Research progress on direct pulp capping of primary teeth / 口腔疾病防治

@#The timely treatment of dental caries and pulp disease in primary teeth holds significant importance for maintaining children's oral health. Direct pulp capping (DPC) is a vital pulp treatment that involves covering the exposed pulp with bioactive materials to promote dentin bridge formation. DPC is commonly used in primary teeth with vital pulp and mechanical pulp exposure not exceeding 1 mm. DPC offers advantages such as minimal invasiveness, comfort, simplicity of operation and short chair-side time, making it suitable for pediatric dental clinical practice. Early studies suggested negative treatment outcomes for DPC in primary teeth with carious pulp exposure. Over the years, there have been advancements in materials and technology demonstrating positive outcomes in the clinical research of primary teeth with deep caries. However, due to the limited quality of related studies, DPC has not been widely recommended for the treatment of primary teeth with carious pulp exposure, and its widespread use needs further support by more high-quality evidence-based medical research. The success rate of DPC in primary teeth is influenced by factors including pulp status, clinical operations (such as isolation and caries removal), pulp capping material, cavity type, tooth position, coronal sealing, and dental fear. In clinical operation, dentists should accurately assess pulp status and minimize bacterial contamination. Mineral trioxide aggregate (MTA) is a DPC agent with relatively sufficient evidence and good therapeutic effects, and the crown should be tightly sealed after pulp capping. Additionally, the effects of novel biocompatible materials such as iRoot BP Plus used in DPC of primary teeth, and the influence of other factors like hemostatic methods on the prognosis of affected teeth, need further exploration.

Comparison of the effect of iRoot BP Plus and MTA on direct pulp capping of carious pulp exposed mature permanent teeth / 口腔疾病防治

Objective@#To study the clinical efficacy of biological ceramics (iRoot BP Plus ) and mineral trioxide aggregate (MTA) in direct pulp capping of mature permanent teeth, to provide referrence for clinical application.@* Methods @# Seventy-four patients with pulp exposure due to deep caries or reversible pulpitis in 75 mature permanent teeth were selected and were randomly divided into two groups. iRoot BP Plus were used as pulp capping agents in the treatment group and MTA were used as pulp capping agents in the control group respectively. The clinical efficacy and imaging analysis were performed at 1, 3, 6 and 12 months after operation. Treatment success rate of the two groups were calculated, and the influence of various factors including gender, age, tooth position, cavity, number and size of pulp exposure on the efficacy of direct pulp capping were analyzed. @* Results @#Sixty patients with 61 mature permanent teeth were selected. Twelve mouths after treatment, 61 teeth of 60 patents were completely investigated (iRoot group: 31 teeth 30 patients; MTA group: 30 teeth 30 patients). The success rates of the 2 groups were 90.3% (iRoot BP Plus) and 90.0% (MTA), respectively. There was no statistical difference between 2 groups (P>0.05). Statistical analysis also showed that gender, age, tooth position, cavity, number and size of pulp exposure had no significant difference between the two groups (P>0.05). @*Conclusion@# Both iRoot BP Plus and MTA are effective in direct pulp capping of mature permanent teeth with carious pulp exposure, while the operation of iRoot is simple and convenient.

Histological study of platelet-rich fibrin combined with MTA for direct pulp capping of rabbit teeth / 口腔疾病防治

