Pulp tissue response to Portland cement associated with different radio pacifying agents on pulpotomy of human primary molars

Abstract

The objective of this research was to evaluate the response of Portland cement associated with different radio pacifying agents on pulp treatment of human primary teeth by clinical and radiographic exams and microscopic analysis. Thirty mandibular primary molars were randomly divided into the following groups: Group I - Portland cement; Group II - Portland cement with iodoform (Portland cement + CHI3 ); Group III - Portland cement with zirconium oxide (Portland cement + ZrO2 ); and treated by pulpotomy technique (removal of a portion of the pulp aiming to maintain the vitally of the remaining radicular pulp tissue using a therapeutic dressing). Clinical and radiographic evaluations were recorded at 6, 12 and 24 months follow-up. The teeth at the regular exfoliation period were extracted and processed for histological analysis. Data were tested using statistical analysis with a significance level of 5%. The microscopic findings were descriptively analysed. All treated teeth were clinically and radiographically successful at follow-up appointments. The microscopic analysis revealed positive response to pulp repair with hard tissue barrier formation and pulp calcification in the remaining roots of all available teeth. The findings of this study suggest that primary teeth pulp tissue exhibited satisfactory biological response to Portland cement associated with radio pacifying agents. However, further studies with long-term follow-up are needed to determine the safe clinical indication of this alternative material for pulp therapy of primary teeth.

The Impact of Iodoform on the Hydration, Bioactivity and Antimicrobial Properties of White Portland Cement

“…Iodoform is among the candidate radiopacifying agents that are currently considered for incorporation in Portland cements for dental applications [3][4][5]. The present study has demonstrated that 20 wt% replacement of iodoform for white Portland cement reduces both initial and final setting times.…”

“…This is an acknowledged advantage of Portlandcement based biomaterials that exhibit the ability to stimulate the formation of new cementum, pulp and bone [3]. Animal and human studies have indicated that 20:80 mixtures of iodoform and Portland cement exhibit similar biocompatibility to that of commercial MTA [4,5]. Hence, from a biological perspective, iodoform has the potential to enhance the antimicrobial properties of the cement without compromising its bioactivity and biocompatibility.…”

“…Up to 5% of gypsum (CaSO 4 .2H 2 O) is also ground into the anhydrous cement during production to regulate the setting of the aluminate phase. 'Tooth-colored' MTA is formulated from white Portland cement (WPC) which contains low quantities of iron and manganese that impart the grey colour to ordinary Portland cement (OPC) from which 'Gray' MTA is produced [2].…”

“…Iodoform (CHI 3 ) is among a range of candidate radiopacifying agents for use in Portland cementbased dental restoratives with potentially superior physicochemical, biological and antimicrobial properties to those of bismuth oxide [3][4][5]. Results of animal and human studies indicate that iodoform is sufficiently biocompatible and radiopaque at 20% addition to Portland cement [4,5].…”

“…Results of animal and human studies indicate that iodoform is sufficiently biocompatible and radiopaque at 20% addition to Portland cement [4,5].…”