This study aimed to evaluate the impact of preoperative pulp inflammation on the histologic outcome of full pulpotomy performed in mature permanent posterior teeth using 4 different biomaterials.
Five beagle dogs (providing a total of 120 roots) were selected. Dentin exposure was performed in teeth from the second and third quadrants. One week later, full pulpotomy procedures were performed using 4 different bioactive materials (ProRoot MTA [MTA], TotalFill BC Putty [BC], Biodentine [BIO], and an experimental cement [ie, pulp capping material]). The hemostasis time was registered. After 14 weeks, the animals were killed. Pulp-dentin tissues were histologically and radiographically assessed. The significance level was set at .05.
Teeth with previously exposed dentin revealed a statistically significant increase in the time required to achieve hemostasis (P < .001), therefore confirming the pulp inflammation status induced by 1-week exposure of occlusal dentin before performing full pulpotomy. There was no radiographic evidence of root resorption, periapical radiolucency, or lamina dura alterations. No statistically significant differences were observed between normal and inflamed pulp regardless of the evaluated histologic parameters. Moreover, histologic data concerning calcified barrier formation and the pulp tissue response show better results for BIO without statistical differences compared with MTA or BC (P > .05). The pulp capping material presented a lower performance, with statistically significant differences being detected in regard to the remaining 3 tested materials (P < .001).
Radiographic and histologic outcomes of full pulpotomy are not jeopardized by short-term preoperative pulp inflammation. Moreover, BIO, MTA, and BC cements present suitable alternatives to be used as pulp capping agents.
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- Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part I: vital pulp therapy.Int Endod J. 2018; 51: 177-205
- Vital pulp therapy in permanent mature posterior teeth with symptomatic irreversible pulpitis: a systematic review of treatment outcomes.Medicina (Kaunas). 2021; 57: 573
- Different materials for direct pulp capping: systematic review and meta-analysis and trial sequential analysis.Clin Oral Investig. 2016; 20: 1121-1132
- Vital pulp therapy.Dent Clin North Am. 2013; 57: 59-73
- Vital pulp therapy in vital permanent teeth with cariously exposed pulp: a systematic review.J Endod. 2011; 37: 581-587
- Partial pulpotomy in mature permanent teeth with clinical signs indicative of irreversible pulpitis: a randomized clinical trial.J Endod. 2017; 43: 1417-1421
- Long-term outcomes of pulpotomy in permanent teeth with irreversible pulpitis: a multi-center randomized controlled trial.Am J Dent. 2017; 30: 151-155
- Pulpotomy for mature carious teeth with symptoms of irreversible pulpitis: a systematic review.J Dent. 2019; 88: 103158
- Vital pulp therapy of mature permanent teeth with irreversible pulpitis from the perspective of pulp biology.Aust Endod J. 2020; 46: 154-166
- Correlation between clinical and histologic pulp diagnoses.J Endod. 2014; 40: 1932-1939
- Comparative evaluation of pro-inflammatory cytokine levels in pulpotomized primary molars.J Oral Sci. 2015; 57: 145-150
- Should pulp chamber pulpotomy be seen as a permanent treatment? Some preliminary thoughts.Int Endod J. 2013; 46: 79-87
- Is pulp inflammation a prerequisite for pulp healing and regeneration?.Mediators Inflamm. 2015; 2015: 347649
- Pulp capping materials modulate the balance between inflammation and regeneration.Dent Mater. 2019; 35: 24-35
- Human pulp responses to partial pulpotomy treatment with TheraCal as compared with Biodentine and ProRoot MTA: a clinical trial.J Endod. 2017; 43: 1786-1791
- Characterization of odontoblast-like cell phenotype and reparative dentin formation in vivo: a comprehensive literature review.J Endod. 2019; 45: 241-249
- Animal research: reporting in vivo experiments: the ARRIVE guidelines.Br J Pharmacol. 2010; 160: 1577-1579
- Periapical inflammation subsequent to coronal inoculation of dog teeth root filled with resilon/epiphany in 1 or 2 treatment sessions with chlorhexidine medication.J Endod. 2014; 40: 837-841
- Response of human dental pulp capped with biodentine and mineral trioxide aggregate.J Endod. 2013; 39: 743-747
- Comparison of pulpal responses to pulpotomy and pulp capping with biodentine and mineral trioxide aggregate in dogs.J Endod. 2014; 40: 1362-1369
- Five-year results of vital pulp therapy in permanent molars with irreversible pulpitis: a non-inferiority multicenter randomized clinical trial.Clin Oral Investig. 2015; 19: 335-341
- Partial pulpotomy with two bioactive cements in permanent teeth of 6- to 18-year-old patients with signs and symptoms indicative of irreversible pulpitis: a noninferiority randomized controlled trial.Int Endod J. 2019; 52: 749-759
- A clinical study of direct pulp capping applied to carious-exposed pulps.J Endod. 1996; 22: 551-556
- Outcome of full pulpotomy using Biodentine in adult patients with symptoms indicative of irreversible pulpitis.Int Endod J. 2018; 51: 819-828
- An immunocytochemical study of the morphological reaction of nerves containing calcitonin gene-related peptide to microabscess formation and healing in rat molars.Arch Oral Biol. 1990; 35: 629-638
- Vital pulp therapy: histopathology and histobacteriology-based guidelines to treat teeth with deep caries and pulp exposure.J Dent. 2019; 86: 41-52
- Clinical and histological evaluation of white ProRoot MTA in direct pulp capping.Am J Dent. 2006; 19: 85-90
- A review of criteria for the evaluation of pulpotomy outcomes in mature permanent teeth.J Endod. 2016; 42: 1167-1174
- Histologic response of human pulp and periapical tissues to tricalcium silicate-based materials: a series of successfully treated cases.J Endod. 2020; 46: 307-317
- Histologic assessment of quick-set and mineral trioxide aggregate pulpotomies in a canine model.J Endod. 2015; 41: 1626-1630
- Histological and scanning electron microscopy assessment of various vital pulp-therapy materials.J Endod. 2003; 29: 324-333
- Cryotherapy: a new paradigm of treatment in endodontics.J Endod. 2020; 46: 936-942
Published online: July 02, 2021
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