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PubMedDate not supplied

[Effect of remaining dentine thickness beneath deep cavities on the rate of reparative dentine formation--experimental study].

The aim of this study was to investigate the effect of remaining dentine thickness beneath deep cavities on the rate of reparative dentine formation throughout 119 days and to establish the limit value of the remaining dentine thickness that enables greatest amount of tertiary dentine in dogs' teeth. Deep buccal cavities were prepared in all canines and molars of three dogs, lined with four different lining materials for indirect pulp capping and filled with silver amalgam. Tetracycline labelling technique was used to demark the layers of reparative dentine produced during the experimental period of 17 weeks. After sacrificing and isolation the teeth from the jaws slices (1 mm thick) were cut off through the middle of the cavity, perpendicular to the cavity floor and mesio-distal tooth axis. Sections were ground to 100 microns thick; the measuring of the remaining and reparative dentine thickness was carried out with Fluoval, Carl-Zeiss, Jena, DDR fluorescent microscope. The results showed: 1. Cavity depth had a strong effect on the quantity of newly formed tertiary dentine; 2. The greatest rate of reparative dentine (348 microns) was produced beneath the cavities with remaining dentine thickness ranging 501-700 microns; 3. The least quantities of tertiary dentine (219 and 227 microns) were produced beneath the deepest cavities, with remaining dentine thickness less than 500 microns, as well as beneath shallower cavities with remaining dentine thickness of over 900 microns.

Animals↗

PubMed2001

Pulp capping with a modified bioglass formula (#A68-modified).

PURPOSE: To evaluate a modified Bioglass (Formula #68 (MBF68) when used as a pulp capping agent. MATERIALS AND METHODS: After exposure, the pulps were contaminated with saliva for 60s, rinsed, dried and treated with Consepsis, acting as a hemostatic and bactericidal agent. After drying the Consepsis, the MFB68, having been pre-mixed in sterile saline, was carefully deposited over the pulp exposure, covered with polycarboxylate cement and restored with the ProBond bonding resin system. A calcium hydroxide group was used as control. RESULTS: There was no evidence of mummification, the incidence of properly positioned dentin bridge formation was higher and the incidence of extruded dentin bridge formation was reduced.

Animals↗

PubMedDate not supplied

[Dentinopulpar organ: biological basis of clinical response to Ca(OH)2 application].

We have studied the changes presented by mediate and immediate roentgenographic images of indirect pulp capping and pulpotomies. In the cases of indirect pulp capping it was observed an increase of radiolucidity in the places occupied by Ca(OH)2, and sclerotic dentin was present. In pulpotomies, it was found the dentin bridge, which thickness increases with time. The radiolucidity of pulp chamber occupied by Ca(OH)2 was greater in the long time treatment. The radiopacity of non-vital dentin of walls and floor chamber was increased too. It has suggested that Ca++ ion would have migrated from its place and probably would take part in the synthesis of sclerotic dentin, independently of the vitality of the tissue.

Adolescent↗

PubMed1990

Autoradiographic analysis of odontoblast replacement following pulp exposure in primate teeth.

Cell migration and replication associated with odontoblast replacement occurring soon after pulp exposure in primate teeth were studied. Class 5 cavity preparations resulting in pulp exposures were restored with a calcium hydroxide-containing capping agent and amalgam. Eighty-four and 96 h after this the animals were injected with 0.5 microCi/g body wt tritiated thymidine (sp. act. 6.7 Ci/mM). Teeth were extracted 6, 8, 10 and 12 days after treatment. The number of labelled cells as well as the number of grains per labelled cell were counted for odontoblast-like, fibroblast-like and perivascular cells in three 60 x 260 microns zones. These zones represented the odontoblast and cell-free (zone 1), cell-rich (zone 2) and deep pulp (zone 3) areas of normal pulp tissue. Ten sections centred around the mid-point of the exposure were counted for each tooth. Matrix formation and labelled odontoblast-like cells were observed at the interface between the capping agent and the pulp as early as day 8. Other significant findings were: (1) an increase in labelled odontoblast-like cells in zone 1 over time, suggesting a continual influx of differentiating cells; (2) an increase in labelled cells in zone 1 over time with a concurrent decrease in zone 3, suggesting that the influx of cells in zone 1 was from the deeper pulp; and (3) differences in grain counts between zones, treatment times and cell types, indicating that at least two DNA replications had occurred between initial treatment and final odontoblast-like cell differentiation.

