Evaluation of Two Different Types of Mineral Trioxide Aggregate Cements as Direct Pulp Capping Agents in Human Teeth

Abstract

Traumatic human dental injuries involving the pulp might necessitate direct capping procedures. This clinical study aimed to analyse the histological outcomes using two different direct capping materials. Twenty patients with bilateral premolars, scheduled for orthodontic extraction, were selected. The teeth were treated either using ProRoot MTA or RetroMTA. All patients were recalled after 30 and 60 days for teeth extraction. The histopathologically stained specimens were blindly evaluated using hard tissue bridge formation, inflammatory reaction and pulpal findings criteria. Data were evaluated statistically. Results: After 60 days, only the parameter for hard tissue bridge formation showed significant difference in the ProRoot MTA group (p = 0.010), while both direct capping materials performed similarly regarding inflammatory pulp reaction and pulpal findings. Although, during the first 30 days, RetroMTA presented better results in terms of continuity, morphology, hard tissue bridge localisation, and extension/general state of the inflammatory reaction, the continuity was better at 60 days when ProRoot MTA was applied. Treatment with RetroMTA healed the pulpal tissue faster compared with ProRoot MTA but it seemed to be rather a reparative process.

Histological Investigation of the Cleaning Effectiveness of Different Biomechanic Processes of Isthmus in Lower Molars

“…Ballal et al compared smear layer removal in the incisor teeth and found that EndoUltra was more effective in the apical area than the side-vented or EndoSafe irrigation system. 36 Karade et al achieved significantly better cleanliness with EndoUltra than with EndoActivator in the apical third areas of the premolar. 37 Sartiono and Iskandar also found EndoUltra effective in debris removal in the apical third area of mandibular premolars.…”

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

“…4 This dentin bridge formation aims to preserve the pulp in its vital condition after the injury. 4,[11][12][13] Dentinal bridges lead to the formation of a calcified barrier, which is advantageous in pulp-capping procedures for dentin formation. 12 The biomaterials used for direct pulp-capping treatments include calcium hydroxide, resin-modified glass ionomer cements (RMGICs), mineral trioxide aggregate (MTA) and calcium silicate-based cements (CSCs).…”

“…2,11 Biomaterial application in the injured areas after excavation aims to form dentinal bridges. 3,12 Calcium hydroxide and mineral trioxide aggregate (MTA) can be used in pulp-capping therapy, which is applied after the dental injury. 3,12,13 Calcium hydroxide, a gold standard material, was commonly used decades ago for direct pulpcapping therapy.…”

“…3,12 Calcium hydroxide and mineral trioxide aggregate (MTA) can be used in pulp-capping therapy, which is applied after the dental injury. 3,12,13 Calcium hydroxide, a gold standard material, was commonly used decades ago for direct pulpcapping therapy. [13][14][15] However, the use of calcium hydroxide has limitations due to tunnel defect formation as a result of the production of dentinal bridgess.…”

Dislodgement resistance and structural changes of tricalcium silicate-based cements after exposure to different chelating agents

“…It was reported that Retro-MTA has a shorter setting time compared to the ProRoot MTA and has no discoloration potential, due to the presence of zirconium oxide as an alternative radiopacifier to bismuth oxide [ 6 ]. Ballal et al reported that Retro-MTA healed pulp tissue faster than ProRoot MTA when used as a direct pulp capping agent [ 7 ]. Ortho-MTA has a similar composition to ProRoot MTA.…”