Cannon Mark, Gerodias Nate, Viera Ana, Percinoto Celio, Jurado Ray
Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
J Clin Pediatr Dent. 2014 Summer;38(4):333-7. doi: 10.17796/jcpd.38.4.m585322121536q71.
The purpose of this in vivo study was to compare the effectiveness of a new light cured resin based dicalcium/tricalcium silicate pulp capping material (TheraCalLC, Bisco), pure Portland cement, resin based calcium hydroxide or glass ionomer in the healing of bacterially contaminated primate pulps.
The experiment required four primates each having 12 teeth prepared with buccal penetrations into the pulpal tissues with an exposure of approximately 1.0 mm. The exposed pulps of the primate teeth were covered with cotton pellets soaked in a bacterial mixture consisting of microorganisms normally found in human pulpal abscesses. After removal of the pellet, hemostasis was obtained and the pulp capping agents applied. The light cured resin based pulp capping material (TheraCal LC) was applied to the pulpal tissue of twelve teeth with a needle tip syringe and light cured for 15 seconds. Pure Portland cement mixed with a 2% Chlorhexidine solution was placed on the exposed pulpal tissues of another twelve teeth. Twelve additional teeth had a base of GIC applied (Triage, Fuji VII GC America) and another twelve had a pulp cap with VLC DYCAL (Dentsply), a light cured calcium hydroxide resin based material. The pulp capping bases were then covered with a RMGI (Fuji II LC GC America). The tissue samples were collected at 4 weeks. The samples were deminerilized, sectioned, stained and histologically graded.
There were no statistically significant differences between the groups in regard to pulpal inflammation (H = 0.679, P = 1.00). However, both the Portland cement and light cured TheraCal LC groups had significantly more frequent hard tissue bridge formation at 28 days than the GIC and VLC Dycal groups (H = 11.989, P = 0.009). The measured thickness of the hard tissue bridges with the pure Portland and light cured TheraCal LC groups were statistically greater than that of the other two groups (H = 15.849, P = 0.002). In addition, the occurrence of pulpal necrosis was greater with the GIC group than the others. Four premolars, one each treated according to the protocols were analyzed with a microCT machine. The premolar treated with the light cured TheraCal LC demonstrated a complete hard tissue bridge. The premolar treated with the GIC did not show a complete hard tissue bridge while the premolar treated with VLC Dycal had an incomplete bridge. The pure Portland with Chlorhexidine mixture created extensive hard tissue bridging.
TheraCal LC applied to primate pulps created dentin bridges and mild inflammation acceptable for pulp capping.
本体内研究的目的是比较一种新型光固化树脂基磷酸二钙/磷酸三钙牙髓盖髓材料（TheraCalLC，Bisco公司）、纯波特兰水泥、树脂基氢氧化钙或玻璃离子体在受细菌污染的灵长类牙髓愈合中的效果。
该实验需要4只灵长类动物，每只动物有12颗牙齿，通过颊侧穿通制备至牙髓组织，暴露约1.0毫米。用浸泡在由人类牙髓脓肿中常见微生物组成的细菌混合物中的棉球覆盖灵长类动物牙齿暴露的牙髓。去除棉球后，实现止血并应用牙髓盖髓剂。用针尖注射器将光固化树脂基牙髓盖髓材料（TheraCal LC）应用于12颗牙齿的牙髓组织，并光固化15秒。将与2%氯己定溶液混合的纯波特兰水泥放置在另外12颗牙齿暴露的牙髓组织上。另外12颗牙齿应用玻璃离子体垫底（Triage，富士VII，GC美国公司），还有12颗牙齿用VLC DYCAL（登士柏公司）进行牙髓盖髓，这是一种光固化树脂基氢氧化钙材料。然后用树脂改性玻璃离子体（富士II LC，GC美国公司）覆盖牙髓盖髓垫底材料。在4周时收集组织样本。对样本进行脱矿质、切片、染色并进行组织学分级。
各组之间在牙髓炎症方面无统计学显著差异（H = 0.679，P = 1.00）。然而，波特兰水泥组和光固化TheraCal LC组在28天时形成硬组织桥的频率明显高于玻璃离子体组和VLC Dycal组（H = 11.989，P = 0.009）。纯波特兰水泥组和光固化TheraCal LC组的硬组织桥测量厚度在统计学上大于其他两组（H = 15.849，P = 0.002）。此外，玻璃离子体组牙髓坏死的发生率高于其他组。用微型CT机对按照方案处理的4颗前磨牙（每颗处理一颗）进行了分析。用光固化TheraCal LC处理的前磨牙显示出完整的硬组织桥。用玻璃离子体处理的前磨牙未显示完整的硬组织桥，而用VLC Dycal处理的前磨牙有不完整的桥。含氯己定的纯波特兰水泥混合物形成了广泛的硬组织桥接。
应用于灵长类牙髓的TheraCal LC形成了牙本质桥和轻度炎症，可接受用于牙髓盖髓。
