strength. Keywords : Calcium hydroxide, Compressive strength, Musa acuminata stem extract