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PubMed1996

Comparison of calcium phosphate cement mixture and pure calcium hydroxide as direct pulp-capping agents.

Calcium phosphate cement (CPC) and pure calcium hydroxide were used as direct pulp-capping agents on the deliberately exposed pulp tissue of 60 teeth in five monkeys. Their effects on the pulp tissue of individual teeth were observed and histologically compared after 12, 20 and 24 weeks. The results showed that both materials produced similar responses with regard to their biocompatibility and induction of hard tissue barrier formation. Vasodilatation, chronic inflammation and calcification nidi scattered within the pulp tissue of the 12-week group were observed. Twenty weeks after application of capping materials, a crude reparative dentinal bridge with inclusion of soft tissue or bulky capping agents appeared. A more mature, hard tissue barrier with a better degree of mineralization and formation of dentinal tubules was demonstrated in the 24-week group. The above findings associated with the abilities of self-setting and fair compressive strength suggest that CPC appears superior to pure calcium hydroxide and may have potential for clinical application, although many issues remain to be further investigated.

Animals↗
PubMed2003

Mineral trioxide aggregate (MTA) and calcium hydroxide as pulp-capping agents in human teeth: a preliminary report.

AIM: To compare mineral trioxide aggregate (MTA) with calcium hydroxide when used as pulp-capping materials in human teeth. METHODOLOGY: Eleven pairs of maxillary third molars in subjects between 20 and 25 years of age were subjected to mechanical pulp exposure. The exposed pulps were capped with MTA or calcium hydroxide, covered with ZOE and restored with amalgam. A total of 14 teeth were extracted after periods of 1 week (two molars) 2 months (three molars), 3 months (five molars), 4 months (two molars) and 6 months (two molars). RESULTS: Histological evaluation demonstrated less inflammation, hyperaemia and necrosis plus thicker dentinal bridge and more frequent odontoblastic layer formation with MTA than calcium hydroxide. CONCLUSIONS: Although the results favour the use of MTA, more studies with larger samples and a longer follow up are suggested.

Adult↗
PubMed2000

Lasers in endodontics: a review.

Since the development of the ruby laser by Maiman in 1960 and the application of the laser for endodontics by Weichman in 1971, a variety of papers on potential applications for lasers in endodontics have been published. The purpose of this paper is to summarize laser applications in endodontics, including their use in pulp diagnosis, dentinal hypersensitivity, pulp capping and pulpotomy, sterilization of root canals, root canal shaping and obturation and apicectomy. The effects of laser on root canal walls and periodontal tissues are also reviewed. The essential question is whether a laser can provide equal or improved treatment over conventional care. Secondary issues include treatment duration and cost/benefit ratio. This article reviews the role of lasers in endodontics since the early 1970s, summarizes many research reports from the last decade, and surmises what the future may hold for lasers in endodontics. With the potential availability of many new laser wavelengths and modes, much interest is developing in this promising field.

Dental Pulp↗
PubMed1982

Histologic study of pulp capping in rat molars using calcitonin.

Calcitonin, a calcium regulating hormone, has been found to affect bone formation and resorption. In this study a calcitonin preparation and a calcium hydroxide preparation for comparison were applied to both exposed and unexposed rat molar pulps. Histologic examinations were conducted after periods of 1 day to 28 days. Calcium hydroxide pulp caps produced varying amounts of secondary dentin and inflammation. Calcitonin applied as an indirect agent had a similar effect. When calcitonin was applied to exposed pulp, a large amount of dense fibrous connective tissue reminiscent of scar tissue was formed. With increased time this connective tissue exhibited signs of progressive, orderly calcification continuing through a large portion of the coronal pulp.

Animals↗
PubMed1983

Protein synthesis in vitro, in the presence of Ca(OH)2-containing pulp-capping medicaments.

Four Ca(OH)2-containing pulp-capping medicaments were compared for their effects on protein synthesis in early subcultures of monkey- and human-pulpal fibroblasts. While protein synthesis, as well as DNA synthesis, was depressed by three of the medicaments, the protein-synthetic rate in human-cell cultures in the presence of Life rose to control levels when the medium was changed daily, but was depressed when the medium was not changed. This suggests that serum proteins play a protective role for pulpal tissues under inflammatory conditions, at least in the case of Life, allowing odontoblasts to differentiate and make dentinal matrix without interference of either toxic components or excess alkalinity.