Objective @# To investigate the outcomes of a novel direct pulp capping agent containing platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA). @*Methods @# A total of 32 New Zealand rabbits were randomly divided into 4 groups, namely, the PRF+MTA group (P+M group), PRF group (P group), MTA group (M group) and blank control group (BC group), with 8 rabbits per group. Dental pulp exposure and direct pulp capping were performed, and complete crown square sealing was performed on 2 mandibular central incisor teeth of each rabbit. Four rabbits from each group were euthanized after each observation period (7 and 28 days). The experimental teeth were subjected to HE staining. Inflammatory cell infiltration, calcified bridge formation and pulp tissue disorganization were observed and graded. @*Results@#Inflammatory cell infiltration: on the 7th day, group P+M and group M were lighter than group BC (P<0.05); on the 28th day, group P+M was lighter than group P and group BC (P<0.05); group P+M and group M did not significantly differ (P>0.05). Calcified bridge formation: on the 7th and 28th days, group P+M was lighter than group P, group M and group BC (P<0.05); on the 28th day, group M was higher than group BC (P<0.05). Under microscope, the calcified bridge contained cellular components and was surrounded by odontoblast-like cells, sharing a structure resembled osteodentin; dentin tubule-like structure could not be observed in calcified bridge, and the calcified bridge resembled certain points of osteodentin. Pulp tissue disorganization: on the 7th day, group P+M and group M were lighter than group BC (P<0.05); on the 28th day, group P+M was lighter than group P and group BC (P<0.05). group P+M and group M did not significantly differ (P>0.05). @*Conclusion @# The combination of PRF and MTA for direct pulp capping provided light inflammatory cell infiltration, stable pulp status and a strong ability of pulp tissue to form calcified bridge, and the calcified bridge resembled certain points of osteodentin.

Protección pulpar directa y posterior apexogénesis: informe de un caso clínico / Direct pulp capping followed by apexogenesis: a clinical case report

Objetivo: Describir el tratamiento de un paciente que pre- sentó un incisivo superior permanente con exposición pulpar y desarrollo radicular incompleto utilizando Biodentine como material para la protección pulpar directa. Caso clínico: Un paciente de 9 años fue derivado para la evaluación y el tratamiento del diente 11. El examen clínico y radiográfico reveló la presencia de una fractura amelodentinaria, con exposición pulpar y desarrollo radicular incompleto. Luego de lavar y desinfectar el área de la fractura, se protegió la pulpa expuesta con Biodentine y se restauró la cavidad. El paciente fue citado para control a los 18 y 25 meses. En los controles se comprobó que el diente se mantuvo asintomático y funcional. Luego de 25 meses, el examen clínico y radiográfico confirmó la presencia de pulpa vital y el completo desarrollo del remanente radicular. Los resultados obtenidos en el presente caso clínico sugieren que el empleo de Biodentine puede ser considerado como una valiosa alternativa para la protección de la pulpa ex- puesta en dientes con desarrollo radicular incompleto (AU)

Aim: To describe the treatment of a patient that presented a permanent maxillary central incisor with pulp exposure and incomplete root formation, using Biodoentine as the material for direct pulp protection. Clinical case A 9-year-old male patient was referred for evaluation and treatment of tooth 11. The clinical and radio-graphic examination revealed the presence of a dentinoe- namel fracture, with pulp exposure and incomplete root for- mation. After cleaning and disinfecting the area, the exposed pulp was protected with Biodentine and the cavity was re- stored. The patient was scheduled for control after 18 and 25 months. In these evaluations, it was confirmed that the tooth remained asymptomatic and functional. After 25 months, the clinical and radiographic examination showed the presence of vital pulp and a completed development of the root. The obtained results of this clinical case suggest that Biodentine can be considered a valuable alternative for pulp capping in teeth with incomplete root formation (AU)

Vital pulp therapy of pulp inflammation of permanent teeth / 口腔疾病防治

@#Vital pulp therapy aims to maintain healthy pulp tissue as much as possible to improve the long-term survival of teeth. It has limited indications and uncertain curative effects. The pathological changes in inflamed pulp are the histological basis for the determination of treatment strategies and the treatment outcome; however, pulp sensitivity testing cannot reflect the actual histological status of the pulp. With the development of basic and clinical research on vital pulp therapy, the innovation of modern diagnostic and therapeutic technology and capping material, vital pulp therapy can be used as a treatment of teeth on which it was previously thought pulpectomy was necessary. Based on the evidence-based literature, this paper analyzes and summarizes the pathological changes of pulpitis and clinical research on the treatment of pulpitis. Vital pulp therapy can be a treatment for mature teeth with carious exposure and symptoms of irreversible pulpitis if comprehensive applications, including laser Doppler flowmetry, tissue oxygen monitoring, magnetic resonance imaging and microscopy, are used to determine the degree of pulp retention and if infection control and the use of biocompatible capping material are emphasized. In the future, it will be necessary to improve the success rate of vital pulp therapy for the treatment of pulpitis through research on the mechanism of pulp repair and regeneration, the precise diagnosis of pulpitis, and the development of pulp capping materials.

