Factors affecting the outcomes of direct pulp capping using Biodentine.

INTRODUCTION: This study aimed to evaluate the prognostic value of factors with regard to the treatment outcome of direct pulp capping using Biodentine (Septodont, Saint-Maur-des-Fossés, France), in permanent teeth in which the pulps were exposed during caries removal. METHODS: Between 2010 and 2014, 112 teeth with deep carious lesions underwent direct pulp capping. The patients were followed up at 2-3 months and 1-1.5 years with a routine examination on both recall visits. Periapical radiographs were taken at 1-1.5 years. Lack of patient complaints, positive reactions to cold and electric testing, no sensitivity to percussion, and no widening of the periapical ligament indicated success. The Fisher exact test was used for statistical analysis. The significance level was P = .05. RESULTS: Eighty-six teeth were available for 1-1.5 years follow-up. The overall success rate was 82.6%. Only age had a significant effect on the pulpal survival rate: the success rate was 90.9% in patients younger than 40 years and 73.8% in patients 40 years or older (P = .0480). Sex, initial or secondary caries treatment, occlusal or cervical/proximal caries, delayed placement of permanent filling, tooth position, and arch type did not influence the outcome. CONCLUSIONS: A patient's age influenced the outcome of direct pulp capping using this new calcium silicate cement. CLINICAL RELEVANCE: Asymptomatic vital permanent teeth with cariously exposed pulp can be treated successfully by direct pulp capping using Biodentine.

Microscopic evaluation of the tooth-bond-composite interface. Images from SEM. Preliminary report.

INTRODUCTION: Systems that bond composite material to enamel are constantly modernized (application is simplified and the number of system components is reduced). The latest products are one-coat systems combining etchant, primer, and bond. Use of such systems is easier for the dentist and adds to patient's comfort. The aim of this work was to evaluate microscopically the composite material--bond-enamel interface in a tooth processed with an abrasive technique. MATERIAL AND METHODS: The material comprised premolar human teeth extracted for orthodontic reasons. Cavities reaching the enamel-dentin border were created on the buccal surface of the teeth with the dental-prosthetic micropreparator (MSP). A self-etching Adper Prompt L-Pop system was applied (separate use of etchant was unnecessary). Bond application was according to manufacturer's recommendations. The cavities were filled with Point composite material from Kerr. Tooth samples were placed in the chamber of JEOL JSM 5500 LV scanning electron microscope and images were obtained at 15 kV. Strong bonding at the composite material-bond interface was observed as evidenced by the melting of composite particles into the self-etching bonding system.