Animals↗
PubMed1990

[Calcitonin in direct and indirect pulp capping].

Calcitonin, the hormone produced by C cells of the thyroid playing a great role in calcium homeostasis, was used for direct and indirect pulp capping. This procedure was done on 200 teeth. Late follow-up after 12, 18 and 24 months or even longer was obtained in 146 cases: 110 with indirect pulp capping and 36 with direct capping. In the first follow-up examination 7 cases were regarded as failures, in late follow-up 5 failures were found, thus the total failure rate was 3.8%. The usefulness of calcitonin for biological treatment of pulp is unquestionable.

Adolescent↗
PubMed1981

Transmission electron microscopy of reparative dentin in rat molar pulps. Primary mineralization via extracellular matrix vesicles.

A reparative dentin bridge was induced in rat molar teeth by pulp exposure and capping with calcium hydroxide. Transmission electron-microscopic examination after 10 days revealed the presence of odontoblastic cells and collagenous matrix with focal calcifications. The calcifying fronts were composed of hydroxyapatite crystals. Numerous extracellular matrix vesicles were scattered between the forming cells and the calcifying fronts. Some of the vesicles contained electron-dense material and in others, apatite crystals were detected. Matrix vesicles could not be identified in normal, mature calcifying dentin matrix. In view of the present observations and studies on surgical manipulations in articular cartilage, it is concluded that matrix vesicle calcification may result from alterations in the metabolic state of mesenchymal tissues. These changes can be induced surgically or chemically.

Animals↗
PubMedDate not supplied

In vivo tetracycline labeling of experimentally induced reparative dentin in human teeth.

Tetracycline hydrocholoride was administered to label reparative dentin in teeth indicated for extraction. Deep cavities or pulp capping performed on the teeth one of four months before extraction served as a stimulus for new dentin formation. Examination of undemineralized sections under ultraviolet light revealed fluorescent bands in the reparative dentin of most teeth. The technique can be safely used in studies of the effects of clinical procedures on the dentin and pulp of human teeth.

Administration, Oral↗
PubMed1991

The effect of pulp capping and pulpotomy on hard tissue bridges of contaminated pulps.

The pulp and dentine of permanent incisors in 13 young monkeys were exposed by grinding. The pulpal perforations were treated by partial pulpotomy with a tungsten carbide fissure bur after exposure for 4, 48, or 168 hours in nine animals, and by direct pulp capping after exposure for 4 or 48 hours in the remaining four animals. After haemostasis, the pulpal wounds were covered with calcium hydroxide (Dycal), followed by conventional amalgam (Revalloy). Initial and subsequent formation of hard tissue bridges over the wounds was studied by conventional histology after 1-6 months. Screening showed three categories of initial bridging development, differing in nature and rate of formation. A significant difference in the distribution of the two main categories was found between the two methods of treatment (P less than 0.02). A similar difference was observed when partial pulpotomy was performed after 168 hours compared with that performed after 4 hours (P = 0.055). No relationship was found between the initial bridging category and the eventual development of complete dentine bridges.

Animals↗
PubMed1993

In vitro release of calcium and hydroxyl ions from two types of calcium hydroxide preparation.

Non-setting and setting pastes are the most common forms of calcium hydroxide, used in endodontics. The aim of this study was to investigate the differences in the availability of calcium and hydroxyl ions from some commercial preparations of both types. In vitro released calcium and hydroxyl ions were determined by a potentiometric method, after diffusion through sintered glass. The non-setting pastes evaluated were Calcipulpe, Calxyl Red, Calxyl Blue and Cinacal; while setting base materials were represented by Dycal, Nu-Cap and Reolit. The data obtained showed significantly higher availability of calcium and hydroxyl ions from non-setting pastes, compared with 'alkaline cements' (P < 0.05). Great variations in the amount of released ions were also found among samples of the same material.

Analysis of Variance↗
PubMed1993

Ultrastructure of wound healing following direct pulp capping with calcium-beta-glycerophosphate (Ca-BGP).

