Direct Pulp Capping with Calcium Hydroxide, Mineral Trioxide Aggregate, and Biodentine in Permanent Young Teeth with Caries: A Randomized Clinical Trial

Brizuela, Claudia; Ormeño, Andrea; Cabrera, Carolina; Cabezas, Roxana; Inostroza, Carolina; Ramı́rez, Valeria; Mercadé, Montse

doi:10.1016/j.joen.2017.06.031

Cited by 129 publications

(116 citation statements)

References 30 publications

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“…Ca(OH) 2 is successful clinically (Brizuela et al . ), but limitations including solubility, handling and biological response have led to the development of new materials such as hydraulic calcium silicates (Pitt Ford et al . ).…”

Section: Reviewmentioning

confidence: 99%

“…Although the exact mechanism of Ca(OH) 2 remains unclear, biologically it stimulates the production of mineralized tissue, albeit often a porous osteodentine (Cox et al 1996, Nair et al 2008. Ca(OH) 2 is successful clinically (Brizuela et al 2017), but limitations including solubility, handling and biological response have led to the development of new materials such as hydraulic calcium silicates (Pitt Ford et al 1996).…”

Section: Materials For Pulp Cappingmentioning

confidence: 99%

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Management of deep caries and the exposed pulp

et al. 2019

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Caries prevalence remains high throughout the world, with the burden of disease increasingly affecting older and socially disadvantaged groups in Western cultures. If left untreated, caries will advance through dentine stimulating pulpitis and eventually pulp infection and necrosis; however, if conservatively managed, pulpal recovery occurs even in deep carious lesions. Traditionally, deep caries management was destructive with nonselective (complete) removal of all carious dentine; however, the promotion of minimally invasive biologically based treatment strategies has been advocated for selective (partial) caries removal and a reduced risk of pulp exposure. Selective caries removal strategies can be one‐visit as indirect pulp treatment or two‐visit using a stepwise approach. Management strategies for the treatment of the cariously exposed pulp are also shifting with avoidance of pulpectomy and the re‐emergence of vital pulp treatment (VPT) techniques such as partial and complete pulpotomy. These changes stem from an improved understanding of the pulp–dentine complex's defensive and reparative response to irritation, with harnessing the release of bioactive dentine matrix components and careful handling of the damaged tissue considered critical. Notably, the development of new pulp capping materials such as mineral trioxide aggregate, which although not an ideal material, has resulted in more predictable treatments from both a histological and a clinical perspective. Unfortunately, the changes in management are only supported by relatively weak evidence with case series, cohort studies and preliminary studies containing low patient numbers forming the bulk of the evidence. As a result, critical questions related to the superiority of one caries removal technique over another, the best pulp capping biomaterial or whether pulp exposure is a negative prognostic factor remain unanswered. There is an urgent need to promote minimally invasive treatment strategies in Operative Dentistry and Endodontology; however, the development of accurate diagnostic tools, evidence‐based management strategies and education in management of the exposed pulp are critical in the future.

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Section: Reviewmentioning

confidence: 99%

Section: Materials For Pulp Cappingmentioning

confidence: 99%

Management of deep caries and the exposed pulp

et al. 2019

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“…The authors also reported no genotoxicity for either material. More recently, a clinical trial was conducted by Brizuela et al comparing the efficacy of MTA, Biodentine, and calcium hydroxide for direct pulp capping in young permanent teeth with caries . The study highlighted that while MTA and Biodentine offered some advantages over calcium hydroxide, there were no significant differences in the clinical results between the three.…”

Section: Endodontic Materialsmentioning

confidence: 99%

“…More recently, a clinical trial was conducted by Brizuela et al comparing the efficacy of MTA, Biodentine, and calcium hydroxide for direct pulp capping in young permanent teeth with caries. 54 The study highlighted that while MTA and Biodentine offered some advantages over calcium hydroxide, there were no significant differences in the clinical results between the three. Thus, current clinical evidence still validates the use of calcium hydroxide while also supporting the use of calcium silicates such as MTA.…”