Influence of pregnancy on the inflammatory process following direct pulp capping: a preliminary study in rats

Abstract The purpose of this study was to evaluate the inflammatory process following direct pulp capping during pregnancy. This experimental study involved 48 maxillary first molars of female Wistar rats. The procedures were performed in pregnant and non-pregnant animals (n =20 each). Direct pulp capping with mineral trioxide aggregate (MTA) and restoration with a light-cured resin composite was performed in half of exposed pulp specimens. In the other half of specimens, light-cured composite was placed directly on the exposed pulp. In the control groups (n=4 each), no intervention was performed. Animals were euthanized at 3 and 7 days. All sections (three per slide) were viewed under an optical microscope. One previously calibrated pathologist performed descriptive analysis and assigned scores for inflammatory response and tissue organization adjacent to the pulp exposure. The Kappa value for intra-examiner variability was 0.91. At 3 days, in animals treated with MTA, inflammatory infiltrate was absent in non-pregnant animals while mild inflammatory infiltrate was observed in some pregnant animals. The inflammatory response ranged from mild to severe in both groups treated with composite alone. At 7 days, the inflammatory response was more intense in pregnant than in non-pregnant animals treated with MTA; while this difference were not evident in animals treated with composite alone. In conclusion, pregnancy may not influence the inflammatory process following direct pulp capping with light-cured resin composite, which was always harmful to the pulp; while the tissue response after the direct pulp with MTA were more favorable in non-pregnant animals.

Resumo O objetivo deste estudo foi avaliar o processo inflamatório do tecido pulpar após o capeamento pulpar direto, realizado durante a gestação. Este estudo experimental envolveu 48 primeiros molares superiores de ratos Wistar fêmeas. Os procedimentos foram realizados em animais prenhes e não prenhes (n=20). Após as exposições pulpares, o capeamento pulpar direto foi efetuado com agregado trióxido mineral (MTA) ou restauração direta com resina composta. Nos grupos controle (n=4), nenhuma intervenção foi realizada. Os animais foram submetidos à eutanásia após 3 e 7 dias. Todos os cortes foram avaliados através de um microscópio ótico. Um patologista previamente calibrado realizou analise histológica descritiva e estabeleceu escores para intensidade da resposta inflamatória e para o grau de organização tecidual na região adjacente à exposição pulpar. O valor de Kappa intra-examinador foi 0,91. No período experimental de 3 dias, nos animais tratados com MTA, o infiltrado inflamatório estava ausente nos não prenhes, enquanto infiltrado inflamatório moderado estava presente nos animais prenhes. A resposta inflamatória variou de moderada a severa em ambos os grupos tratados apenas com resina composta. Após o periodo experimental de 7 dias, a resposta inflamatória foi mais intensa nos animais prenhes que nos não prenhes do grupo do MTA, enquanto esta diferença não foi tão evidente nos animais que receberam capeamento pulpar direto com resina composta. Pode-se concluir, que a gestação pode não exercer influência no processo inflamatório do tecido pulpar após proteção pulpar direta com resina composta; a qual foi sempre danosa aos tecidos pulpares. No entanto, a resposta tecidual ao capeamento pulpar com MTA foi mais favorável nos animais não prenhes.

