DOI QR코드

DOI QR Code

A preliminary report on histological outcome of pulpotomy with endodontic biomaterials vs calcium hydroxide

  • Nosrat, Ali (Iranian Center for Endodontic Research, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences) ;
  • Peimani, Ali (Department of Oral and Maxillofacial Surgery, Dental School, Rafsanjan University of Medical Sciences) ;
  • Asgary, Saeed (Iranian Center for Endodontic Research, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences)
  • Received : 2013.08.06
  • Accepted : 2013.09.17
  • Published : 2013.11.29

Abstract

Objectives: The purpose of the study was to evaluate human dental pulp response to pulpotomy with calcium hydroxide (CH), mineral trioxide aggregate (MTA), and calcium enriched mixture (CEM) cement. Materials and Methods: A total of nine erupted third molars were randomly assigned to each pulpotomy group. The same clinician performed full pulpotomies and coronal restorations. The patients were followed clinically for six months; the teeth were then extracted and prepared for histological assessments. The samples were blindly assessed by an independent observer for pulp vitality, pulp inflammation, and calcified bridge formation. Results: All patients were free of clinical signs/symptoms of pulpal/periradicular diseases during the follow up period. In CH group, one tooth had necrotic radicular pulp; other two teeth in this group had vital uninflamed pulps with complete dentinal bridge formation. In CEM cement and MTA groups all teeth had vital uninflamed radicular pulps. A complete dentinal bridge was formed beneath CEM cement and MTA in all roots. Odontoblast-like cells were present beneath CEM cement and MTA in all samples. Conclusions: This study revealed that CEM cement and MTA were reliable endodontic biomaterials in full pulpotomy treatment. In contrast, the human dental pulp response to CH might be unpredictable.