Tissue changes in rat incisors after direct pulp capping with calcium-beta-glycerophosphate (Ca-BGP) have been studied using light and electron microscopy. Immediately after pulp capping, Ca-BGP was converted to hydroxyapatite (HAP) at the cavity floor. At Day 1, the exposure site was covered with Ca-BGP-mediated mineralized tissue. Osteodentine had developed below this mineralized tissue at Day 3. Matrix vesicles (MV) were observed in the extracellular matrix between large cells and osteodentine. At Day 5, tubular dentine was observed below the osteodentine. Three days after the application of Ca(OH)2 in a control experiment, osteodentine had formed below the necrotic zone; however, tubular dentine was not observed at Day 5. These findings suggest that the applied Ca-BGP might be the source of Ca and inorganic phosphate (Pi) through hydrolysis by alkaline phosphatase (ALP), and that Ca-BGP-mediated mineralized tissue induces the early formation of tubular dentine.

Animals↗
PubMed1999

Hydroxyapatite applied as direct pulp capping medicine substitutes for osteodentin.

Tissue changes in rat incisors after direct pulp capping with hydroxyapatite (OH-AP) have been investigated using light and electron microscopy. Immediately after direct pulp capping, necrotic cells and cell debris were scattered only in the superficial zone of an exposed site. At day 1, both neutrophils having many vacuoles and macrophages phagocytizing numerous OH-AP granules appeared in the lower part of the OH-AP layer. At day 3, the cells surrounding the basal part of the OH-AP layer had large nuclei and well-developed rough-surfaced endoplasmic reticulum. At day 5, the newly formed mineralized tissue consisting of needle-like crystals was observed directly adjacent to the deepest zone of the OH-AP layer. However, fibroblast-like cells phagocytosing applied OH-AP granules were seen even at this period. These findings suggest that the applied OH-AP could directly substitute for osteodentin.

Animals↗
PubMed1998

Dentin bridge formation following direct pulp capping in dog's.

The effectiveness of two different calcium hydroxide pastes; "Calvital and "Dycal", for the direct pulp capping in dog's permanent teeth with incompletely formed roots were evaluated in this study. Forty-eight vital permanent premolar teeth with incompletely formed apices were obtained from 6 dog's (6 months of age). Exposure sites on contralateral pairs of teeth were capped with either "Calvital" or "Dycal". Then intravenous injections of tetracycline were administered to the dogs at various intervals. Animals were sacrificed at 56 days. The teeth were fixed, undecalcified ground sectioned, observed by microradiography, and evaluated by ultraviolet light. In cases treated with "Calvital", a fluorescent line resulting from tetracycline administration 7 days after experimental procedures was seen in the newly formed dentin bridge. In cases treated with "Dycal", a fluorescent line resulting from tetracycline administration 14 days after experimental procedures was seen in the newly formed dentin bridge. Continued physiological root formation was observed well in all teeth. This experiment may explain why some "Dycal" failures occur in the earlier postoperative periods; serves as a stimulus potential for a hardening reaction.

Animals↗
PubMed2003

[Success rate of direct pulp capping with calcium hydroxide].

Aim of this retrospective study was to evaluate the success rate of direct pulp-capping treatment using calcium hydroxide-containing agents according to the age of the patient, the type of tooth and the person who performed the treatment. Over a period of seven years a total of 659 patients were treated. 763 direct pulp-cappings were recorded. From these 308 patients a total of 359 pulp-cappings (= 100%) were reexamined one to eight years after treatment. 45.1% of the reexamined teeth were in males and 54.9% in females. 61.7% of the treated teeth were in the upper and 38.8% in the lower jaw. Out of the 359 teeth (= 100%) the success rate was 61% (219 teeth); while 113 teeth (31.4%) had received a root canal treatment and 27 (7.6%) had been extracted. In this study the success rate depended on the group of teeth. It decreased continuously from the anterior teeth to the molars. The central incisors showed the highest (83.3%) and the wisdom teeth the lowest (38.9%) success rate. In addition, the success rate decreased with increasing age of the patients. The most successful treatments (76.4%) were registered in the group of patients, aged 10-19 years.

Adolescent↗
PubMedDate not supplied

[The use of a bactericidal substance as medication in the indirect capping of healthy dentin].

