Dentin Growth after Direct Pulp Capping with the Different Fractions of Plasma Rich in Growth Factors (PRGF) vs. MTA: Experimental Study in Animal Model

Abstract

Background: This study aimed to evaluate the area of dentin growth in rabbit incisors after pulp capping with plasma rich in growth factors (PRGF) compared with mineral trioxide aggregate (MTA) by fluorescence. Methods: twenty-seven upper and lower incisors of rabbits were divided into 4 groups: poor PRGF (F1) (n = 9 teeth), rich PRGF (F2) (n = 8 teeth), ProRoot MTA (positive control, n = 5 teeth), and untreated (NC) (negative control, n = 5). Fluorochrome markers were injected 24 h before surgery and the day before euthanasia, 28 days after the vital pulp therapy (VPT). Two transverse cuts were performed to every tooth: the first cut (A), 1 mm incisal to the gingival margin, and the second cut (B), 5 mm apical to the first cut. The sections were assessed with histomorphometric evaluation by fluorescence microscopy, comparing the dentin area between fluorescence marks and the total mineralized area. Results: The higher percentage of dentin growth was observed in the F2 group (B = 63.25%, A = 36.52%), followed by F1 (B = 57.63%, A = 30,12%) and MTA (B = 38.64%, A = 15,74%) The group with lowest percentage of dentin growth was the NC group (B = 29.22%, A = 7.82%). Significant difference (p < 0.05) was found between F2 group and MTA, also statistically significant difference has been observed comparing dentin growth areas of NC group with F1 and F2 groups. Conclusions: The application of PRGF rich and poor fraction as a pulp capping material stimulated dentin formation more intensively than MTA and NC.

Successful regenerative approach with direct pulp capping using mineral trioxide aggregate after pulpal injury 2 years follow-up: Case report

“…1 Post-injury pulp repair requires multiple growth factors, including BMP-2, BMP-4, BMP-7/OP-1, FGF-2, IGF-1, and -2, and TGF-b1, to induce the formation of tertiary dentinogenesis. 19 Direct pulp-capping is a treatment procedure to maintain pulp vitality and form reparative dentin after exposure, either traumatically or mechanically, without inducing inflammation using biomaterials. [3][4][5] The objective of direct pulp-capping treatment is to produce regeneration at the injured area of dental pulp by creating dentinal bridges.…”

“…3 The application of permanent restoration directly after pulp-capping treatment can be a determining factor in successful treatment. 19…”

Histological Characterization of Modified Calcite Paste as Pulpotomy Material in Partially Pulpotomized Rabbit Incisors

“…the dose of general anesthesia calculated according to each animal weight, using of Intra muscular injection of xylazine HCl 2% (5 mg/kg), followed by another of Ketamine HCL( 35 mg/kg) to induce general anesthesia, after achieving good sedation, Class V cavities were prepared in the cervical buccal surface 1 mm incisal to the marginal gingiva by using of a high-speed round diamond 0.8 mm carbide tungsten bur (Komet Dental, Lemgo, Germany) with intermittent drilling under irrigation with sterile normal saline, drilling done at a 45 degrees inclination apically and extended for the pulp chamber, the pulp exposure done by using small spoon excavator, removing part of pulp tissue , the cavity formed is approximately of 2 mm depth necessary to apply capping material with final restoration, 30 the bleeding at the exposure site was controlled by irrigation with 5.25% concentration of NaOCl for 30 Sc then the cavity washed with distilled water and dry by brief air blot, the cavity of Group I left empty and just covered with resin modified glass ionomere cement were cured for 30 Second and the cavity of Group II filled with paste-like mixture of the novel cement then covered with resin modified glass ionomere cement were cured for 30 Second. 30,31 Histologic Assessment: Six rabbits were euthanized per interval by intravenous injection with anaesthetic overdose. Jaws were fixed in 10% neutral buffered formalin, decalcified in 10% nitric acid for 3 days, dehydrated sequentially in graded alcohols, 70%, 80%, 90%, and 100%, then immersed in xylene, and finally embedded in paraffin blocks.…”

TheraCal as the material of choice for direct pulp treatment compared to two other materials: MTA and biodentine

“…MTA-based products show discrete antimicrobial activity compared to calcium hydroxide-based materials, which show higher antimicrobial activity [27] . One study showed that the application of PRGF-rich and PRGF-poor fraction as pulp capping material, stimulated dentin formation more strongly than MTA and untreated negative control [28] . A study compared MTA and HA / β-TCP / C local action, being similar to that of MTA, when used as a vital pulp treatment agent in terms of absence of inflammation and maintenance of pulp vitality, although there are significant differences between the two materials in terms of dentin bridging [29] .…”