An experimental study of simvastatin-collagen composite sponge as a direct pulp capping material in rat molars / 华西口腔医学杂志

OBJECTIVE@#To assess the feasibility and efficacy of simvastatin-collagen composite sponge as a novel, direct pulp capping material.@*METHODS@#A total of 120 Sprague-Dawley rats were randomly divided into three groups: the simvastatin-collagen composite sponge group (SIM group), the collagen sponge group (CS group), and the Ca(OH)2 group (CH group). An endodontic entry cavity was prepared on the occlusion of the first molar on the left maxillary of each rat. The contralateral teeth were utilized as the normal control group. The rats were experimented after 1, 3, 7, 14, and 28 days. X-ray observations were conducted and the specimens underwent hematoxylin-eosin (HE) and Masson's Thichrome staining. Dentin bridge formations and pulpal biology reactions were evaluated histopathologically.@*RESULTS@#X-ray results: high-density images could be observed on the pulp exposure sites in the CH group on the 28th day. In the SIM group, high-density images could be observed after 14 and 28 days, whereas in the CS group, high-density images were not observable in the exposed area. HE and Masson's Thichrome staining results: different degrees of inflammation under the cavity were detected in the three groups at different time points. The inflammatory reaction of the CS group was the most serious. The degree of the inflammatory reaction varied significantly between the SIM and the CS groups on the 14th and 28th days (P<0.01). The inflammatory reaction in the SIM group was lighter than in the CH group. There was a statistical difference between the SIM and the CH groups on the 14th day (P<0.05). During the observation period, the SIM group induced the best and fastest formation of reparative dentin. As for dentin bridge formation, a significantly higher complete bridge rate was observed in the SIM group than in the CH and in the CS groups on the 14th day (P<0.05) and for the SIM and the CH groups compared with the CS group on the 28th day (P<0.05).@*CONCLUSIONS@#The simvastatin-collagen composite sponge exhibited satisfactory biocompatibility with the pulp tissue and promoted the formation of reparative dentin. The application of simvastatin-collagen composite sponge as a pulp-capping material has satisfactory potential.

Contemporary concept and clinical perspective of direct pulp capping therapy / 中华口腔医学杂志

There are several trends in contemporary endodontics such as development of minimally invasive biologically based therapies, preservation of dental pulp in a healthy status with sustained vitality, prevention of apical periodontitis and improvement of long-term survival rates of teeth with pulpal disorders. As for the vital pulp therapy, direct pulp capping is a less invasive approach to keep the exposed dental pulp intact, which may improve the long-term treatment outcome employing a minimally invasive biologically strategy. With the recent progress in pulp biology, improvement of treatment modality and development of bioactive dental cements, great advancements have been achieved in direct pulp capping therapy. This review article focuses on the transition of indications, prognostic factors and future perspectives of direct pulp capping therapy, attempting to provide evidence and practical guidance for minimally invasive biologically based therapies of teeth with injured pulp.

Protección pulpar directa en dientes de cabra: un modelo experimental / Direct pulp capping in goat teeth: an experimental model

Objetivos: Evaluar la utilidad de un modelo animal mamífero como la cabra, a fin de estudiar biomateriales indicados para protección pulpar directa. Materiales y métodos: Bajo anestesia general, se realizaron exposiciones pulpares en las caras vestibulares de los ocho incisivos inferiores de cuatro (n=4) cabras de raza criolla. En cada animal, 6 (n=6) exposiciones fueron protegidas con un material experimental (ACPc), y las 2 (n=2) restantes, con un material de control a base de MTA (WMTA). En total se realizaron 24 (n=24) protecciones con ACPc y 8 (n=8) con WMTA. Las cabras fueron separadas en dos grupos de dos (n=2) animales cada uno. Bajo anestesia general, los dientes se extrajeron a los 30 (Grupo 1) y 60 días (Grupo 2), se fijaron en formol búffer fosfato al 10% y se procesaron para el estudio histológico de rutina. Los animales no fueron sacrificados. En cada período, se analizaron 12 (n=12) protecciones pulpares con ACPc y 4 (n=4) con WMTA. Resultados: Grupo 1: Once (n=11) pulpas protegidas con ACPc presentaron puente dentinario completo e inflamación crónica remanente. En un caso no hubo puente dentinario y la pulpa estaba crónicamente inflamada. Las 4 (n=4) pulpas protegidas con WMTA presentaron puente dentinario e inflamación crónica. Grupo 2: Las 12 (n=12) pulpas protegidas con ACPc se encontraban normales, con puente dentinario completo, buena irrigación y capa de odontoblastos continua. Las 4 (n=4) pulpas protegidas con WMTA revelaron condiciones similares. Los resultados se analizaron mediante el test de probabilidad exacta de Fischer (P<0,05). Con respecto al factor inflamación, hubo diferencias significativas (P<0,001) entre los resultados obtenidos a 30 y 60 días, pero no hubo diferencias entre ACPc y WMTA (P>0,05) dentro de cada uno de los períodos de observación. En cuanto a la presencia de puente dentinario, no hubo diferencias significativas (P>0,05) entre ACPc y WMTA en ambos períodos de observación. Conclusiones: Los resultados sugieren que la cabra constituye un modelo animal adecuado para los ensayos de protección pulpar directa (AU)

