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Results for “DENTAL PULP CAPPING”

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PubMed1981

Endodontic treatment during root formation.

Various forms of endodontic treatment may be used in an attempt to maintain pulpal vitality during the period of root formation. In teeth with advanced caries but with no clinical evidence of pulpitis, indirect pulp capping with the retention of a small amount of softened dentine in the base of the cavity is preferable to further excavation and direct capping of a resulting exposure. Direct capping of pulpal exposures in traumatized incisors is confined to teeth in which the tissue loss is limited and the exposure is small and recent. Where there is more serious contamination of the pulp, whether by trauma or by caries, pulpotomy is indicated. In each of these three forms of treatment, calcium hydroxide is the dressing of choice. In incompletely formed teeth with necrotic pulps, the anatomy of the root canal poses problems which may not be entirely evident radiographically because of differential root development in the buccolingual and mesiodistal planes, whilst surgical treatment may result in excessive root shortening, besides being unacceptable to many patients. Treatment of these teeth is directed towards stimulating calcific closure of the apical foramen, preparatory to the insertion of a conventional root filling. Important factors in this form of treatment are the removal of necrotic tissue from the root canal, the preservation of vital tissue in the apical part of the root, and the use of a suitable agent as a root canal dressing. Calcium hydroxide is the agent of choice for this purpose.

Calcium Hydroxide↗

PubMed2002

Differential repair responses in the coronal and radicular areas of the exposed rat molar pulp induced by recombinant human bone morphogenetic protein 7 (osteogenic protein 1).

Bone morphogenetic protein 7 (BMP 7), also termed osteogenic protein 1, a member of the transforming growth-factor superfamily, was examined for its efficacy in inducing reparative dentinogenesis in the exposed pulps of rat molars. To determine if the reaction was dose-dependent, collagen pellets containing 1, 3 or 10 microgram of recombinant BMP 7 were inserted in intentionally perforated pulps (10-12 pulps per group) in the deepest part of half-moon class V-like cavities cut in the mesial aspect of upper first molars. As controls, the collagen carrier (CC group) alone and calcium hydroxide (Ca group) were used as capping agents. All cavities were then restored with a glass-ionomer cement. Half of the animals were killed after 8 days and the other half after 28 days, by intracardiac perfusion of fixative. The molars were processed for histological evaluation by light microscopy. No difference in effect could be detected between the three concentrations of BMP 7 groups at either time interval. After 8 days, all groups showed varying inflammation, from mild of severe, and the Ca group demonstrated early formation of a reparative dentine bridge. At 28 days the CC group displayed irregular osteodentine formation, leaving some unmineralized areas at the exposure site and interglobular unmineralized areas containing pulp remnants. In the Ca-treated pulps, the initial formation of thick reparative osteodentine bridges that sealed more or less completely the pulp perforation was followed, in the deeper part, by irregular tubular dentine. In most BMP 7-treated specimens, the initial inflammation has resolved at 8 days and at 28 days heterogeneous mineralization or osteodentine filled the mesial coronal pulp. They also had complete filling of the radicular pulp by homogenous mineralization in the mesial root; this reaction was found in 11 teeth in the BMP 7 group, one tooth in the CC group an none of the Ca group. These results emphasize the biological differences the coronal and radicular parts of the pulp, and the potential of bioactive molecules such as BMP 7 to provide an a alternative conventional endodontic treatments.

Animals↗

PubMed2000

Effects of topical Catalase application on dental pulp tissue: a histopathological evaluation.

OBJECTIVES: recently, the role of antioxidant enzymes in wound healing and their therapeutic potential has been a subject of interest in medical sciences. However there is restricted knowledge on the results of topical application, optimal therapeutic dosage and carrier types. The purpose of this study was to investigate the wound healing response of dental pulp after direct pulp capping with an antioxidant enzyme; Catalase (C-40). METHODS: three mongrel dogs were used in this study. A total of 32 perforated Cl V preparations were treated with either 0.8mg (n=16) or 1.6mg (n=16) Catalase (C-40) which was incorporated in gelatin carriers whereas 16 control teeth had carriers without Catalase. One millimeter thick Teflon disks were placed over the gelatin pellets and the cavities restored with silver amalgam. Short term and long term histopathologic reactions were evaluated after 7 and 90 days. RESULTS: there were no statistically significant differences between the inflammatory cell responses of control and either dosage groups of Catalase at the 7-day evaluation period. However, after 90 days, better tissue healing was observed in the teeth treated with Catalase, resulting in significant differences with the control group. CONCLUSIONS: it can be concluded that the results of this study encourage the topical use of antioxidant Catalase as a pulp-capping agent. However, further studies are required to determine optimal antioxidant dosages.

Administration, Topical↗

PubMedDate not supplied

Short-term dentin bridging of mechanically-exposed pulps capped with adhesive resin systems.

Dentin bridging of 150 mechanically exposed monkey pulps to two adhesive resins [BondWell LC (BW); Clearfil Liner Bond II (LB)] and a calcium hydroxide cement [Dycal (DY)] were histopathologically evaluated at 3, 7, 14, 30, and 60 days after operation (n = 10). The dentin bridge structure was three-dimensionally reconstructed from serial sections using a computer-aided reconstruction system. At three and seven days, in all pulps, no necrotic tissue and slight inflammatory cell infiltration was observed just below the exposure site. At 14 days, spindle-shaped fibroblast cells could be detected at the wound surface. All dentin chips showed reparative dentin deposition along the periphery of the wound surface. From this stage, the formation of secondary dentin from the pulpal wall at the periphery of the exposed area was recognized in all pulps. At 30 days, initial signs of dentin bridging were observed at the wound surface with a well-organized layer of odontoblastoid cells. The exposed area became occluded with a dentin bridge as the observation period increased. Group DY showed significantly higher incidence of dentin bridging than other groups at 30 days (p < 0.05). However, no significant difference of dentin bridge formation was found between Group DY and Groups BW and LB at 60 days. Bacterial penetration along the cavity walls and pulp tissue could not be detected in all groups. Histopathological observations and three-dimensional image analysis suggested that dentin bridge formation may occur following three patterns: (1) formed from the periphery of the residual dentin chip at the wound surface within 14 days, (2) formed within 14 days from the periphery of the cavity floor and with formation of reparative dentin by stimulation during the cavity preparation, and (3) formed from the wound surface within 30 days after exposure.

Animals↗

PubMed1968