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confidence: 91%

Oroactive dental biomaterials and their use in endodontic therapy

et al. 2019

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Dental biomaterials have revolutionized modern therapies. Untreated dental caries remains the major etiological factor for endodontic treatment, and together with a decreasing rate of tooth loss escalates the importance of continuously improving the materials used for endodontic therapies. Endodontic biomaterials are used for vital pulp therapies, irrigation, intracanal medicaments, obturation and regenerative procedures. These materials offer several functions including: antimicrobial activity, mechanical reinforcement, aesthetics, and therapeutic effects. Vital pulp therapies have seen an improvement in clinical results with an incremental approach to build on the strengths of past materials such as calcium hydroxide and calcium silicates. While sodium hypochlorite remains the gold standard for canal irrigation, numerous nanoparticle formulations have been developed to promote sustained antimicrobial action. Gutta‐percha based bulk fillers remain the most common materials for root filling. However, while multiple studies focus on the development of novel formulations containing drugs, glass derivatives or ionic‐, polymeric‐, or drug‐ loaded nanoparticles, a lack of reliable and long‐term clinical evidence obligates further study as experienced clinicians prefer to use what has worked for decades. This review delves in to the biochemistry of the materials to scrutinize their shortcomings, and where opportunity lies to further enhance their efficacy in endodontic practice. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 108B:201–212, 2020.

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“…Many materials have been used to cover the exposed pulp, and have been extensively histologically and clinically studied and have achieved different success rates, such as zinc oxide eugenol (ZoE) (6) , glass ionomer cement (GIC) (7) , adhesive systems (8) , calcium hydroxide (9) , mineral trioxide aggregate (MTA) (10) , Biodentine (11) and calcium-enriched mixture cement CEM (12) .…”

Section: Introductionmentioning

confidence: 99%

Dexamethasone - loaded polymeric porous sponge as a hard tissue regeneration agent

Alagha¹

2020

Preprint

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Background : The aim of this study is to achieve the principles of tissue engineering using biopolymers to be applied in the field of vital endodontic treatment with the aim of stimulating stem cells and engineering and regeneration of dentin tissue. the blend was loaded with the steroidal antiinflammatory drug, dexamethasone, and the porous drug-loaded bio-sponge was produced by lyophilization. Bio-sponge, as a direct pulp capping agent, was histologically studied compared to calcium hydroxide Ca(OH)2 in an animal experiment.Results: The results indicated the effectiveness of the bio-sponge as a direct pulp agent, where the dentin bridge was formed faster than Ca(OH)2 treated samples,. There was no inflammatory response in the pulp tissue throughout the follow-up period.Conclusions : The porous bio-sponge loaded with dexamethasone with a neutral pH resulted in enhancement the odontoblast differentiation from stem cells, resulted in the formation of a renewed dentin bridge without the slightest inflammatory response in the pulp. aminoglycan GAG (13) . ECM is responsible for cellular metabolism and the forming of new tissues since it gives the mechanical and biochemical properties for the formed tissue (14) . ECM plays a crucial role in regulating the expression of the differentiated phenotype and in supporting both migration and proliferation of fibroblast cells (15) .Chitin, the most abundant polysaccharide in nature after cellulose, is synthesized by an enormous number of living organisms, presents in the exoskeleton of crustaceans, insects and fungal cell walls (16) . Chitin consists of a saccharide backbone with β-1,4-linked glucosamine units and characterized by a high availability of acetyl group (17) . Chitin has a cellulose-like structure with the difference of hydroxyl-group replacement by (-NHCOCH 3 ) at the C 2 site (18) . Chitosan is the main derivative of chitin and derived by alkaline deacetylation of chitin (19) . The availability of functional groups allows chemical modifications, making it possible to load and release drugs from chitosan (20) .Chitosan scaffolds with an interconnected porous structure have been shown to be easily manufactured by lyophilization of chitosan solution (21) , and have been widely studied in the bone tissue engineering, and it has been shown that it promotes osteoblast cells growth and deposition of the mineralized matrix by cells (22) . The addition of chitosan molecules to the human bone marrow transplantation medium stimulates bone deposition by promoting cell differentiation (23) . It has been suggested that chitosan enhanced bone formation in vivo through indirect mechanisms (23) , and it can be used as a standard GAG in tissue regeneration processes (24) .Collagen is the most abundant protein in the body and it is the major component in body tissues, it forms also about 30% of total proteins in mammals (25) . About 28 types of collagen have been identified (26) , among which, the type-I collagen is the prevalent type and it is the main component of the ECM (27) ....

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Direct Pulp Capping with Calcium Hydroxide, Mineral Trioxide Aggregate, and Biodentine in Permanent Young Teeth with Caries: A Randomized Clinical Trial

Cited by 129 publications

References 30 publications

Management of deep caries and the exposed pulp

Management of deep caries and the exposed pulp

Oroactive dental biomaterials and their use in endodontic therapy

Dexamethasone - loaded polymeric porous sponge as a hard tissue regeneration agent

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