Current status of direct pulp-capping materials for permanent teeth

Komabayashi, Takashi; Zhu, Qiang; Eberhart, Robert C.; Imai, Yohji

doi:10.4012/dmj.2015-013

Cited by 120 publications

(168 citation statements)

References 129 publications

(147 reference statements)

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“…The hydration slowly results in a gel which solidifies after several hours. MTA/calcium silicates are believed to have better sealing ability, biocompatibility and higher physical strength than calcium hydroxide 1,21) . For instance, the compressive strength of Biodentine (calcium silicates) was reported to be 49 MPa after 7 days, while Dycal (two-paste selfsetting calcium hydroxide) was only 16 MPa 21) .…”

Section: Calcium Silicates and Resin-modified Calcium Silicatesmentioning

confidence: 99%

“…These products may also contain a radiopacifier, such as barium sulfate. The major disadvantages of one-paste calcium hydroxide systems include: lack of setting, weak physical properties, gradual resorption/dissolution, and the so-called "tunnel effects" (the porosities in the newly formed dentin) 1) . Although calcium hydroxide has been widely accepted in clinical practice, studies have shown it may be cytotoxic due to high alkalinity.…”

Section: Calcium Hydroxide and Resin-modified Calcium Hydroxidementioning

confidence: 99%

“…A pulp exposure could cause inflammation of the dental pulp (pulpitis), which may become irreversible, causing pain, pulp necrosis, and eventually may require an extraction or root canal treatment 1) . Clinically, the treatment of a pulp exposure includes a direct pulp capping or pulpotomy.…”

Section: Introductionmentioning

confidence: 99%

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Cytotoxicity and biocompatibility of resin-free and resin-modified direct pulp capping materials: A state-of-the-art review

Chen¹,

Suh²

2017

Dental Materials Journal

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Direct pulp capping is the placement of a dental material directly over exposed pulp to prevent dental pulp from dying and avoid the need for root canal treatments. Calcium hydroxide and calcium silicates/mineral trioxide aggregates (MTA) have been commonly used for direct pulp capping with great success clinically. In recent years, resin-modified calcium hydroxide and calcium silicates have been developed with the advantages of precise placement, command set, and superior physical strength. As pulp capping materials would be in direct contact with the pulp, the cytotoxicity and biocompatibility is of particular importance in order to avoid pulp irritation and maintain pulp vitality. Therefore, this review article will summarize the cytotoxicity and biocompatibility of direct pulp capping materials, particularly resin-modified materials.

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Section: Calcium Silicates and Resin-modified Calcium Silicatesmentioning

confidence: 99%

Section: Calcium Hydroxide and Resin-modified Calcium Hydroxidementioning

confidence: 99%

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Cytotoxicity and biocompatibility of resin-free and resin-modified direct pulp capping materials: A state-of-the-art review

Chen¹,

Suh²

2017

Dental Materials Journal

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“…16 However certain resins such as 4-Meta have been reported to be less cytotoxic and also forms soft tissue hybrid layer on top of the exposed pulp. 17 A research hypothesis was generated to assess if the light-cured calcium silicate based and calcium hydroxyapatite based pulp capping agents performed better than self-cure calcium hydroxide. The null hypothesis generated was that there was no difference in the hard tissue barrier formation and pulpal response with all the three tested materials.…”

Section: Introductionmentioning

confidence: 99%

Histological evaluation of human pulp capped with light-cured calcium based cements: a randomized controlled clinical trial