Keywords

References

  1. Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol 1965;20:340-349. https://doi.org/10.1016/0030-4220(65)90166-0
  2. Witherspoon DE. Vital pulp therapy with new materials: new directions and treatment perspectives-permanent teeth. J Endod 2008;34:S25-S28. https://doi.org/10.1016/j.joen.2008.02.030
  3. Tziafas D, Smith AJ, Lesot H. Designing new treatment strategies in vital pulp therapy. J Dent 2000;28:77-92. https://doi.org/10.1016/S0300-5712(99)00047-0
  4. Witherspoon DE, Small JC, Harris GZ. Mineral trioxide aggregate pulpotomies: a case series outcomes assesment. J Am Dent Assoc 2006;137:610-618. https://doi.org/10.14219/jada.archive.2006.0256
  5. Nosrat IV, Nosrat CA. Reparative hard tissue formation following calcium hydroxide application after partial pulpotomy in cariously exposed pulps of permanent teeth. Int Endod J 1998;31:221-226.
  6. Costa CA, Hebling J, Hanks CT. Current status of pulp capping with dentin adhesive systems: a review. Dent Mater 2000;16:188-197. https://doi.org/10.1016/S0109-5641(00)00008-7
  7. Barrieshi-Nusair KM, Qudeimat MA. A prospective clinical study of mineral trioxide aggregate for partial pulpotomy in cariously exposed permanent teeth. J Endod 2006;32:731-735. https://doi.org/10.1016/j.joen.2005.12.008
  8. Ford TR, Torabinejad M, Abedi HR, Bakland LK, Kariyawasam SP. Using mineral trioxide aggregate as a pulp-capping material. J Am Dent Assoc 1996;127:1491- 1494. https://doi.org/10.14219/jada.archive.1996.0058
  9. Holland R, de Souza V, de Mello W, Nery MJ, Bernabé PF, Otoboni Filho JA. Permeability of the hard tissue bridge formed after pulpotomy with calcium hydroxide: a histologic study. J Am Dent Assoc 1979;99:472-475. https://doi.org/10.14219/jada.archive.1979.0317
  10. Asgary S, Eghbal MJ, Parirokh M, Ghanavati F, Rahimi H. A comparative study of histologic response to different pulp capping materials and a novel endodontic cement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:609-614. https://doi.org/10.1016/j.tripleo.2008.06.006
  11. Nair PN, Duncan HF, Pitt Ford TR, Luder HU. Histological, ultrastructural and quantitative investigations on the response of healthy human pulps to experimental capping with mineral trioxide aggregate: a randomized controlled trial. Int Endod J 2008;41:128-150.
  12. Eghbal MJ, Asgary S, Baghlue RA, Parirokh M, Ghoddusi J. MTA pulpotomy of human permanent molars with irreversible pulpitis. Aust Endod J 2009;35:4-8. https://doi.org/10.1111/j.1747-4477.2009.00166.x
  13. Chueh LH, Chiang CP. Histology of Irreversible pulpitis premolars treated with mineral trioxide aggregate pulpotomy. Oper Dent 2010;35:370-374. https://doi.org/10.2341/09-307-S
  14. Yang WK, Ko HJ, Kim MR. Evaluation of the rat tissue reaction to experimental new resin cement and mineral trioxide aggregate cement. Restor Dent Endod 2012;37:194-200. https://doi.org/10.5395/rde.2012.37.4.194
  15. Torabinejad M, Parirokh M. Mineral trioxide aggregate: a comprehensive literature review-part II: leakage and biocompatibility investigations. J Endod 2010;36:190-202. https://doi.org/10.1016/j.joen.2009.09.010
  16. Nosrat A, Seifi A, Asgary S. Regenerative endodontic treatment (revascularization) for necrotic immature permanent molars: a review and report of two cases with a new biomaterial. J Endod 2011;37:562-567. https://doi.org/10.1016/j.joen.2011.01.011
  17. Asgary S, Kamrani FA. Antibacterial effects of five different root canal sealing materials. J Oral Sci 2008; 50:469-474. https://doi.org/10.2334/josnusd.50.469
  18. Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review-part III: clinical applications, drawbacks, and mechanism of action. J Endod 2010;36:400-413. https://doi.org/10.1016/j.joen.2009.09.009
  19. Asgary S, Eghbal MJ, Parirokh M, Ghoddusi J, Kheirieh S, Brink F. Comparison of mineral trioxide aggregate's composition with Portland cements and a new endodontic cement. J Endod 2009;35:243-250. https://doi.org/10.1016/j.joen.2008.10.026
  20. Asgary S, Shahabi S, Jafarzadeh T, Amini S, Kheirieh S. The Properties of a New Endodontic Material. J Endod 2008;34:990-993. https://doi.org/10.1016/j.joen.2008.05.006
  21. Mozayeni MA, Milani AS, Marvasti LA, Asgary S. Cytotoxicity of calcium enriched mixture cement compared with mineral trioxide aggregate and intermediate restorative material. Aust Endod J 2012; 38:70-75. https://doi.org/10.1111/j.1747-4477.2010.00269.x
  22. Tabarsi B, Parirokh M, Eghbal MJ, Haghdoost AA, Torabzadeh H, Asgary S. A comparative study of dental pulp response to several pulpotomy agents. Int Endod J 2010;43:565-571. https://doi.org/10.1111/j.1365-2591.2010.01711.x
  23. Asgary S, Nosrat A, Homayounfar N. Periapical healing after direct pulp capping with calcium-enriched mixture cement: a case report. Oper Dent 2012;37:571-575. https://doi.org/10.2341/11-417-S
  24. Parirokh M, Mirsoltani B, Raoof M, Tabrizchi H, Haghdoost AA. Comparative study of subcutaneous tissue responses to a novel root-end filling material and white and grey mineral trioxide aggregate. Int Endod J 2011;44:283-289. https://doi.org/10.1111/j.1365-2591.2010.01808.x
  25. Asgary S, Eghbal MJ, Parirokh M. Sealing ability of a novel endodontic cement as a root-end filling material. J Biomed Mater Res A 2008;87:706-709.
  26. Nosrat A, Asgary S. Apexogenesis treatment with a new endodontic cement: a case report. J Endod 2010; 36:912-914. https://doi.org/10.1016/j.joen.2009.11.025
  27. Asgary S, Ehsani S. Permanent molar pulpotomy with a new endodontic cement: a case series. J Conserv Dent 2009;12:31-36. https://doi.org/10.4103/0972-0707.53340
  28. Nosrat A, Asgary S. Apexogenesis of a symptomatic molar with calcium enriched mixture. Int Endod J 2010; 43:940-944. https://doi.org/10.1111/j.1365-2591.2010.01777.x
  29. Nosrat A, Seifi A, Asgary S. Pulpotomy in cariesexposed immature permanent molars using calciumenriched mixture cement or mineral trioxide aggregate: a randomized clinical trial. Int J Paediatr Dent 2013;23: 56-63. https://doi.org/10.1111/j.1365-263X.2012.01224.x
  30. Asgary S, Eghbal MJ, Ghoddusi J, Yazdani S. Oneyear results of vital pulp therapy in permanent molars with irreversible pulpitis: an ongoing multicenter, randomized, non-inferiority clinical trial. Clin Oral Investig 2013;17:431-439. https://doi.org/10.1007/s00784-012-0712-6
  31. Asgary S, Eghbal MJ. Treatment outcomes of pulpotomy in permanent molars with irreversible pulpitis using biomaterials: a multi-center randomized controlled trial. Acta Odontol Scand 2013;71:130-136. https://doi.org/10.3109/00016357.2011.654251
  32. Dominguez MS, Witherspoon DE, Gutmann JL, Opperman LA. Histological and scanning electron microscopy assessment of various vital pulp-therapy materials. J Endod 2003;29:324-333. https://doi.org/10.1097/00004770-200305000-00003
  33. Zarrabi MH, Javidi M, Jafarian AH, Joushan B. Histologic assessment of human pulp response to capping with mineral trioxide aggregate and a novel endodontic cement. J Endod 2010;36:1778-1781. https://doi.org/10.1016/j.joen.2010.08.024
  34. Caliskan M. Clinical reliability of the dentine bridge formed after pulpotomy: a case report. Int Endod J 1994;27:52-55. https://doi.org/10.1111/j.1365-2591.1994.tb00230.x
  35. Sarkar NK, Caicedo R, Ritwik P, Moiseyeva R, Kawashima I. Physicochemical basis of the biologic properties of mineral trioxide aggregate. J Endod 2005;31:97-100. https://doi.org/10.1097/01.DON.0000133155.04468.41
  36. Asgary S, Eghbal MJ, Parirokh M, Ghoddusi J. Effect of two storage solutions on surface topography of two root-end fillings. Aust Endod J 2009;35:147-152. https://doi.org/10.1111/j.1747-4477.2008.00137.x
  37. Barthel CR, Rozenkranz B, Leuenberg A, Roulet JF. Pulp capping of carious exposures: treatment outcome after 5 and 10 years: a retrospective study. J Endod 2000; 26:525-528. https://doi.org/10.1097/00004770-200009000-00010
  38. Torabinejad M, Hong CU, McDonald F, Pitt Ford TR. Physical and chemical properties of a new root-end filling material. J Endod 1995;21:349-353. https://doi.org/10.1016/S0099-2399(06)80967-2
  39. Chang SW. Chemical characteristics of mineral trioxide aggregate and its hydration reaction. Restor Dent Endod 2012;37:188-193. https://doi.org/10.5395/rde.2012.37.4.188
  40. Alongi DJ, Yamaza T, Song Y, Fouad AF, Romberg EE, Shi S, Tuan RS, Huang GT. Stem/progenitor cells from inflamed human dental pulp retain tissue regeneration potential. Regen Med 2010;5:617-631. https://doi.org/10.2217/rme.10.30

