Clinical Comparison of Eggshell Derived Calcium Hydroxyapatite with Dycal® as Indirect Pulp Capping Agents in Primary Molars

Abstract

To evaluate and compare the efficacy of eggshell derived calcium hydroxyapatite with Dycal ® as indirect pulp capping material in primary molars. Material and Methods: A total of 32 carious primary molars from 22 children (6-10-years) were screened, of which 26 primary molars meeting inclusion criteria were selected and equally divided into two groups. At the first appointment, the infected dentin was excavated using a spoon excavator after treating the carious part with Carie-Care™ chemomechanical caries removal agent. After this, eggshell derived calcium hydroxyapatite in Group 1 and Dycal ® in Group 2 were used as liners followed by restoration of the cavity with type IX glass ionomer cement. Clinical assessment for pain and radiographic assessment for measurement of the amount of reparative dentin thickness formation was performed at baseline, 8 weeks and 3 months. The data were subjected to statistical analysis by one-way ANOVA and Kruskal-Wallis tests. Results: Higher mean reparative dentin formation was found in eggshell derived calcium hydroxyapatite group than Dycal ® group at the end of 8 weeks and 3 months and the difference was significant statistically (p<0.001). Conclusion: Eggshell derived calcium hydroxyapatite seems to be a suitable alternative to Dycal ® (calcium hydroxide) that can be used as a liner for indirect pulp capping in primary molars.

Advances in scaffolds used forpulp–dentinecomplex tissue engineering: A narrative review

“…CPCs, specifically hydroxyapatite (HA) and tricalcium phosphate (TCP), are amongst the most widely used bioceramics in clinical settings. They dissolve gradually in the physiological environment and release Ca 2+ and PO 4 3− ions that can contribute to the cellular response (Reddy et al, 2020; Swarup et al, 2014). Calcium phosphate bioceramics mimic to some extent the mineral phase of biological hard tissues.…”

Clinical Finding of Inert Collagen Sponge Saturated by Remineralizing Solution from Eggshell Powder versus Ca-OH in Indirect Pulp Capping Measured by Cone Beam Computed Tomography Radiograph

“…Evidently, synthetic hydroxyapatite (SHAp) is the most thermodynamically stable calcium phosphate ceramic offering an amazing biocompatibility due to its neutral pH (7.0) (6) . Chicken eggshell powder (CESP) represents an excellent source for hydroxyapatite due to rich content of calcium in chemical forms of oxides and carbonates.…”

“…Chicken eggshell powder (CESP) represents an excellent source for hydroxyapatite due to rich content of calcium in chemical forms of oxides and carbonates. Prepared CESP is considered a sustainable renewable source for biological SHAp that is cost-effective as well (6,7) . Elaborated CESP was not only applied as a biodegradable efficient bone substitute for repair of osseous defects, but also it was successfully used for remineralization of early carious tooth tissues (8,9) .…”

Effect of Bioinductive Cavity Liners on Shear Bond Strength of Dental Composite to Dentin

“…Traditionally, calcium hydroxide has been considered the gold standard of cavity lining materials for several years, in the case of direct and indirect pulp capping treatment procedures due to its excellent antibacterial properties, alkaline pH, and its bioactivity in terms of formation of the hard tissue barrier [ 5 ]. However, the unfavorable effects of calcium hydroxide, such as the weak physical properties, tunnel defects, high solubility, and gradual dissolution, led to a decline in its use as a liner with time [ 6 ]; to overcome these undesirable drawbacks, several other materials have been introduced; light-activated calcium hydroxide lining materials were one of them which provide improved physical properties and decreased solubility in acids and water, although their bond to the substrate is weak and can shrink during polymerization. [ 3 , 7 ].…”