Self-solidifying hydroxyapatite/norvancomycin composite for pulp capping

Xiao XU; Junjun ZHAO; Junli HAN

ABSTRACT

BACKGROUND:

Hydroxyapatite has favorable biocompatibility, can protect pulp tissue and promote the formation of osteoid dentin and the concrescence of pulp tissue. However, hydroxyapatite has no capability of anti-infection. Increasing scholars deem that antibacterials should be added with the hydroxyapatite during the treatment of vital pulp conservation to elevate curative effects.

OBJECTIVE:

To observe the curative effects of self-solidifying hydroxyapatite/norvancomycin composite as pulp capping material and to make a comparison with calcium hydroxide.DESIGN, TIME AND

SETTING:

The present randomized controlled observation experiment was performed at the General Dental Clinic, the Ninth People's Hospital, Shanghai Jiao Tong University Medical College between January 2004 and June 2005.PARTICIPANTS AND MATERIALS A total of 60 patients (60 teeth) that suffered from deep caries or pulp exposure, could return visit on time, and agreed to sign informed consents were selected for this study. These patients comprised of 28 males and 32 females, aged 9-40 years. Diagnosis criteria Teeth with food impaction pain and/or caloric stimulation pain which can relieve after stimulation removal; in addition, with no spontaneous pain, radiating pain, and hypnalgia. Self-solidifying hydroxyapatite/2.5% norvancomycin composite were prepared in the Department of Dental Material, Shanghai Second Hospital. Self-hardening calcium hydroxide was provided by Dentsply Company, USA.

METHODS:

All 60 patients were randomly divided into an experimental group and a control group, with 30 patients (30 teeth) per group. Self-solidifying hydroxyapatite/2.5% norvancomycin composite and self-hardening calcium hydroxide were applied as pulp capping agents in the experimental and control groups, respectively. Pulpal tissue reactions were assessed after 8 weeks. Teeth with normal response were restored permanently, and the others were given root canal treatment.MAIN OUTCOME

MEASURES:

Pulpal tissue reaction of patients.

RESULTS:

In the experimental group, one case showed vague pain after 1-week pulp capping and received root canal therapy, with success rate of 97%. In the control group, two cases presented with vague pain after 3-day and 1-week pulp capping, respectively, and also received root canal therapy, with success rate of 93%.

CONCLUSION:

Self-solidifying hydroxyapatite/norvancomycin composite acquires a high success rate of pulp capping, with curative effects similar to calcium hydroxide, it is a good pulp capping agent for vital pulp preservation.