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The influence of some dentin primers on calcium hydroxide lining cement.

UNLABELLED: Dentin primer is applied as a routine procedure prior to bonding to improve the sealing properties of direct polymerizing resins. Some primers contain acetone or alcohol that may affect the properties of calcium hydroxide liner which is placed as a direct or indirect pulp cap. If calcium hydroxide is softened or smeared over the cavity walls, the bonding will be impaired. Therefore, if this occurs, the cement must be removed, the walls must be cleansed, and the procedure must be repeated with careful application of dentin primer. OBJECTIVE: The purpose of this study was to determine the wear and compressive strength of a calcium hydroxide liner after exposure to different kinds of dentin primers for different periods of time. METHODS: The calcium hydroxide used in this study was Dycal. It was mixed according to the manufacturer's instructions and placed in plastic rings of 0.5 mm x 5 mm and allowed to set at 37 degrees C for 15 min under 500 gm load. To determine erosion, the height for each sample before and after application of primers was recorded using a Digital Height Measuring Instrument "Digmar" 817. Compressive strength specimens were also prepared. RESULTS: Calcium hydroxide treated with Optibond (alcohol based) or Syntac (acetone based) for 1 min or 5 min had the highest erosion values and the lowest compressive strength values. Gluma CPs (water based primer) had the least effect on calcium hydroxide values.

Analysis of Variance↗

Dycal versus Nd:YAG laser and Vitrebond for direct pulp capping in permanent teeth.

PURPOSE: To determine the efficacy of laser-assisted direct pulp capping by comparing the survival rates of permanent teeth treated with Nd:YAG laser and Vitrebond (3M Corporation, St. Paul, MN) direct pulp caps to permanent teeth treated with the traditional calcium hydroxide direct pulp cap over intervals of up to 54 months. SUMMARY BACKGROUND DATA: While there are case reports and evaluations of various laser techniques in the literature, statistical studies comparing the success of laser-assisted applications to traditional techniques are needed. This is a retrospective investigation of one such laser assisted application. METHODS: A retrospective chart review of all active and inactive patients resulted in the identification of 83 patients who received direct pulp caps in a total of 93 permanent teeth; 29 with calcium hydroxide and 64 with Nd:YAG laser and Vitrebond. RESULTS: Life table analysis of the data of this retrospective study demonstrated that the teeth treated with the laser and Vitrebond direct pulp cap showed significantly greater survival rates than those treated with Dycal direct pulp cap over intervals of nine to 54 months postoperatively. The cumulative proportion of teeth surviving postoperatively for the Dycal (L.D. Caulk Corporation, Milford, CT) direct pulp cap was 89.7% at 1 month declining to 79.4% at 3 months and 76% at 6 months and then continued to decline in the final two intervals finishing after 54 months at 43.6%. For the laser and Vitrebond direct pulp cap the cumulative proportion surviving stood at 98.4% after 1 month, declining to 93.8% at 3 months and 90.3% after 6 months but then held steady in the final 2 intervals finishing at 90.3% after 54 months. CONCLUSION: The laser and Vitrebond direct pulp cap produces a significantly more predictable pulpal response after the first 6 months than the Dycal direct pulp cap. The survival rate of teeth treated with the laser and Vitrebond direct pulp cap is significantly greater than those treated with the Dycal direct pulp cap over intervals of 9 to 54 months. Direct pulp capping is a worthwhile procedure that should be performed when indicated, especially in light of the 90.3% survival rate achieved with the laser and Vitrebond direct pulp cap at 54 months.

Calcium Hydroxide↗

Clinical and microbiological effect of calcium hydroxide protection in indirect pulp capping in primary teeth.

PURPOSE: To evaluate clinically and microbiologically the effect of calcium hydroxide (CH) on carious dentin on primary teeth submitted to indirect pulp capping (IPC). METHODS: Twenty 4-7 year-old subjects with 42 treated teeth participated in the study. The treatment consisted of incomplete excavation of the demineralized dentin, application of a CH or gutta-percha (GP) layer and sealing with a resin-based composite for 4-7 months. After cavity preparation and sealing, the dentin was evaluated clinically (color and consistency) and microbiologically. Dentin samples were cultured on blood agar under aerobic and anaerobic conditions, in Mitis Salivarius agar and Rogosa SL agar. RESULTS: 39 teeth (20 in the CH Group and 19 in the GP Group) were reopened 4-7 months post-treatment for clinical and microbiological evaluation. In all teeth, the initial demineralized dentin was wet and soft or leathery. In the CH Group, 10% of the lesions were yellow, 80% light brown and 10% dark brown and in the GP Group, 94.7% were light brown and 5.3% dark brown. After treatment, the dentin was dry, 90% (Group CH) and 84.2% (Group GP) were dark brown. The final consistency was either leathery or hard. Three samples in the CH Group and five in Group GP changed from soft to leathery; only one sample (GP) remained leathery. 85% in the CH Group and 68.4% in GP Group turned hard after treatment. All bacterial counts decreased significantly by the end of treatment. In the CH Group, the bacterial (Log10 CFU + 1) anaerobic growth decreased from 4.84 +/- 1.31 to 1.35 +/- 1.54, aerobic from 4.09 +/- 1.04 to 0.92 +/- 1.30 and lactobacilli from 3.24 +/- 1.22 to 0.36 +/- 0.89, respectively; the mutans streptococci from 2.05 +/- 1.84 to 0.14 +/- 0.60. In GP Group, anaerobic growth decreased from 5.22 +/- 0.96 to 2.02 +/- 1.65 and aerobic from 4.23 +/- 1.37 to 1.08 +/- 1.29 and lactobacilli from 2.06 +/- 1.81 to 0.00 +/- 0.00, respectively; the mutans streptococci from 3.16 +/- 1.59 to 0.28 +/- 0.84.

Calcium Hydroxide↗

Induction of dentin formation on canine amputated pulp by recombinant human bone morphogenetic proteins (BMP)-2 and -4.

Dental pulp cells have the potential to differentiate into odontoblasts. The molecular mechanisms underlying differentiation are not clear. Demineralized dentin matrix is osteoinductive and contains bone morphogenetic protein (BMP) activity. BMPs have been implicated in embryonic odontogenic differentiation and hence may play a role in the differentiation of adult pulp cells into odontoblasts during pulpal healing. This study examined the hypothesis that BMPs induce dentin formation on amputated canine pulp. Recombinant human BMP-2 and BMP-4 were capped with inactivated dentin matrix on amputated pulp. At two months, the amputated pulp was filled with tubular dentin in the lower part and osteodentin in the upper part. The amount of dentin formed was markedly diminished when dentin matrix alone was implanted. These findings imply that recombinant human BMP-2 and BMP-4 induce differentiation of adult pulp cells into odontoblasts. Thus, BMPs may have a role in dentistry as a bioactive pulp-capping agent to induce dentin formation.

Animals↗