Aim: To evaluate the suitability of the goat as an animal model for the study of biomaterials indicated for direct pulp capping. Materials and methods: Under general anaesthesia, pulp exposures were performed on the buccal surfaces of the eight mandibular incisors of four (n=4) healthy Creole goats. The exposures were capped with two biomaterials developed for PPD. In each animal, 6 (n=6) exposures were capped with an experimental material (ACPc) while for the remaining 2 (n=2) exposures a white MTA (WMTA) was used as the control. A total of 24 (n=24) direct pulp capping with ACPc and 8 (n=8) with WMTA were done. The goats were separated into two groups of two (n=2) animals each. The teeth were extracted after 30 days (Group 1) and 60 days (Group 2) and fixed in 10% phosphate buffered formalin and processed for routine histology. The animals were not euthanized. In each period, 12 (n=12) PPD with ACPc and 4 (n=4) with WMTA were analyzed. Results: Group 1: Eleven (n=11) pulps capped with ACPc showed complete dentin bridges and chronic inflammation. In one case without dentin bridges the pulp was chronically inflamed. The four pulps capped with WMTA revealed the presence of dentin bridges and chronic inflammation. Group 2: Twelve pulps protected with ACPc showed a complete dentin bridges. In addition, well irrigated and healthy pulp tissues along with a continuous odontoblast palisade were observed. The four pulps capped with WMTA revealed similar features. In cases showing dentin bridges, a few numbers of empty spaces as well as odontoblast like cell inclusions were detected. The results were analyzed by the Fisher's exact test (P<0.05). With respect to the inflammation factor there were significant differences between the 30 and 60-day observation periods (P<0.001), but no differences were observed between ACPc and WMTA (P>0.05) within each of the observation periods. When the presence or absence of a dentin bridges was analyzed, no significant differences (P>0.05) were found between materials at each observation period. Conclusions: The results suggest that the goat seems to be an appropriate animal model for direct pulp capping evaluation (AU)

Observation of clinical effects of mineral trioxide aggregate as direct pulp capping in immature permanent an-terior teeth / 口腔疾病防治

Objective@# To evaluate the clinical effects of mineral trioxide aggregate (MTA) as apulp-dressing agent in immature permanent anterior teeth. @*Methods @#68 perma nent anterior teeth with deep caries or accidental pulp exposure were randomly divided into treatment group (MTA) and control group (calcium hydroxide). The exposed pulps were treated permanently with direct pulp capping. The effect of potential clinical variables on the treatment outcome was evaluated clinically and radiographically during a 24-month follow-up. In order to assess the cumulative successes, data were analyzed with chi-square test and log-rank test (α= 0.05). @*Results @#The successful rate of the treatment group (91.4%) was higher than that of the control group (60.6%) significantly (P < 0.05). None of the gender, occlusal site, type of pulp exposure, site and diameter of pulp exposure had a considerable influence on the outcome (P > 0.05).@*Conclusion@# MTA as a biocompatable, osteogenesis-inducing and inflammation-controlling material appears to be suitable for direct pulp capping.