Animals↗

PubMed2004

Dentin adhesion and microleakage of a resin-based calcium phosphate pulp capping and basing cement.

An experimental resin-based bioactive calcium phosphate cement, intended as a pulp capping and basing material, was evaluated for dentin shear bond strength and microleakage. The interfacial morphology was examined by scanning electron microscopy (SEM). For microleakage, dentin cavities without (Group A) or after (Group B) acid etching were restored with the calcium phosphate cement. A resin-based calcium hydroxide (VLC Dycal; Group C) was used as control material according to the manufacturer's instructions. After water storage and thermocycling, the microleakage was scored using a AgNO(3) staining procedure. For the shear bond strength, flat exposed dentin surfaces were treated as for the microleakage test. Metal irises pressed against the dentin surface were filled with the cements, which were photocured. Both tests were carried out after 1 wk. While acid etching did not result in significantly greater microleakage, it led to higher shear bond strength, and allowed, as shown by SEM, the formation of a hybrid layer and resin tags. Both groups treated with the calcium phosphate cement had significantly lower microleakage scores and higher mean shear bond strength values than the groups treated with the control material.

Acid Etching, Dental↗

PubMed2005

[Histological evaluation of direct pulp capping with a self-etching adhesive and calcium hydroxide].

OBJECTIVE: To evaluate the beagles' pulp response following direct pulp capping with Clearfil SE BOND (SB). METHODS: 130 sound teeth were used. 120 had their pulps mechanically exposed and were divided in two groups. In group A, teeth were capped with SB. In group B, teeth were capped with calcium hydroxide (CH). The left 10 teeth were used as control. After 7, 30 and 90 days, the teeth were extracted and processed for light microscopical examination. RESULTS: In 7 day observation period, inflammatory reaction in SB group was slighter than that of CH group, but the difference was statistical insignificant. In the 30 day and 90 day observation period, inflammatory reaction was slight in both groups, but specimens with dentin bridge formation was significantly less in SB group than in CH group (P < 0.05). CONCLUSION: SB showed acceptable biocompatibility with pulp, but its ability to induce hard tissue barrier on pulp exposure is weaker than CH.

Adhesives↗

PubMed1980

Clinical and histologic study of human pulpal response to new cements containing calcium hydroxide.

Two newly developed cements were used for pulp capping in human teeth. The biologic response and the reaction induced by the cements were assessed both clinically and histologically and compared with those of Dycal. A total of ninety-seven pulps were treated with the materials for periods extended for 2 months in the histologic part and up to 8 months in the clinical part of the study. The response to the cements was very mild, and the pulps healed by the formation of intact dentine bridges. Dycal induced a mild to moderate pulpal response in the early stages of the experiment. Healing took place by the formation of thin dentine bridges at after a period of 2 months under Dycal. The new cements induced faster healing, with the formation of regular complete dentine bridges.

Adolescent↗

PubMed1978

A 2-year follow-up of primary molars, pulpotomized with a gentle technique and capped with calcium hydroxide.

The prognosis for pulpotomy of primary molars with calcium hydroxide as wound dressing was evaluated clinically and radiographically. Thirty-three primary mandibular molars were amputated under the following conditions: (1) chronic coronal pulpitis, (2) the amputation was done with diamond instruments and a high-speed machine under aseptic conditions, and (3) application of calcium hydroxide in contact with the wound surface. After 1 year the treatment was regarded as successful for 22 of the teeth (67%); 11 teeth showed internal dentin resorption. After 2 years the frequency of success, allowing for drop-out, was 59%. Internal dentin resorption was seen in 14 root canals; in 10 of them within the first 6 months. A histologic study of nine root pulps with internal dentin resorption revealed an extra-pulpal blood clot on the wound surface in five.

Blood Coagulation↗

PubMed2006

Histologic evaluation of direct pulp capping with a self-etching adhesive and calcium hydroxide in beagles.

