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PubMed1986

Endodontics.

It is known that pets with broken teeth or teeth with other diseases of the pulp suffer considerable pain and frequent infection. To ignore these problem teeth would not only be inhumane, it would risk chronic infection, abscessation, and tooth loss. Although extraction of these teeth is sometimes necessary, the procedure is often difficult to perform and painful for the animal. The resultant tooth loss is cosmetically displeasing and, frequently, there is compromise in function. The endodontic treatment of these teeth, on the other hand, is relatively easy to perform. It almost always results in immediate cessation of pain and will usually allow the tooth to remain functional for the lifetime of the pet.

Animals↗
PubMedDate not supplied

Comparison of pulp responses following restoration of exposed and non-exposed cavities.

OBJECTIVES: The purpose of this study is to compare and contrast differences of pulp responses between non-exposed and exposed cavity preparations in terms of inflammation, frequency of bacterial microleakage, odontoblast and odontoblastoid cell numbers, and tertiary dentine formation. METHODS: Class V non-exposed cavities (n=161) and exposed cavities (n=161 teeth) were prepared in non-human primate teeth. Cavities were restored with calcium hydroxide [Ca(OH)(2)], resin modified glass ionomer, or resin composite. Following extraction (7-730 days), bacteria were detected with McKays stain and pulp reactions were categorized according to ISO guidelines. Teeth were analyzed histomorphometrically and statistically using analysis of variance tests. RESULTS: Exposed cavities in comparison with non-exposed cavities were found to have more severe inflammation (p=0.0001), greater quantities of tertiary dentine (p=0.0001), and an increased frequency of bacterial microleakage (p=0.0034). The density of odontoblastoid cells beneath pulp exposed tertiary dentine was found to be 47.8% of odontoblast cell density beneath non-exposed dentine (p=0.0001). CONCLUSIONS: The restoration of exposed cavity preparations is associated with more traumatic pulp injury and repair responses. Consequently, efforts should be made to minimize iatrogenic dentine removal during cavity preparation and the creation of pulp exposures whenever possible.

Analysis of Variance↗
PubMed2002

[Mineralization of the dental pulp: contributions of tissue engineering to tomorrow's therapeutics in odontology].

When bioactive molecules such as bone sialoprotein (BSP), bone morphogenetic protein-7 (BMP-7, also termed OP-1) and chondrogenic Inducing Agents (CIA, A+4 and A-4) were implanted in the pulp of the first upper molars, mineralizations were induced. They were either limited to the formation of a reparative dentinal bridge closing the pulpal wound (CIA A+4), or filled the mesial part of the coronal pulp (BSP), or filled totally the pulp located in the root canal (BMP-7 and CIA A-4). Consequently, these molecules may change in the next future the every day practice in dentistry.

Animals↗
PubMed1995

Human pulp response after partial pulpotomy with two calcium hydroxide products.

Twenty human permanent teeth were used to study the pulpal response of two calcium hydroxide products, Dycal and Pulpdent Multi-Cal, after partial pulpotomy. Teeth were extracted at 4 months, fixed, and prepared for histologic examination. All 10 teeth treated with Dycal showed complete soft tissue healing and bridge formation. No stained bacteria were seen throughout the serial sections. One tooth treated with Dycal showed acceptable histologic results, dentin deposition in the root canal. Six cases dressed with Pulpdent Multi-Cal showed acceptable histologic results, whereas four teeth showed severe inflammation or necrosis associated with bacterial penetration into the pulp tissue. Clinically, one tooth treated with Pulpdent Multi-Cal showed pulpal pain and was extracted at 90 days. Our data support the thesis that human permanent pulps will promote tissue healing and dentin bridge formation as long as bacterial microleakage is excluded.

Bacteria↗
PubMed2002

Crown fractures in the permanent dentition: pulpal and restorative considerations.

Crown fractures account for the highest percentage of all traumatic injuries in the permanent dentition. This review paper will discuss the different types of crown fracture, from the uncomplicated to complicated, including crown-root fractures. It will focus on two different aspects: the pulp, with an attempt to correlate epidemiological, experimental, histopathological and clinical studies, so that the clinician can better understand the underlying processes accounting for success or failure to maintain pulp vitality. Also, we will consider the restoration: knowledge about bonding to dentin and new material is evolving extremely quickly making it difficult for the clinician to keep up with the developments. If handled properly, prognosis of the pulp, after traumatic crown fracture, is good. Prognosis of the restoration has also improved considerably over the last few years, and it appears that this trend will continue in the future.

Composite Resins↗
PubMed2002

The induction of reparative dentine by enamel proteins.

AIM: This study was designed to examine whether enamel matrix derivative (EMD) could induce reparative dentine formation without eliciting adverse side-effects in pulpotomized teeth in the miniature swine. METHODOLOGY: Pulpotomy was performed in 36 mandibular incisor teeth from 11 adult miniature swine. Following the surgical procedure, the exposed pulp tissue was treated with EMD or covered with a calcium hydroxide preparation (Dycal). Following an observation period of 3, 4 and 8 weeks, the experimental teeth were extracted and examined using light microscopy and histometric analysis. The total amount of reparative dentine formed in the EMD-treated teeth was calculated as total area using digital histomorphometry analysis of the five central-most sections from each experimental tooth. RESULTS: In the EMD-treated teeth, substantial amounts of dentine-like tissue formation consistently led to a complete hard-tissue bridging of the defects. The onset of hard tissue formation could be observed after 2 weeks and was located only on the pulpal wound. More limited dentine formation was also observed in Dycal-treated teeth. However, in these teeth the new hard tissue formed at the expense of pulp chamber width, causing narrowing of root canals. The total amount of reparative dentine formed in the EMD-treated teeth was significantly higher (P<0.005) than in the Dycal-treated specimens. CONCLUSION: These results demonstrate the potential of EMD as a biologically active pulp-dressing agent that specifically induces pulpal wound healing and dentine formation in the pulpotomized teeth without affecting the normal function of the remaining pulp.