Histopathologic responses of human dental pulp to calcium hydroxide and mineral trioxide aggregate as pulp capping agents / 实用医学杂志

Objective To investigate human pulpal response to mineral trioxide aggregate (MTA) and calcium hydroxide (CH) as pulp capping agents. Methods This study was conducted on 90 intact first and second premolars of human maxillary and mandibular teeth of 30 volunteers. The patients were randomly assigned into three groups with 10 in each group. Under local anesthesia, the teeth were exposed and capped either with MTA, or CH. After 30, 60, and 90 days, 10 teeth of each group were extracted and prepared for histologic ob-servation. The data were analyzed with Wilcoxon rank sum test and paired t-tests (α = 0.05). Results MTA had a higher success rate and resulted in less pulpal inflammatory response and more predictable hard dentin bridge formation than CH (P < 0.05). Conclusion MTA appears to be a suitable replacement for CH in direct pulp capping.

Analysis to Detecting Prostaglandin E2 and Elastase Levels in the Pulp Blood of the Patients with Carious Tooth Complicated with Exposed Pulp and Its Clinical Significance / 现代检验医学杂志

Objective To observe and analyze the changes of prostaglandin E2 (PGE-2)and elastase (EA)levels in the pulp blood of the patients with carious tooth complicated with exposed pulp and its influence on the curative effects of direct pulp capping treatment.Methods 80 cases of the patients with carious tooth complicated with exposed pulp treated with direct pulp capping treatment were selected as the observation group and 40 cases of the patients treated with normal removal of impacted third molar were selected as the control group.The levels of PGE-2 and EA in the pulp blood of the patients in the two groups before the treatments were detected and compared.A one-year follow-up was employed for the patients in the observation group and the curative effects were evaluated and compared.Results The levels of PGE-2 and EA in the pulp blood of the patients in the observation group were 132.28±63.55 ng/ml and 114.36±19.57μg/ml respectively,and the levels of PGE-2 and EA in the pulp blood of the patients in the control group were 0.61±1.26 ng/ml and 19.38±6.34μg/ml respectively.There were statistically significant differences between the two groups (t=43.129,29.675,P<0.05). There was a positive relationship between the PGE-2 level and EA level in the pulp blood of the patients in the observation group (r=0.782,P<0.05).The levels of PGE-2 and EA in the pulp blood before the treatment of the patients with suc-cessful effects were 84.63±13.17 ng/ml and 68.25±8.16μg/ml,and the levels of PGE-2 and EA in the pulp blood before the treatment of the patients with failed effects were 177.35±41.42 ng/ml and 152.36±16.28μg/ml.There were statisti-cally significant differences between the two types of patients (t=31.578,21.556,P<0.05).Conclusion The patients with carious tooth complicated with exposed pulp show the significantly increased expression levels of PGE-2 and EA in pulp blood.The higher expression levels of PGE-2 and EA before the treatment could put adverse influence on the curative effects of direct pulp capping treatment.The clinicians should give the comprehensive consideration to the specific condition of pa-tients to choose the proper treatment methods.

The effectiveness of using different pulp-capping agents on the healing response of the pulp.

Background: Some of the disadvantages of calcium hydroxide Ca(OH) 2 as pulp-capping material are related to the inflammatory response, and its poor sealing ability. Cyanoacrylate glue was proposed in this study as pulp-capping agent because of its sealing ability, and diprogenta, on the other hand, was proposed because of its anti-microbial and anti-inflammatory effects. The aim of this study is to evaluate and compare the histopathological response of the pulp toward cyanoacrylate and diprogenta in direct pulp capping (DPC). Materials and Methods: Cyanoacrylate, diprogenta, and calcium hydroxide were applied on 20 permanent teeth of 6 rabbits divided into four groups, each contains five teeth, as follow: G1: Diprogenta and calcium hydroxide. G2: Cyanoacrylate. G3: Diprogenta and cyanoacrylate. G4: Calcium hydroxide (control group). Results: A remarkable dentin bridge formation was found in all groups. No pulp necrosis was found in any tooth of the four groups. Pathological reactions of the pulp were found in 25%, 40%, 20%, and 100% of groups 1, 2, 3, and 4, respectively. Differences between study and control groups were found statistically significant ( P < 0.05). Conclusion: All materials used in this study were biocompatible and suggested to be studied further on human teeth. These materials when used in combination with Ca(OH) 2 , may give better results