OBJECTIVE: To evaluate the pulpal response of beagles following direct pulp capping with Clearfil SE Bond (SB), a self-etching adhesive. STUDY DESIGN: One hundred thirty sound teeth from 6 male beagles were used. One hundred twenty teeth had their pulp mechanically exposed at the bottom of the class V cavities and were divided into 2 groups. In group 1, teeth were capped with SB; group 2 teeth were capped with calcium hydroxide cement (CH). Ten teeth were kept intact as an untreated control group. After 7, 30, and 90 days, 40 teeth from 2 beagles were extracted and processed for light microscopic examination. RESULTS: After the 7-day observation period, inflammatory reaction in the SB group was similar to that of the CH group (P > .05). After the 30-day and 90-day observation periods, inflammatory reaction was slight in both groups, but less dentin bridge formation was observed in specimens from the SB group than in those from the CH group (P < .05). CONCLUSION: SB showed good biocompatibility with pulp, but its ability to induce reparative dentin was lower than that of CH.

Animals↗

PubMed1982

Follow-up study of permanent incisors with complicated crown fractures after acute trauma.

Complicated fractures occur in 3.5% of acute traumatized incisors. A pulp exposure results in almost all cases in endodontic treatment. The present investigation evaluated the prognosis for the different types of endodontic treatments following complicated crown fractures. Only incisors with an observation period of more than 23 months are included; the material comprises 301 incisors. Pulp capping was successful in 90.5% of the cases. There was a clear tendency for a positive correlation between the stage of the root development and the success rate of the endodontic treatment. In cases with pulpotomy ZnO/eugenol cement or calcium hydroxide was used as amputation material. The pulp reactions following the different treatments are discussed. If calcium hydroxide was used 90% was successful, while in cases with ZnO/eugenol cement as amputation material 8.9% developed necrosis of the pulp and 34.4% showed an undesirable reaction with formation of hard tissue barrier or obliteration. The healing frequency was 83.9% for teeth treated with pulpectomy but there was a clear correlation between the standard of the root filling and the success rate. For all three treatment groups there was a correlation between damage to the supportive tissue and treatment success.

Adolescent↗

PubMed2005

Cytotoxicity of substances leached or dissolved from pulp capping materials.

AIM: To evaluate the cytotoxic effects of substances leached or dissolved from pulp capping materials on human pulp fibroblasts. METHODOLOGY: The substances were applied to cell cultures in conditioned media. The experimental groups were: GI (control; n = 24)--cultures treated with fresh medium; GII (n = 24)--cultures treated with calcium hydroxide cement; GIII (n = 24)--cultures treated with adhesive resin and GIV (n = 24)--cultures treated with 37% orthophosphoric acid. The media were conditioned by placing the crude materials in contact with fresh culture medium for 1 h. The cytotoxicity analysis was performed using the Trypan blue dye exclusion assay at times of 0, 6, 12 and 24 h for cell viability assay, and at 1, 3, 5 and 7 days for survival assay. Data were treated by anova (P < 0.05) and Tukey's test (P < 0.05). RESULTS: GI and II presented similar cell viability and cell growth. GIII and IV exhibited statistically significant lower percentages of cell viability: GIV only at the 0 h experimental time, whereas in GIII this viability markedly diminished reaching values of 10% by 12 h. Cell growth was impaired only in cultures of GIII. CONCLUSIONS: Substances dissolved from the adhesive system tested were cytotoxic for human dental pulp fibroblasts in culture, whilst substances leached from calcium hydroxide were biocompatible.

Acid Etching, Dental↗

PubMed1977

Endodontic therapy of traumatised teeth in children.

One of the most difficult problems met with in endodontic therapy for children is the traumatized anterior tooth whose root is still incomplete. In cases where the pulp is vital, treatment by pulp capping or pulpotomy is directed to preserving the vitality of the radicular pulp to ensure completion of root formation. Calcium hydroxide remains the material of choice in both forms of treatment. Once root formation is complete, removal of the pulp residue and filling of the root canal may be performed as a preliminary to restoration by means of a post retained crown. Where the pulp is non vital, attempts to fill the funnel shaped apical part of the canal, whether from a coronal approach or by open operation for retrograde filling, have proved unsatisfactory. Many workers have shown however that a number of root filling materials and root dressings are capable of inducing either continued root growth or a closure of the apical region by a calcific scar. A detailed survey of 34 teeth treated by this method has been made and the important principles which appear to influence the success of the technique are enumerated.

