Nangia Udeeksha, Mala Kundabala, Shetty Neeta, Natarajan Srikant, Shenoy Ramya
Private Practitioner, USA.
Professor, Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Affiliated to Manipal Academy of Higher Education, Manipal, Mangaluru, Karnataka, India.
J Conserv Dent. 2021 Nov-Dec;24(6):585-588. doi: 10.4103/jcd.jcd_486_21. Epub 2022 Apr 1.
The predictability of direct pulp capping (DPC) depends on the quality of the dentin bridge formation and the inflammatory response to the capping material. Various materials are available with variable success.
The aim of this study is to evaluate histologically the effectiveness of calcium hydroxide, mineral aggregate, and dentin bonding agent when used as DPC in mechanically exposed adult pulp tissue.
Pulpal exposures were made in 45 intact human premolars, scheduled for extraction for orthodontic purposes. Teeth were capped with hard setting calcium hydroxide (Dycal), mineral trioxide aggregate (ProRoot MTA), and dentin bonding agent (adper Single Bond). The final restoration was done with posterior composites using resin-modified glass-ionomer cement as a base. Pulps of teeth were evaluated histologically at the 15 and 45 day for inflammatory cell response and dentin bridge formation according to the criteria described by Cox . The statistical analysis of data was done using Chi-square test and P ≤ 0.05 was considered statsiticlly significant.
MTA as DPC agent showed milder inflammatory response compared to Dycal and Single Bond. The quality of bridge formation by MTA was similar to Dycal, which took the least time. Adper Single Bond Plus and Dycal showed a significantly higher degree of pulpal inflammation. Among all materials used, Adper Single Bond Plus took the longest time for both the resolution of pulpal inflammation and improvement of the quality of bridge formation.
Based on the result, it can be concluded that Dycal and MTA produce similar types of dentin bridge formation when used a DPC agent. Adper Single Bond has the potential to be used as DPC agents, but it takes a longer time for the resolution of inflammation and dentin bridge formation.
直接盖髓术(DPC)的可预测性取决于牙本质桥形成的质量以及对盖髓材料的炎症反应。有多种材料可供使用,成功率各不相同。
本研究的目的是从组织学角度评估氢氧化钙、矿物聚集体和牙本质粘结剂在机械暴露的成人牙髓组织中用作直接盖髓术材料时的有效性。
选取45颗因正畸需要拔除的完整人类前磨牙,造成牙髓暴露。分别用硬固型氢氧化钙(Dycal)、三氧化矿物凝聚体(ProRoot MTA)和牙本质粘结剂(Adper Single Bond)覆盖牙髓。最终修复使用树脂改性玻璃离子水门汀作为基底的后牙复合树脂。根据考克斯描述的标准,在第15天和第45天对牙髓进行组织学评估,观察炎症细胞反应和牙本质桥形成情况。数据的统计分析采用卡方检验,P≤0.05被认为具有统计学意义。
与Dycal和Single Bond相比,MTA作为直接盖髓术材料时炎症反应较轻。MTA形成桥的质量与Dycal相似,且所需时间最短。Adper Single Bond Plus和Dycal的牙髓炎症程度明显更高。在所有使用的材料中,Adper Single Bond Plus在牙髓炎症消退和桥形成质量改善方面所需时间最长。
基于结果可以得出结论,Dycal和MTA用作直接盖髓术材料时产生的牙本质桥形成类型相似。Adper Single Bond有潜力用作直接盖髓术材料,但炎症消退和牙本质桥形成所需时间较长。