Cited by

  1. Cytocompatibility and Antibacterial Properties of Capping Materials vol.2014, pp.1537-744X, 2014, https://doi.org/10.1155/2014/181945
  2. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part I: vital pulp therapy pp.01432885, 2018, https://doi.org/10.1111/iej.12841
  3. Surgical management of a failed internal root resorption treatment: a histological and clinical report vol.39, pp.2, 2014, https://doi.org/10.5395/rde.2014.39.2.137
  4. Periodontal healing following non-surgical repair of an old perforation with pocket formation and oral communication vol.43, pp.2, 2018, https://doi.org/10.5395/rde.2018.43.e17
  5. Calcium-Enriched Mixture Pulpotomy of Primary Molar Teeth with Irreversible Pulpitis. A Clinical Study vol.10, pp.None, 2013, https://doi.org/10.2174/1874210601610010043
  6. Conservative Management of Class 4 Invasive Cervical Root Resorption Using Calcium-enriched Mixture Cement vol.42, pp.8, 2013, https://doi.org/10.1016/j.joen.2016.05.001
  7. Which procedures and materials could be applied for full pulpotomy in permanent mature teeth? A systematic review vol.77, pp.7, 2013, https://doi.org/10.1080/00016357.2019.1614217
  8. Postendodontic Pain after Pulpotomy or Root Canal Treatment in Mature Teeth with Carious Pulp Exposure: A Multicenter Randomized Controlled Trial vol.2020, pp.None, 2013, https://doi.org/10.1155/2020/5853412
  9. Dexamethasone- loaded polymeric porous sponge as a direct pulp capping agent vol.31, pp.13, 2013, https://doi.org/10.1080/09205063.2020.1769801
  10. Long-term Outcomes of Full Pulpotomy in Permanent Molars for Patients Treated in a Single, Short Session under Special Conditions vol.46, pp.11, 2013, https://doi.org/10.1016/j.joen.2020.08.003