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.

Incorporation of a polymerization catalyst for improved mechanical behavior and physicochemical characteristics of a light-cured pulp capping material / Incorporação de um catalisador de polimerização para aprimorar propriedades mecânicas e fisíco-químicas de um protetor pulpar fotoativável

Objective: To evaluate the influence of the incorporation of a polymerization catalyst to a light-cured pulp capping material on mechanical behavior and physicochemical characteristics. Material and Methods: Different percentages (2 wt%, and 4 wt%) of diphenyliodonium hexafluorophosphate (DPI) were incorporated into the Ultra-Blend Plus, a resin-modified calcium-based cement. The material without incorporation of DPI (0 wt%) served as control. Degree of Conversion (DC), Flexural Strength (FS), Elastic Modulus (EM), Water Sorption (WSp), Solubility (Sl), and pH of eluate at 24-h, 72-h, and 7-day storage times were measured. One-way ANOVA/Tukey posthoc tests were used to analyze the data (p <0.05). Results: For DC, FS, and EM, materials with different % of DPI showed statistically significant differences, so that 0% provided the lowest values and 2% the highest values. Materials with 0% and 2% of DPI provided statistically the lowest WSp, whilst material with 0% of DPI showed statistically the highest Sl. Conclusion: All materials provided statistically similar pH to eluates regardless of storage time, although only materials with DPI at 2% and 4% maintained pH of eluates statistically similar from 72 h to 7 days storage times.(AU)

Objetivo: avaliar a influência nas propriedades mecânicas e físico-químicas da incorporação de um catalisador de polimerização a um protetor pulpar fotoativável. Material e Métodos: foram adicionadas diferentes porcentagens em massa (2% e 4%) de hexafluorofosfato de difeniliodônio (DPI) ao Ultra-Blend Plus, um cimento à base de hidróxido de cálcio modificado por resina. O material sem a adição do DPI (0%) serviu como controle. Foram avaliados: Grau de Conversão (DC), Resistência Flexural (FS), Módulo de Elasticidade (EM), Sorção (WSp), Solubilidade (SI) e o pH do eluato nos tempos de 24h, 72h e 7 dias de armazenamento. ANOVA 1-way com pós-teste de Tukey (p <0.05). Foi utilizado para avaliar os resultados estatisticamente. Resultados: Os materiais com diferentes % de DPI apresentaram diferenças significativas para os testes de DC, FS e EM. A porcentagem em massa de 0% de DPI mostrou valores inferiores a todos os testados e os materiais com adição 2% apresentaram a melhor performance. Materiais com 0% e 2% de DPI apresentaram valores inferiores de WSp; a porcentagem de 0% proporcionou valores estatisticamente maiores para SI. Conclusão: Todos os materiais testados apresentaram pH semelhante nos eluatos independente do tempo de armazenamento, contudo, apenas os materiais com 2% e 4% mantiveram o pH dos eluatos estatisticamente similares nos tempos de estocagem de 72h a 7 dias.(AU)

Microleakage and Shear Bond Strength of Biodentine at Different Setting Time / 대한소아치과학회지

The purposes of this study were to evaluate microleakage of Biodentine, one of the tricalcium silicate based pulp-capping materials, and to compare the shear bond strength between composite resin and Biodentine with different setting times. For microleakage evaluation, 70 bovine teeth were used. Cavities were formed on the labial surfaces and filled with Biodentine. The teeth were divided into seven groups, each consisting of 10 teeth. The specimens were prepared by applying the composite resin on the upper side after different setting times. To evaluate shear bond strength, 210 acrylic resin blocks with central grooves were prepared, and the grooves were filled with Biodentine. The acrylic resin blocks were divided into seven groups of 30 specimens each, and the specimens were prepared by applying the composite resin on the upper side after different setting times.In samples with setting time of 24 hours or longer period, the microleakage between composite resin and Biodentine was reduced significantly while the shear bond strength increased to offset the polymerization shrinkage of the composite resin. Setting Biodentine for more than 24 hours before composite resin restoration would lead to more favorable clinical result.

Desenvolvimento e análise de bandagem de bioestimulação dentino/pulpar (BBio) / Development and analysis of dental/pulpar bio-stimulation bandage ("BBIO")

O desenvolvimento de biomateriais com aplicações na área da saúde mostram-se cada vez mais importantes e a procura por novos polímeros com propriedades bioativas, biodegradabilidade, atoxicidade são o foco das principais pesquisas em diferentes aplicações médicas e odontológicas. Os materiais capeadores pulpares evoluíram rapidamente na ultima década, sendo que são disponibilizadas atualmente diversas alternativas para uso clínico odontológico. Este trabalho teve como objetivo o desenvolvimento de um novo produto bioestimulador e capeador dentino/pulpar que poderá ser base para o desenvolvimento e recobrimento de scaffolds para reparo das diferentes estruturas dentárias. O desenvolvimento das bandagens BBio e os resultados obtidos nos testes das propriedades físico-químicas (absorção de água, perda de massa e pH), bem como as análises biológicas da morfologia celular e viabilidade celular com MTT a BBio apresentaram dados favoráveis e desejáveis para sua aplicação clínica. A propriedade de liberação de cálcio foi bastante promissora, sendo esta uma condição que dará a diferenciação positiva da BBio como um produto bioestimulador pulpar. Com esses dados pode-se concluir que a mesma se encontra dentro dos parâmetros desejados para o produto final e com propriedades semelhantes aos produtos existentes no mercado, de qualidade e aprovados pelas agências reguladoras.(AU)

The development of biomaterials with applications in the health area are increasingly important and the search for new polymers with bioactive properties, biodegradability and toxicity are the focus of the main researches in different medical and dental applications. The pulp capping materials evolved rapidly in the last decade, and several alternatives are now available for clinical dental use. This project aimed to develop a new biostimulating and dentin / pulp capping product that could be the basis for the development and recoating of "scaffolds" for repair of different dental structures. The development of the BBio bandages and the results obtained in the physical-chemical properties tests (water absorption, loss of mass and pH), as well as the biological analyzes of the cellular morphology and cell viability with MTT to BBio presented favorable and desirable data for its clinical application. The calcium release property was quite promising, and this is a condition that will give BBio a positive differentiation as a pulp biostimulator product. With this data it can be concluded that it is within the parameters desired for the final product and with properties similar to the products on the market, of quality and approved by the regulatory agencies.(AU)