Considerations during crown reattachment procedure over the pulpal exposure: case report

Crown reattachment is the most conservative treatment which can be used to restore fractured tooth, presumably with sufficient strength, while maintaining original contour, incisal translucency, and reducing chair time and cost. However, in case of crown fracture with pin-point pulp exposure, we should cautiously minimize the irritation to the pulp and consider pre-treatment pulpal status, choice of pulp capping materials, choice of bonding system and treatment sequence during crown reattachment procedures. This case reports the considerations while crown reattachment with direct pulp capping using calcium hydroxide (Dycal, Dentsply Caulk).

Mineral Trioxide Aggregate. A Better Pulp-Capping Material. Review And Case Report.

Pulp capping is defined as the placement of a dental material over an exposed pulp to initiate the formation of irritation dentin at the site of injury. Classically, different formulations of calcium hydroxide have been used. Today, a newer material is advocated for vital pulp therapy, mineral trioxide aggregate (MTA). It is proved that the exposed dental pulp has the capacity to heal when micro leakage and bacterial contamination are prevented. An effective pulp-capping material should be biocompatible, osteoinductive and it should provide a biological seal and prevent bacterial leakage.This article describes these properties of MTA and a case report of direct pulp capping with MTA in a molar.

Pulp response of beagle dog to direct pulp capping materials: Histological study / 대한치과보존학회지

The purpose of this study was to evaluate the pulp tissue reaction to direct pulp capping of mechanically exposed beagle dogs'pulp with several capping materials. A total of 36 teeth of 2 healthy beagle dongs were used. The mechanically exposed pulps were capped with one of the followings: (1) Mineral Trioxide Aggregate (MTA: ProRoot(R) MTA, Dentsply, Tulsa, USA), (2) Clearfil SE Bond (Dentin adhesive system: Kuraray, Osaka, Japan), (3) Ultra-Blend (Photo-polymerized Calcium hydroxide: Ultradent, South Jordan, USA), (4) Dycal (Quick setting Calcium hydroxide: LD Caulk Co., Milford, USA) at 7, 30, and 90 days before sacrificing. The cavities were restored with Z350 flowable composite resin (3M ESPE, St. Paul. MN, USA). After the beagle dogs were sacrificed, the extracted teeth were fixed, decalcified, prepared for histological examination and stained with HE stain. The pulpal tissue responses to direct pulp capping materials were assessed. In MTA, calcium hydroxide, and photo-polymerized calcium hydroxide groups, initial mild inflammatory cell infiltration, newly formed odontoblast-like cell layer and hard tissue bridge formation were observed. Compared with dentin adhesive system, these materials were biocompatible and good for pulp tissue regeneration. In dentin adhesive system group, severe inflammatory cell infiltration, pulp tissue degeneration and pulp tissue necrosis were observed. It seemed evident that application of dentin adhesive system in direct pulp capping of beagle dog teeth cannot lead to acceptable repair of the pulp tissue with dentine bridge formation.

Direct pulp capping with a self-etching adhesive and calcium hydroxide on human pulp / 实用口腔医学杂志

Objective:To evaluate the human pulp response following direct pulp capping with Clearfil SE BOND (SB). Methods:45 sound human third molars in 24 volunteers were used. Pulp of 41 molars was mechanically exposed and then the teeth were divided into two groups: in group A the pulp was capped with SB, in group B the pulp was capped with calcium hydroxide (CH), another 4 teeth were served as the control. After 7, 30 and 90 days, the teeth were extracted and processed for light microscopic examination. Results:7-30 days after capping slight inflammatory reaction was observed in group A and group B. The reaction in group A was sligter than that in group B(P