Dental materials science in dental practice.
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A calcium hydroxide-containing cement (Reocap) was tested with regard to its suitability as a pulp capping agent. The pulp of 34 monkey teeth was exposed and Reocap was applied to the pulp wound and the cavity floor, after which the cavities were filled with amalgam. The observation periods were 8 days (10 teeth) and 80 days (24 teeth). After 8 days a necrotic area was seen in the pulp subjacent to the pulp capping agent and the surrounding tissue was inflamed to varying degree. After 80 days hard tissue formation was observed at the exposure site in 21 teeth. The hard tissue enclosed areas of necrotic and/or vital tissue and a complete bridge had not formed. In 7 teeth the pulp was necrotic whereas 3 teeth presented a pulp free of inflammation. In the remaining teeth the pulp showed a chronic inflammatory reaction. As judged by these results, Reocap does not appear to be as well suited as a pulp capping agent as pure calcium hydroxide.
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The purpose of this study was to compare the responses of mechanically exposed dental pulps which had been capped with three dissimilar materials: a bioactive ceramic (Bioglass), autologous demineralized dentin matrix (DDM), and a calcium hydroxide product (Life), with Teflon discs as controls. Mechanical dental pulp exposures were made after preparation of deep buccal Class V cavities in 48 teeth in four miniature swine. The exposures were capped and the cavity preparations restored with zinc oxide-eugenol (IRM) cement. The animals were killed after 90 days, the coronal 2/3 of the teeth removed, and sections prepared for either histological or microradiographic examination. The pulpal inflammatory reactions and the degree of reparative dentin formation were assessed from demineralized serial sections. A qualitative assessment of the degree of mineralization of the reparative dentin was made from microradiographs of undecalcified sections. The observations suggest that reparative dentin formation occurs under a variety of pulp-capping materials, but the structure of the reparative dentin varies with the material and the condition of the underlying pulp.
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This study was designed to investigate by SEM the ultrastructure of the dentinal bridge formed upon pulp capping and its attachment to the contiguous dentinal walls. The pulps of 20 sound premolars and third molars were deliberately exposed and capped with a calcium hydroxide paste, Pulpdent. After 4 to 15 weeks the teeth were extracted. SEM observations suggested complete bridging, increasing in thickness after succeeding postoperative periods. Cross-sections of the specimens older than 6 weeks showed the presence of three different layers within the bridges: the superior amorphous layer was composed of tissue debris and Ca(OH)2, in the medial portion a coarse meshwork of fibers was identified as fibrodentine and the pulpal aspects exhibited tubularlike orthodentinal structures. The bridge attachment was secured by bundles of fibres linking the intertubular dentine of the pulpal walls with the dentine of the neodentinal bridge.
OBJECTIVE: To investigate the reparative dentine formation induced by the complex of recombinant human bone morphogenetic protein 2 (rhBMP2) and fibrin sealant (FS) in dog tooth. METHODS: Freshly exposed molars, premolars and cuspids were treated with the complex of rhBMP2/FS, rhBMP2 and Ca(OH)(2) paste which served as control. RESULTS: The wound healing of exposed pulp treated with FS seemed to be better than that without FS. Dentine bridge formation was observed in pulp treated with the complex at 7 days, with rhBMP2, Ca(OH)(2) at 28 days. At 63 days after operation, the cases of tubular dentine bridge formation of the pulp treated with the complex were more than that of pulp treated with rhBMP2. CONCLUSION: The synergistic effects of FS and the complex rhBMP2 exist and can be used as bioactive pulp capping agent.
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The purpose of this research was to compare the effect of two different particle sizes of hydroxyapatite and beta-tricalcium phosphate as capping agents on hard tissue barrier formation after experimental pulpotomy in canine dental pulp. By the thirtieth day after pulp exposure and capping with hydroxyapatite-300 (particle size, 300 microns), a hard tissue barrier was formed in 8 of 17 specimens. A newly formed barrier was seen around the hydroxyapatite particles and connecting neighboring particles. Capping with tricalcium phosphate-300 (particle size, 300 microns) led to the formation of a hard tissue barrier surrounding the particles in 11 of 17 specimens. In contrast, using hydroxyapatite-40 (particle size, 40 microns) and beta-tricalcium phosphate-40 (particle size, 40 microns), hard tissue barrier formation was poor and almost all pulp tissues showed infiltrations of inflammatory cells or abscess formation. These findings suggest that the particle size of hydroxyapatite and beta-tricalcium phosphate is an important factor in reparative hard tissue formation.
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