Histologic comparison of two pulp capping agents.
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Dental Materials↗
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Results for “Pulp Capping and Pulpectomy Agents”
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Mineral trioxide aggregate as a pulpotomy agent in primary molars: an in vivo study.
The retention of pulpally involved deciduous tooth in a healthy state until the time of normal exfoliation remains to be one of the challenges for Pedodontists. A scientific noise has been generated about several materials some of which have been popular pulpotomy medicaments. Concerns have been raised about the toxicity and potential carcinogenicity of these materials, and alternatives have been proposed to maintain the partial pulp vitality, however to date no material has been accepted as an ideal pulpotomy agent. Mineral trioxide aggregate (MTA) is a biocompatible material which provides a biological seal. MTA has been proposed as a potential medicament for various pulpal procedures like pulp capping with reversible pulpitis, apexification, repair of root perforations, etc. Hence the present study was done to evaluate the efficacy of MTA as a pulpotomy medicament. A clinical and radiographic evaluation was done on children where MTA was used as pulpotomy medicament in primary molars for a period of 6 months and it was found to be a successful material.
Aluminum Compounds↗
Current and potential pulp therapies for primary and young permanent teeth.
OBJECTIVES: This paper aims to alert the dental practitioner to the rapidly evolving therapies for treating the pulps of primary and young permanent teeth. DATA SOURCES: Experimental research on animals, clinical studies and case reports. STUDY SELECTION: Indirect pulp capping, direct pulp capping, pulpotomies, and pulpectomies are standard procedures for treating primary teeth. However, direct pulp capping, heretofore not very successful, is being revisited. Based on studies in animals and clinical findings in humans, there has been a movement in pediatric dentistry to find alternatives to formocresol and calcium hydroxide for pulpotomy therapy. Venues range from eradication by cautery to the possibility of healing with growth factors. New studies with iodoform paste for pulpectomies are confirming the success rates of previous publications. The new dental adhesives are being tested as agents for direct pulp capping, as well as partial and complete pulpotomy protocols. CONCLUSIONS: More thought is being given by clinicians to preserving pulp, either through more ambitious indirect pulp therapy or partial pulpotomy. Formocresol and calcium hydroxide pulpotomies, while still popular, may soon be challenged by other chemical treatments, electrocautery or stimulation of reparative dentine by growth factors. Iodoform pastes are promising easier and more successful pulpectomy therapy. Total etch direct bonding materials could soon transform direct pulp capping, as well as partial and complete pulpotomy protocols.
Adolescent↗
Pulp conservation. The vitality of the pulp should be maintained whenever possible in preference to pulpectomy and endodontic treatment.
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Anti-Inflammatory Agents↗
[Clinical and radiographic follow up examination on direct pulp capping in primary teeth].
The purpose of this investigation was to evaluate direct pulp capping in primary teeth with calcium hydroxide agents. All utilized datas were selected from all the charts of the 3,675 patients at Pediatric Dentistry clinic of the School of Dentistry, Hiroshima University. The results obtained were as follows: 1) The number of all primary teeth where direct pulp capping, pulpotomy and pulpectomy were performed, was 2,511, and direct pulp capping was performed on 124 primary teeth (4.9%). Out of the 124 primary teeth, 100 were clinically evaluated. 2) At the time of the final follow up examination for each treated tooth, the ratio of teeth judged as being clinically successful were 94 (94.0%) and 6 (6.0%) as being unsuccessful. In the first year after treatment, the majority of unsuccessful cases were found. 3) We had many unsuccessful cases of anterior teeth on which composite resin and glassinomer cement had been filled after direct pulp capping. 4) Of 6 teeth judged as being clinically unsuccessful, 2 showed spontaneous pain, 1 discoloration of the tooth, 1 gingival swelling and 2 abscess formation. 5) Out of 100 primary teeth in the clinical examination, 66 became available for radiographic evaluation, and the ratio of teeth judged as being successful were 58 (87.9%) and 8 (12.1%) as being unsuccessful. During the two years following the treatment, we found most of unsuccessful cases.
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↗
Treatment options for the exposed vital pulp.
The exposure of dental pulp generally occurs as the result of accidental trauma or preparation techniques utilized during the restoration of carious lesions. While frank carious exposures are optimally treated with pulpectomy and root canal therapy, the ideal treatment of mechanically exposed pulps has remained controversial. This article describes the indications, clinical techniques, and prognosis for direct pulp capping and partial pulpotomy.
Anti-Infective Agents, Local↗
An ultrastructural study of the process of hard tissue formation in amputated dental pulp dressed with alpha-tricalcium phosphate.
This study was undertaken to determine the reaction of amputated dental pulp to the capping agent, alpha-tricalcium phosphate (alpha TCP), and to reveal the exact nature of the processes involved in both the healing of, and new hard tissue formation in the pulp when dressed with alpha TCP. The dental pulps of the anterior teeth of Macaca fuscata were dressed with alpha TCP ceramic 4-10 microns in diameter. The teeth were fixed by perfusion, then observed with light and electron microscopes. At 10 and 14 days postoperatively, the phagocytosis of the alpha TCP layer by the many macrophages and multinucleated giant cells, both of which had emerged beneath it, was seen. The synthesis of collagenous matrix underlying the alpha TCP layer began at 14 or 21 days, the cells involved exhibiting morphologic characteristics similar to those seen in osteoblasts. By the 90th day, only a bone-like hard tissue remained. No inflammation was observed in the residual dental pulp at any time during the experimental period. At 14 days, needle-like crystals were seen to have formed on the surface of alpha TCP particles, and by the 21st day, these crystals had extended to the newly synthesized matrix, with the result that calcification of the matrix was initiated, a calcified layer being superficially produced in the matrix. In the region of the matrix adjacent to the superficial calcified layer, a number of matrix vesicles were also found to function as another mechanism of matrix mineralization. Thus, it was concluded that the bone-like hard tissue was induced in the pulp capped with alpha TCP, and its potential for clinical application to exposed dental pulp was confirmed.
Animals↗