Initial inflammatory response after the pulpotomy of rat molars with MTA or ferric sulfate

Abstract Purpose To compare, both qualitatively and quantitatively, the inflammatory cells, vascular density and IL-6 immunolabeled cells present in the pulp after pulpotomy with white MTA versus 15.5% ferric sulfate (FS). Methodology Forty-eight mandibular first molars from 24 Wistar rats were divided into MTA or FS groups and subdivided according to the period after pulpotomy procedure (24, 48 and 72 hours). Four teeth (sound and untreated) were used as controls. Histological sections were obtained and assessed through the descriptive analysis of morphological aspects of pulp tissue and the quantification of inflammatory cells, vascular density and interleukin-6 (IL-6) expression. Data were statistically analyzed (p<0.05). Results The number of inflammatory cells was similar in both groups, being predominantly localized at the cervical radicular third. In the MTA group, increased inflammation was observed at 48 hours. Vascular density was similar in both groups and over time, being predominant in the medium radicular third. No correlation was found between the number of inflammatory cells and the vascular density. Pulp tissue was more organized in MTA-treated teeth. In both groups, a weak to moderate IL-6 expression was detected in odontoblasts and inflammatory cells. Comparing both groups, there was a greater IL-6 expression in the cervical radicular third of teeth treated with MTA at 24 hours and in the medium and apical thirds at 72 hours, while in the FS group a greater IL-6 expression was found in the apical third at 24 hours. Conclusion The MTA group presented better histological features and greater IL-6 expression than the FS group. However, no difference was observed between the groups regarding the inflammatory status and vascularization, suggesting the usefulness of FS as a low-cost alternative to MTA.

Pulpotomías con sulfato férrico y MTA en dientes primarios: serie de casos / Ferric sulfate and MTA pulpotomies in primary teeth: a case series

En 11 pacientes se realizaron 7 pulpotomías con agregado trióxido mineral (MTA) y 6 con Sulfato Férrico (SF). Se incluyeron pacientes que presentaron dientes primarios con exposición accidental de la pulpa durante la remoción de caries en ausencia de signos y síntomas clínicos y/o radiográficos de patología pulpar. Las piezas tratadas fueron restauradas con coronas preformadas de acero inoxidable y controladas clínica y radiográficamente cada 6 meses. El seguimiento promedio fue de 15,6 meses para ambos grupos, con éxito clínico de un 100 por ciento para ambos medicamentos. El éxito radiográfico fue de 85,71 por ciento para el MTA y de 83,33 por ciento para el SF. Si bien ambos medicamentos presentaron un buen desempeño clínico y radiográfico durante el periodo de seguimiento, el SF fue más económico y necesitó un menor tiempo de trabajo, característica deseable en odontopediatría.

In eleven patients 7 pulpotomies were performed with Mineral Trioxide Aggregate (MTA) and 6 with ferric sulphate (FS). We included patients who had primary teeth with accidental exposure of the pulp during caries removal in the absence of clinical signs and symptoms and / or radiographic evidence of pulpal pathology. The treated pieces were restored with preformed stainless steel crowns and controlled clinically and radiographically every 6 months. The average follow-up was 15.6 months for both groups, with clinical success of 100 percent for both treatments. Radiographic success was 85.71 percent for the MTA and 83.33 percent for SF.ÊAlthough both procedures showed good performance during the clinical and radiographic follow-up period, the SF was cheaper and required less working time, a desirable characteristic in pediatric dentistry.

[Histopathological evaluation of pulp changes after ferric sulfate and formocresol pulpotomy in primary teeth]

Formocresol is an inrtacanal medicament commonly used for pulpotomy in the primary dentition. Because of its toxic and carcinogenic potential, it has been challenged by other chemical treatments. The purpose of this study was to histologically assess the pulpal healing process in pulpotomized primary teeth, using two different agents: formocresol and ferric sulfate. A total of 16 primary cuspids [8 pairs] from 8 patients who were scheduled for orthodontic extraction were selected and randomly divided into 2 groups. One tooth from each pair of contralatcral teeth was assigned to either formocresol or ferric sulfate pulpotomy. Four pairs were extracted after 1 month and the other 4, after 2 months. Pulpal response was determined according to the degree of inflammation and extent of pulpal involvement. Dentinal bridge formation was also evaluated. The data were analyzed using Wilcoxon test. No significant difference was found between the two groups for inflammation, absecess, root resorption and dcntinal bridge formation. Necrosis was more extensive in the formocresol pulpotomy group [p<0.05]. Based on these results, formocresol can be substituted with ferric sulfate for pulpotomy of primary teeth

O uso do agregado de trióxido mineral (MTA) em odontopediatria / The use of mineral trioxide aggregate in pediatric dentistry

O material MTA (Agregado de Trióxido Mineral) foi inicialmente desenvolvido para selar comunicações entre o dente e a superfície externa periodontal. Foram encontradas no MTA propriedades como a alta alcalinidade, baixa solubilidade, excelente selamento marginal, capacidade antimicrobiana, radiopacidade, estabilidade dimensional, resistência à compressão e elvada biocompatibilidade, com formação de barreira de tecido mineralizado pela polpa dentária em maior quantidade e qualidade que o hidróxido de cálcio. Diante destas características, o MTA passou a ser credenciado com um material promissor para uso em procedimentos conservadores com pulpotomias de dentes decíduos e capeamento pulpar direto e pulpotomias em dentes permanentes jovens, procedimentos usuais na odontologia infanto-juvenil. Este trabalho tem como objetivo, através de revisão da literatura, demonstrar a viabilidade da utilização do matrial MTA para os procedimentos realizados em odontopediatria e seu potencial futuro de vir a ser o material de eleição para esses procedimentos

Pulpotomy therapy in primary teeth: seeking a biological material

A pulpotomia ainda é um procedimento muito empregado em Odontopediatria. Em funçäo disso, muitas pesquisas têm sido desenvolvidas com o objetivo de identificar um material que produza a reparaçäo do tecido pulpar de forma mais natural e biológica. Dentro dessa ótica, este trabalho visa fazer uma revisäo da literatura apresentando as alternativas de materiais que produzam reaçöes biológicas, testados em pulpotomias, quais sejam: hidróxido de cálcio, colágeno e proteínas morfogenéticas ósseas