Comparison of bioactive glass, mineral trioxide aggregate, ferric sulfate, and formocresol as pulpotomy agents in rat molar

Abstract

Bioactive glass (BAG) is often used as a filler material for repair of dental bone defects. Although there is evidence of osteogenic potential of this material, it is not clear yet whether the material exhibits potential for dentinogenesis. Hence, the aim of the present study was to evaluate BAG as a pulpotomy agent and to compare it with three commercially available pulpotomy agents such as formocresol (FC), ferric sulfate (FS), and mineral trioxide aggregate (MTA). Pulpotomies were performed in 80 maxillary first molars of Sprague Dawley rats, and pulp stumps were covered with BAG, FC, FS, and MTA. Histologic analysis was performed at 2 weeks and then at 4 weeks after treatment. Experimental samples were compared with contra-lateral normal maxillary first molars. At 2 weeks, BAG showed inflammatory changes in the pulp. After 4 weeks, some samples showed normal pulp histology, with evidence of vasodilation. At 2 weeks, MTA samples showed some acute inflammatory cells around the material with evidence of macrophages in the radicular pulp. Dentine bridge formation with normal pulp histology was a consistent finding at 2 and 4 weeks with MTA. Ferric sulfate showed moderate inflammation of pulp with widespread necrosis in coronal pulp at 2 and 4 weeks. Formocresol showed zones of atrophy, inflammation, and fibrosis. Fibrosis was more extensive at 4 weeks with evidence of calcification in certain samples. Among the materials tested, MTA performed ideally as a pulpotomy agent causing dentine bridge formation while simultaneously maintaining normal pulpal histology. It appeared that BAG induced an inflammatory response at 2 weeks with resolution of inflammation at 4 weeks.

Histological, ultrastructural and quantitative investigations on the response of healthy human pulps to experimental capping with Mineral Trioxide Aggregate: a randomized controlled trial¶

“…In the literature there are a limited number of animal studies on pulp capping in which MTA has been compared with Ca(OH) 2 in monkeys (Pitt Ford et al 1996), dogs (Tziafas et al 2002, Asgary et al 2006) and rats (Salako et al 2003). These studies consistently demonstrated more hard tissue bridge formation and less inflammation in the MTA group compared with the Ca(OH) 2 control over a 2-5 month period.…”

“…Attempts have also been made to use it as a root canal filling material in dogs (Holland et al 1999b). Dentine bridge-like hard tissue was consistently observed when MTA was used as a pulp capping agent in monkeys (Pitt Ford et al 1996), dogs (Tziafas et al 2002, Asgary et al 2006 and rats (Salako et al 2003). It is essential to test the pulp healing ability of MTA on human teeth before its routine clinical application (ISO 1997).…”

Physicochemical Basis of the Biologic Properties of Mineral Trioxide Aggregate

“…The superior sealing ability of MTA over conventional retrograde filling materials, such as amalgam, IRM, and Super EBA, has been demonstrated in numerous microleakage tests using dye, fluid, bacteria, and endotoxin infiltration techniques (5-10). Its excellent biocompatibility has been evidenced in several favorable biologic processes induced by MTA, namely, minimal toxicity and pulpal irritation, mild periapical inflammation, nonmutagenicity, cell adherence and growth, increased levels of alkaline phosphatase and osteocalcin, interleukin production (IL-6, IL-8), periodontal ligament attachment, cementum growth, and dentinal bridge formation (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26).Studies on MTA have mainly examined its various biologic properties, but little or no attention has been paid to the fundamental physicochemical interaction between MTA and the oral environment that instigates those biologic responses. The purpose of this study was to elucidate the nature of this interaction, specifically to characterize the interaction of MTA with (a) a synthetic tissue fluid (STF) and (b) endodontically prepared root canal walls in extracted human teeth.…”

Treatment of Internal Resorption with Mineral Trioxide Aggregates: A Case Report

“…Being originally developed as a surgical root end filling material, MTA has been successfully used in several clinical applications such as pulp capping [5] pulpotomy [6] perforation repair [7] treatment of traumatized teeth with immature apices [8] and for treatment of root resorptions [9].…”