[Indirect pulp capping with calxyl in comparison to the so-called natural pulp capping; clinical and histological study].
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Monkey pulpal responses to four adhesive resin systems used as direct pulp capping agents were histopathologically evaluated at 3, 7, 14, 30, and 60 days after operation. No serious inflammatory reaction of the pulp, such as necrosis or abscess formation, was observed. Slight inflammatory cell infiltration was the main inflammatory reaction of the exposed pulp, and the exposed area became occluded with dentin bridging as the observation period increased. Healing of exposed dental pulp beneath adhesive resin capping slightly differed depending on the materials used.
This article presents a case with traumatic tooth fracture that was treated by direct pulp capping followed by fragment restoration. The fixed parts were reinforced by resin bonded metal plates.
It has been previously reported that short term application of calcium-hydroxide to the dental pulp resulted in the formation of a dentin bridge with matrix vesicle calcification. The present study deals with the induction of reparative dentin in rat molar pulps by direct capping with calcium-hydroxide. The teeth were examined after 21 and 35 days. Transmission electron microscopy (TEM) revealed that the calcification process in the newly formed dentin was characterized by apatite deposition in matrix vesicles and the occurrence of calcifying nodules in the matrix. The persistence of these features of primary mineralization, during the experimental period, was associated with the continuous calcium hydroxide contact with pulp tissue, producing changes in its metabolic state.
The results from this study showed a variety of pulpal responses to various calcium hydroxide materials when placed directly on the dental pulp. Two of the materials proved to be more successful at stimulating reparative dentin bridging and healing of the underlying pulp tissue. The remainder of the pulp capping agents were ineffective at healing the pulp and forming a reparative dentin bridge. When teeth were capped with these other agents, the pulp showed necrosis and chronic inflammation.
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As the reliability of dentine bonding agents has improved, the clinical uses of these systems has increased and now include the bonding of directly and indirectly constructed restorations, amalgam bonding and treatment of dentinal sensitivity. Areas of potential use which require further evaluation include pulp capping and the attachment of fractured tooth fragments.
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