Child↗

PubMed2005

Activation of the Notch signaling pathway in response to pulp capping of rat molars.

Notch signaling is an evolutionarily conserved pathway that controls the developmental choices made by individual cells. Cells communicate via Notch receptors and their ligands, which direct decisions on the fate of stem cells according to the states of their neighbors. In this study we explored Notch signaling after the pulp capping of adult first upper rat molars. The wound was capped with calcium hydroxide. In situ hybridization revealed an increased expression of Notch signaling genes on day 1, which showed a tendency to decrease on day 3. Notch1 increased in the subodontoblast zone and close to the lesion limited to a few cells. Notch2 increased in pulp stroma surrounded by coronal odontoblasts. Notch1 and, especially, Notch3 expression increased, corresponding to perivascular cell groups. A low increase of ligand expression was observed near the injury with Delta1 expression along the dentin wall and Jagged1 in the stroma. Expression of the downstream target, Hes1, was observed along the lesion and adjacent dentin walls. Hes5 expression was not observed. The results indicate that Notch signaling is activated in response to injury and associated with the differentiation of pulp cells into perivascular cells and odontoblasts. The findings are consistent with the concept that the Notch pathway controls stem cell fate during pulp regeneration.

Animals↗

PubMed1989

[Evaluation of cytotoxicity of VLC Dycal in tissue culture for clinical use].

The purpose of this study was to evaluate the VLC Dycal (visible light cured composite-calcium hydroxide material) to see whether it is suitable or not as a direct or indirect pulp capping agent for clinical use by means of the cell culture test. Two light cured composite resins, P-30 and Silux, and also Dycal and Ca(OH)2 were used as a control for a comparative cytotoxicity test with VLC Dycal. All test materials were put into the glass tubes (4 mm diameter X 1 mm high), then illuminated for 10, 20, 30, 40, 50 and 60 seconds through a matrix strip with direct contact with a Prisma-light source (L.D. Caulk), just before testing. Fibroblasts, 5 ml of 1 X 10(5) cells per ml in Eagle's MEM medium with 10% FCS, penicillin (100 U/ml) and streptomycin (100 micrograms/ml) were evenly seeded on a cover glass in a tissue culture dish and incubated for 24 hours at 37 degrees C in a humidified atmosphere of a 5% CO2 in air. After 24 hours, the medium was replaced with 5 ml of agar overlay medium consisting of 10% FCS, Eagle's MEM medium and 1.5% agar. Glass tubes (n = 8) filled with the test materials were placed at the center of the agar, and incubated for 24 hours in 5% CO2 in air at 37 degrees C. After 24 hours of incubation, the cover glass was removed and the cells were fixed in 10% neutral formalin and then stained by H.E. to differentiate the areas of affected and unaffected cells beneath the test specimens. The affected area was quantitatively determined using an image analysis system.(ABSTRACT TRUNCATED AT 250 WORDS)

Bisphenol A-Glycidyl Methacrylate↗

PubMed1993

Induction of reparative dentine formation in monkeys by recombinant human osteogenic protein-1.

Osteogenic protein-1 (OP-1, BMP-7), a member of the transforming growth factor-beta supergene family, induces cartilage and bone formation when implanted in intra- and extraskeletal sites in vivo. The human OP-1 gene has been cloned and biologically active recombinant OP-1 homodimers (hOP-1) produced. The amount of bone induced by hOP-1 in vivo is related to the amount of protein implanted. Dentine possesses bone morphogenetic protein (BMP) activity. Impure material from allogenic bone with BMP activity induced reparative dentine formation in dogs. The objective of this study was to determine if the amount of reparative dentine stimulated by hOP-1 is related to the amount of protein utilized in direct pulp-capping experiments. Freshly exposed molar and premolar pulps were treated with varying amounts of a complex comprising hOP-1 and a carrier matrix of purified bovine type-1 collagen powder (CM) moistened with sterile saline. Reparative dentine was present in all hOP-1/CM treated teeth (12 of 15) that remained sealed for the 6 weeks' healing. Substantially more new dentine was present in teeth treated with hOP-1/CM than in those treated with Ca(OH)2 paste and the amount of reparative dentine formed was proportional to the amount of hOP-1/CM (P < 0.05). No reparative dentine formed in collagen carrier or untreated teeth. The appearances of the new tissue suggested that much of the mass of the hOP-1/CM was replaced first by a pulp-like connective tissue, which mineralized to form reparative dentine.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed2005

The treatment of deep dentine caries lesions.