Gopika¹,

Ramarao²,

Usha³

et al. 2017

Int J Sci Rep

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INTRODUCTIONDirect pulp capping (DPC) is defined as the treatment of a mechanical or traumatic vital pulp exposure by sealing the pulpal wound with a biomaterial placed directly on exposed pulp to facilitate formation of reparative dentin and maintenance of the vitality of pulp.1 Calcium hydroxide has been the gold standard for this purpose.The alkalinity of calcium hydroxide causes superficial necrosis of exposed pulp. This necrosis acts as mild irritation and thus stimulates the pulp to form a reparative dentin bridge. The success rate of calcium hydroxide direct capping was 80.1% after 1 year, 68.0% after 5 years, and 58.7% after 9 years.2 The reason for failure over time is attributed to tunnel defects that form in the bridge. This fails to provide a permanent barrier and a ABSTRACT Background: Calcium hydroxide has traditionally been used as the pulp capping material for pulpal exposures in permanent teeth. The tunnel defects in the barrier and the tendency for dissolution, however, fails to provide permanent protection to the pulp. Light curable resin based cements have been introduced to enable a better marginal seal and lesser dissolution. The purpose of this study was to compare and evaluate the response of human pulp following direct pulp capping with the new resin based Calcium silicate (TheraCal LC) and Calcium hydroxide with hydroxyapatite (Septocal LC) cements compared with calcium hydroxide (Dycal). Methods: 72 intact human premolars scheduled for orthodontic extractions were exposed to direct pulp capping procedures using three different pulp capping agents. Teeth were randomly divided into 3 groups, Group A: Dycal, Group B: TheraCal LC, Group C: Septocal LC. The teeth were extracted at the end of 15 and 40 days' and were evaluated histologically. They were scored for reparative dentin formation and inflammatory response. Inferential statistics was done using Chi square test. Results: Majority of the specimens in all three groups at the end of 15 days' showed partial to lateral deposition of hard tissue. There was continuous deposition of hard tissue and severe inflammatory response at the end of 40 days' in Dycal. There was partial deposition of hard tissue and reduced inflammatory response at the end of 40 days' in TheraCal LC and Septocal LC. However, the results were not statistically significant between the three groups at two different time periods. Conclusions: Light cured, Calcium silicate (TheraCal LC) and Calcium hydroxide with hydroxyapatite (Septocal LC) cements were as effective as calcium hydroxide (Dycal) in inducing the formation of reparative dentin and evoking inflammatory response.

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“…2 Compared with calcium hydroxide, MTA exhibits less pulp inflammation, higher quality dentin bridge formation, [3][4][5] higher mechanical strength, lower solubility, 6 and greater effectiveness in maintaining long-term pulp vitality. 7 MTA-like materials are developed because MTA has some disadvantages, including poor management, long setting time, 8 and coronal tooth discoloration.…”

mentioning

confidence: 99%

Controlled release of lovastatin from poly(lactic-<em>co</em>-glycolic acid) nanoparticles for direct pulp capping in rat teeth

Lin¹,

Tu²,

Hsieh³

et al. 2017

IJN

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Statin at appropriate concentrations has been shown to induce odontoblastic differentiation, dentinogenesis, and angiogenesis. However, using a carrier to control statin release might reduce toxicity and enhance its therapeutic effects. The aim of this study was to prepare poly( d , l -lactide- co -glycolide acid) (PLGA) nanoparticles that contain lovastatin for application in direct pulp capping. The PLGA–lovastatin particle size was determined using dynamic light scattering measurements and transmission electron microscopy. In addition, the release of lovastatin was quantified using a UV–Vis spectrophotometer. The cytotoxicity and alkaline phosphatase (ALP) activity of PLGA–lovastatin nanoparticles on human dental pulp cells were investigated. Moreover, a real-time polymerase chain reaction (PCR) assay, Western blot analysis, and an enzyme-linked immunosorbent assay (ELISA) were used to examine the osteogenesis gene and protein expression of dentin sialophosphoprotein (DSPP), dentin matrix acidic phosphoprotein 1 (DMP1), and osteocalcin (OCN). Finally, PLGA–lovastatin nanoparticles and mineral trioxide aggregate (MTA) were compared as direct pulp capping materials in Wistar rat teeth. The results showed that the median diameter of PLGA–lovastatin nanoparticles was 174.8 nm and the cumulative lovastatin release was 92% at the 44th day. PLGA–lovastatin nanoparticles demonstrated considerably a lower cytotoxicity than free lovastatin at 5, 9, and 13 days of culture. For ALP activity, the ALP amount of PLGA–lovastatin (100 μg/mL) was significantly higher than that of the other groups for 9 and 13 days of culture. The real-time PCR assay, Western blot analysis, and ELISA assay showed that PLGA–lovastatin (100 μg/mL) induced the highest mRNA and protein expression of DSPP, DMP1, and OCN in pulp cells. Histological evaluation of the animal studies revealed that MTA was superior to the PLGA–lovastatin in stimulating the formation of tubular dentin in an observation period of 2 weeks. However, in an observation period of 4 weeks, it was evident that the PLGA–lovastatin and MTA were competitive in the formation of tubular reparative dentin and a complete dentinal bridge.

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Current status of direct pulp-capping materials for permanent teeth

Cited by 120 publications

References 129 publications

Cytotoxicity and biocompatibility of resin-free and resin-modified direct pulp capping materials: A state-of-the-art review

Cytotoxicity and biocompatibility of resin-free and resin-modified direct pulp capping materials: A state-of-the-art review

Histological evaluation of human pulp capped with light-cured calcium based cements: a randomized controlled clinical trial

Controlled release of lovastatin from poly(lactic-<em>co</em>-glycolic acid) nanoparticles for direct pulp capping in rat teeth

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