Dammaschke Till, Wolff Philipp, Sagheri Darius, Stratmann Udo, Schäfer Edgar
Westphalian Wilhelms-University, Department of Operative Dentistry, Münster, Germany.
Quintessence Int. 2010 Feb;41(2):e20-30.
Several studies reported superior healing results for ProRoot mineral trioxide aggregate (MTA; Dentsply Tulsa) cement in direct pulp capping when compared to calcium hydroxide. However, this could not be confirmed by other authors. The aim of this study was to compare the reaction of MTA-treated rat pulp tissue to calcium hydroxide [Ca(OH)2]-treated rat pulp tissue in direct pulp capping after 1 to 70 days.
Seventy-two caries- free, maxillary right and left first molars of 36 Wistar rats were prepared with an occlusal cavity. The pulp chambers were then perforated with a sharp probe. For each of four time periods, MTA was placed on the exposed pulp of 10 molars according to the manufacturer's instructions, and Ca(OH)2 was placed on 8 molars. All cavities were then filled with dentin adhesive and flowable composite. The animals were sacrificed 1, 3, 7, and 70 days after pulp capping. The pulps were histologically analyzed (light and transmission electron microscopic) for bacterial infection, inflammatory cells, necrosis, and reparative dentin and classified according to occurrence in scores from 1 to 4. To ensure that the coronal restorations did not leak, occlusal cavities were prepared in four maxillary molars of one rat. The coronal cavity was then sealed with resin. After 70 days, the rat was sacrificed, and the molars were immersed in new fuchsin. Data were statistically evaluated with the Kruskal-Wallis test (P<.05).
The MTA group showed statistically significantly lower signs of necrosis 1 and 3 days after pulp capping when compared with the Ca(OH)2 group (P<.05). No other statistically significant differences were found (P>.05). After 70 days, all pulps displayed healthy tissue. In the leakage test no specimens revealed any dye penetration.
MTA showed equally good results as Ca(OH)2 and can berecommended clinically for direct pulp capping.
多项研究报告称，与氢氧化钙相比，ProRoot三氧化矿物凝聚体（MTA；登士柏 Tulsa）水门汀用于直接盖髓时愈合效果更佳。然而，其他作者并未证实这一点。本研究的目的是比较MTA处理的大鼠牙髓组织与氢氧化钙[Ca(OH)₂]处理的大鼠牙髓组织在直接盖髓后1至70天的反应。
选取36只Wistar大鼠的72颗无龋上颌左右第一磨牙，制备咬合面洞型。然后用尖锐探针在髓腔打孔。在四个时间段中，按照制造商说明，将MTA放置于10颗磨牙的暴露牙髓上，将Ca(OH)₂放置于8颗磨牙的暴露牙髓上。随后所有窝洞用牙本质黏结剂和流动复合树脂充填。在盖髓后1、3、7和70天处死动物。对牙髓进行组织学分析（光镜和透射电镜），观察细菌感染、炎症细胞、坏死及修复性牙本质情况，并根据出现情况按1至4分进行分类。为确保冠部修复体无渗漏，在一只大鼠的四颗上颌磨牙制备咬合面洞型。然后用树脂封闭冠部洞型。70天后，处死大鼠，将磨牙浸入新复红中。数据采用Kruskal-Wallis检验进行统计学评估（P<0.05）。
与Ca(OH)₂组相比，MTA组在盖髓后1天和3天坏死迹象在统计学上显著更低（P<0.05）。未发现其他统计学显著差异（P>0.05）。70天后，所有牙髓均显示健康组织。在渗漏试验中，无标本显示有染料渗透。
MTA与Ca(OH)₂效果相当，临床上可推荐用于直接盖髓。