Animals↗
PubMed2000

Primary molar pulp therapy--histological evaluation of failure.

OBJECTIVES: Qualitative comparison of the clinical, radiographic and histological outcomes in a small sample of cariously exposed primary molars, extracted after unsuccessful pulp treatment by two vital pulpotomy methods. SUBJECTS AND METHODS: The primary molars were extracted, because of treatment failure, during a longitudinal clinical investigation of the relative efficacy of 20% Buckley's Formocresol versus calcium hydroxide powder as pulp dressings in vital pulp therapy (in press). Fifty-two child patients were sequentially enrolled in the longitudinal clinical investigation, 26 boys and 26 girls. Primary molar teeth requiring vital pulp therapy were randomly allocated to either the formocresol group (F) or the calcium hydroxide group (C). Coronal pulp amputation was prescribed only in teeth with vital, cariously-exposed pulp tissue. All cases were reviewed using predefined clinical and radiological criteria. Seventy-nine cariously-exposed primary molars required vital pulp therapy. Forty-four teeth were included in group F and 35 in group C. Five per cent (n = 2) of teeth in group F and 11 per cent of teeth (n = 4) in group C were terminated from the trial due to clinical and/or radiographic failure. Of the six teeth extracted, five were sufficiently intact to be retained for histological evaluation. RESULTS: Post-extraction radiographs taken before specimen preparation showed reactionary dentine barrier (bridge) formation in teeth treated with calcium hydroxide. However, the narrowing of root canals, indicative of appositional reactionary dentine deposition, was seen in both groups (F and C). Histological examination confirmed these findings and revealed that pus cells were evident in all specimens examined. There was also histological evidence of resorption of reactionary dentine within the root canal and that forming the calcified barrier (dentine bridge). CONCLUSION: The clinical and radiographic outcomes for the five teeth correlate well with the reported findings from decalcified histological section. Although numbers are small, the histological findings may indicate possible reasons for treatment failure. There are few reports of this sort in the literature of this under-researched treatment modality.

Calcium Hydroxide↗
PubMed2003

Comparison of bioactive glass, mineral trioxide aggregate, ferric sulfate, and formocresol as pulpotomy agents in rat molar.

Bioactive glass (BAG) is often used as a filler material for repair of dental bone defects. Although there is evidence of osteogenic potential of this material, it is not clear yet whether the material exhibits potential for dentinogenesis. Hence, the aim of the present study was to evaluate BAG as a pulpotomy agent and to compare it with three commercially available pulpotomy agents such as formocresol (FC), ferric sulfate (FS), and mineral trioxide aggregate (MTA). Pulpotomies were performed in 80 maxillary first molars of Sprague Dawley rats, and pulp stumps were covered with BAG, FC, FS, and MTA. Histologic analysis was performed at 2 weeks and then at 4 weeks after treatment. Experimental samples were compared with contra-lateral normal maxillary first molars. At 2 weeks, BAG showed inflammatory changes in the pulp. After 4 weeks, some samples showed normal pulp histology, with evidence of vasodilation. At 2 weeks, MTA samples showed some acute inflammatory cells around the material with evidence of macrophages in the radicular pulp. Dentine bridge formation with normal pulp histology was a consistent finding at 2 and 4 weeks with MTA. Ferric sulfate showed moderate inflammation of pulp with widespread necrosis in coronal pulp at 2 and 4 weeks. Formocresol showed zones of atrophy, inflammation, and fibrosis. Fibrosis was more extensive at 4 weeks with evidence of calcification in certain samples. Among the materials tested, MTA performed ideally as a pulpotomy agent causing dentine bridge formation while simultaneously maintaining normal pulpal histology. It appeared that BAG induced an inflammatory response at 2 weeks with resolution of inflammation at 4 weeks.

Aluminum Compounds↗
PubMed2000

A light and transmission microscopic study of mechanically exposed monkey pulps: dynamics of fiber elements during early dentin bridge formation.

OBJECTIVE: The aim of this investigation was to assess the role of the von Korff-like fibers (VKF) during the process of dentin bridging. STUDY DESIGN: The monkey pulps, exposed to a hard-set calcium hydroxide, were evaluated at 3, 7, 14, 21, 30, 90, and 180 days. RESULTS: At 21 days, longitudinal and transverse collagen fibrils were organized as lamellar structures in close proximity to and subjacent to the newly formed predentin. VKF bundles were present between newly formed odontoblastoid cells. The VKF were bundles of thin collagen fibrils inserted into the predentin, which consisted of thick collagen fibrils. At 30 days, the exposure site was completely occluded with a new predentin matrix; lamellar structures and VKF were no longer present. CONCLUSIONS: The VKF may play a role in the connective tissue attachment to the dentin bridge, early in its formation.

Animals↗