UNLABELLED: This paper discusses the excavation of deep caries lesions, focusing on indirect pulp-capping and the stepwise excavation approach. The concept of a modified and less invasive stepwise excavation is presented, based on considerations of caries pathology. The aim of the first excavation is primarily to make a change within the cariogenic environment, and not to remove carious dentine close to the pulp because this risks an iatrogenic pulp exposure. Microbiological and clinical studies have shown that the number of bacteria decrease during stepwise excavation procedures, and that lesions clinically arrest. The active, soft-yellowish, demineralized dentine turns into a darker, harder and drier demineralized dentine, resembling a slowly progressing lesion, where the carious dentine is easier to remove at the final visit. The final excavation has two aims: (i) to verify that arrestation has taken place, ie a clinical control of the tooth reactions and (ii) to remove the slowly progressing but still slightly infected discoloured demineralized dentine, before carrying out the permanent and final restoration. CLINICAL RELEVANCE: Knowledge of guidelines for treatment of deep dentine caries may reduce the risk of pulpal exposure.

Dental Caries↗

PubMed1977

Corticosteroids in dentistry.

The application of corticosteroids to cut dentine following cavity preparation, to carious dentine in indirect pulp capping, to the exposed pulp or to pulp remnants and periapical tissues during root canal therapy has been claimed to eliminate post operative pain and inflammation. Other investigators have thrown doubt on the validity of these claims and have reported continued inflammation progressing to necrosis following such applications. This paper reports detailed clinical and histological findings in a series of over 500 teeth some of which received conventional treatment while others were treated with various corticosteroids including Mosteller's solution, tritiated prednisolone, and Ledermix paste and cement. The results confirm the fact that no clear correlation exists between symptoms and histological findings in pulp disease. The absence of pain following application of corticosteroids cannot therefore be taken as evidence of a specific therapeutic effect. In some cases pain returned after a period and histologic examination showed the slow development of inflammatory changes coupled with calcification in pulp tissue and on the walls of the canal. Further investigation is needed to clarify the relative contribution of the removal of toxic products by instrumentation and the anti-inflammatory properties of corticosteroids in the reduction of pain of pulpal origin.

Adrenal Cortex Hormones↗

PubMed1994

Comparative effect of calcium hydroxide and hydroxyapatite on the cellular activity of human pulp fibroblasts in vitro.

When, in vivo, calcium hydroxide [Ca(OH)2] or hydroxyapatite are used as dental pulp-capping agents, a reparative dentine bridge is observed. New hard tissue is formed directly on the hydroxyapatite, whereas a characteristic necrotic area appears under Ca(OH)2. The differing pulpal reactions to these two capping agents suggest differing cell responses. After isolation and selection of human pulp fibroblasts in vitro, the cells were characterized by their morphology, their high alkaline phosphatase specific activity, and their synthesis of type I and III collagens and fibronectin. They were then incubated in the presence of either hydroxyapatite (1 mg/ml) or Ca(OH)2 (0.8 mg/ml). With Ca(OH)2, the cells exhibited dramatical alterations in morphology, DNA synthesis, alkaline phosphatase activity and protein synthesis, in accordance with the necrosis observed in vivo. With hydroxyapatite, phagocytic activity of pulpal fibroblasts toward hydroxyapatite particles (< 10 microns) was seen. As a consequence, DNA synthesis was affected. This inhibitory effect was not due to cell damage, as demonstrated by increased [3H]-proline and [3H]-leucine incorporation by the cells. There was also an inhibitory effect of hydroxyapatite on alkaline phosphatase activity, suggesting that the pulp fibroblasts were not in a differentiation stage. In conclusion, compared to the effects of Ca(OH)2 on human pulp fibroblasts, these data are consistent with the biocompatibility of hydroxyapatite previously described in vivo and testify to the occurrence of a biological response elicited by this synthetic biomaterial.

Adolescent↗