An association of trimethoprim and sulphamethoxazol (Bactrim, Roche) was employed in the indirect capping of healthy teeth in the dog. Tetracycline labelling showed dentinogenesis in these teeth and comparison was made with the controls, A quantitative and qualitative change in dentinogenesis was noted below the control cavities. This alteration was less marked in Bactrim-treated teeth. It is deduced, therefore, that the operations involved in the preparation and filling of cavities in healthy teeth leads to pulp damage that can be partly prevented by using a bactericide.

Animals↗
PubMed2001

Comparative in vitro study of pulp capping materials.

AIM: In a comparative in vitro study we examined the bactericidal effect, adhesion and shrinkage of 5% potassium nitrate in Carboxy-Adhaesor, 5% potassium chloride in Carboxy-Adhaesor, Carboxy-Adhaesor, Adhaesor and Dycal. MATERIAL AND METHODS: The bactericidal effect of the investigated pulp capping materials on the isolated microorganisms Staphylococcus aureus, Staph. epidermidis, Streptococcus viridans alpha-haemolyticus, Streptococcus pneumoniae and Streptococcus beta-haemolyticus was assessed by the diffusion method around each disk in mm. The adhesion and shrinkage were assessed after hardening of the material. RESULTS: The results obtained showed higher bactericidal activity of polycarboxylate cements in comparison to Adhaesor and Dycal. The largest zone of inhibition was found around the disks with polyacrilic acid, followed by 5% KNO3 in polyacrilic acid, 5% KCl in polyacrilic acid; significantly smaller is the zone around Dycal. The difference was statistically significant (p<0.01). The adhesion and shrinkage of polycarboxylate cements were estimated as very good, better than those of Adhaesor and Dycal. CONCLUSION: The bactericidal effect of 5% KNO3 in polycarboxylate cement is very good for the microorganisms isolated from deep caries. The adhesion to hard tissues is very good, which suggests good marginal adaptation to the cavity.

Anti-Bacterial Agents↗
PubMed1990

[Experimental studies of direct pulp capping in permanent teeth with incompletely formed apices].

In permanent teeth described as having incompleted roots, dentin is still in the process of deposition on internal dentin walls and the root is in the process of completion. The purpose of this study of dog's immature permanent teeth was to investigate pulp healing and continuous root and internal dentin-wall developments after direct pulp capping with two types of calcium hydroxide paste on mechanically exposed pulp. Material and methods In this study, 148 vital permanent premolars with incompletely formed apices were obtained from 26 dogs (6 months old). The animals were generally anesthetized with 5% sodium pentobarbital, and a cavity was prepared on the occlusal surface of each experimental tooth using an air turban handpiece with diamond bur. After the cavity preparation, the central pulp horn of each tooth was mechanically exposed with a sterile round bur (ISO No. 007, 2/0). In experimental teeth on the right side, a calcium hydroxide-iodoform paste "Calvital" was applied on the exposed pulp, in experimental teeth on the left side, the exposed pulp was capped with a hard-setting calcium hydroxide paste "Dycal". The cavities were lined with first a zinc-oxide eugenol cement and then a zinc-phosphate cement. Then the cavities were filled with silver amalgam. The dogs were sacrificed by means of sodium pentobarbital at intervals of 3, 7, 14, 28, and 56 days after direct pulp capping. Their jaws and teeth were removed, fixed with formalin, and 100 cases out of 148 teeth with bones from 20 dogs were decalcified, and embedded in celloidin. Each specimen was serially sectioned, stained with hematoxylin-eosin, thionin-picric acid and van Gieson's stain, and evaluated microscopically. In order to identify postoperative dentin formation, intravenous injections of tetracycline were administered to the remaining 6 dogs (48 teeth) at various intervals after the experimental procedure. Two dogs were sacrificed each of the experimental periods. Specimens were embedded in resin and sectioned to a thickness of 50 microns. Undecalcified ground sections were observed by contact microradiography, and tetracycline labeling was evaluated by ultraviolet light. Results and Conclusion 1. Pathological evaluations of the 2 groups "Calvital" group: 49 (98.0%) of 50 cases were evaluated as good, and 1 case (2.0%) as moderately good. "Dycal" group: 31 (62.0%) of 50 cases were evaluated as good, 15 (30.0%) as moderately good, and 4 (8.0%) as bad.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