• Journal of Yeungnam Medical Science
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• 제37권3호
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• pp.217-225
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• 2020

Background: This study was performed to provide a long-term bacterial seal through the formation of reparative dentin bridge, calcium silicate-based pulp capping materials have been used at sites of pulpal exposure. The aim of this study was to evaluate the mineralization-inducing potentials of calcium silicate-based pulp capping materials (ProRoot MTA [PR], Biodentine [BD], and TheraCal LC [TC]) in human dental pulp cells (HDPCs). Methods: Specimens of test materials were placed in deionized water for various incubation times to measure the pH variation and the concentration of calcium released. The morphology of HDPCs cultured on the specimens was examined using a confocal laser scanning microscope (CLSM). Alizarin red S staining and alkaline phosphatase assays were used to evaluate mineralization-inducing potentials of the capping materials. Results: BD showed the highest calcium release in all test periods, followed by PR and TC. (p<0.05). All experimental groups showed high alkalinity after 1 day, except at 14 days. BD showed the highest cell viability compared with PR and TC after 1 and 3 days, while TC showed the lowest value (p<0.05). The CLSM analysis showed that cells were well adhered and expressed actin filaments for all pulp capping materials. Mineralization by PR and BD groups was higher than that by TC group based on alizarin red S staining. BD showed significantly higher alkaline phosphatase activity than PR and TC, while TC showed the lowest value (p<0.05). Conclusion: Within the limitations of the in vitro study, BD had higher mineralization-inducing potential than PR and TC.

• Restorative Dentistry and Endodontics
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• 제37권4호
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• pp.240-244
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• 2012

Crown reattachment is the most conservative treatment which can be used to restore fractured tooth, presumably with sufficient strength, while maintaining original contour, incisal translucency, and reducing chair time and cost. However, in case of crown fracture with pin-point pulp exposure, we should cautiously minimize the irritation to the pulp and consider pre-treatment pulpal status, choice of pulp capping materials, choice of bonding system and treatment sequence during crown reattachment procedures. This case reports the considerations while crown reattachment with direct pulp capping using calcium hydroxide (Dycal, Dentsply Caulk).

• Restorative Dentistry and Endodontics
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• 제46권3호
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• pp.40.1-40.12
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• 2021

Objectives: The purpose of this study was to critically evaluate the quality, reliability and educational content of the information of vital pulp treatment videos available on YouTube. Materials and Methods: The keywords "pulpotomy" and "pulp capping" were searched on YouTube on 5th July 2020, until 60 English language videos of each search term with a duration shorter than 15 minutes were acquired. Video characteristics were recorded and Video Power Index (VPI) was calculated. Reliability and educational quality of videos were evaluated using the Modified DISCERN score, the Journal of American Medical Association (JAMA) benchmark criteria and Global Quality Scores (GQS). Videos were categorized by uploading source. Results: Regarding pulpotomy, 31.7% of the videos were uploaded by specialists and 68.3% were directed by non-specialists. In the case of pulp capping, the corresponding percentages were 45% and 55%, respectively. Videos uploaded by specialists had significantly higher modified DISCERN, JAMA and GQS scores compared to those uploaded by non-specialists. Endodontists tended to have the highest reliability and VPI scores. Conclusions: YouTube videos on vital pulp treatment contain low educational quality or incomplete information. Low popularity of dental pulp capping and pulpotomy videos may be attributed to the specialized nature of these procedures. As YouTube represents an important source for patient information about different health topics, reliable informative videos should be uploaded by specialized dental professionals.

• Restorative Dentistry and Endodontics
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• 제43권4호
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• pp.36.1-36.12
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• 2018

Objectives: Direct pulp capping is a treatment for mechanically exposed pulp in which a biocompatible capping material is used to preserve pulpal vitality. Biocompatibility tests in animal studies have used a variety of experimental protocols, particularly with regard to the exposure site. In this study, pulp exposure on the occlusal and mesial surfaces of molar teeth was investigated in a rat model. Materials and Methods: A total of 58 maxillary first molars of Wistar rats were used. Forty molars were mechanically exposed and randomly assigned according to 3 factors: 1) the exposure site (occlusal or mesial), 2) the pulp-capping material (ProRoot White MTA or Bio-MA), and 3) 2 follow-up periods (1 day or 7 days) (n = 5 each). The pulp of 6 intact molars served as negative controls. The pulp of 12 molars was exposed without a capping material (n = 3 per exposure site for each period) and served as positive controls. Inflammatory cell infiltration and reparative dentin formation were histologically evaluated at 1 and 7 days using grading scores. Results: At 1 day, localized mild inflammation was detected in most teeth in all experimental groups. At 7 days, continuous/discontinuous calcified bridges were formed at exposure sites with no or few inflammatory cells. No significant differences in pulpal response according to the exposure site or calcium-silicate cement were observed. Conclusions: The location of the exposure site had no effect on rat pulpal healing. However, mesial exposures could be performed easily, with more consistent results. The pulpal responses were not significantly different between the 2 capping materials.

• 생체재료학회지
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• 제22권4호
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• pp.346-351
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• 2018

Background: Carbonate apatite ($CO_3Ap$) and silica-calcium phosphate composite (SCPC) are bone substitutes with good prospect for dental application. SCPC creates a hydroxyapatite surface layer and stimulate bone cell function while, $CO_3Ap$ induce apatite crystal formation with good adaptation providing good seal between cement and the bone. Together, these materials will add favorable properties as a pulp capping material to stimulate mineral barrier and maintain pulp vitality. The aim of this study is to investigate modification of $CO_3Ap$ cement combined with SCPC, later term as $CO_3Ap-SCPC$ cement (CAS) in means of its chemical (Calcium release) and physical properties (setting time, DTS and pH value). Methods: The study consist of three groups; group 1 (100% calcium hydroxide, group 2 $CO_3Ap$ (60% DCPA: 40% vaterite, and group 3 CAS (60% DCPA: 20% vaterite: 20% SCPC. Distilled water was employed as a solution for group 1, and $0.2mol/L\;Na_3PO_4$ used for group 2 and group 3. Samples were evaluated with respect to important properties for pulp capping application such as pH, setting time, mechanical strength and calcium release evaluation. Results: The fastest setting time was in $CO_3Ap$ cement group without SCPC, while the addition of 20% SCPC slightly increase the pH value but did not improved the cement mechanical strength, however, the mechanical strength of both $CO_3Ap$ groups were significantly higher than calcium hydroxide. All three groups released calcium ions and had alkaline pH. Highest pH level, as well as calcium released level, was in the control group. Conclusion: The CAS cement had good mechanical and acceptable chemical properties for pulp capping application compared to calcium hydroxide as a gold standard. However, improvements and in vivo studies are to be carried out with the further development of this material.

• 대한치과의사협회지
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• 제9권4호
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• pp.157-160
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• 1971

To compare the effects of various pulp capping agents that are usually applied to human pulp tissue, adult dogs were bred for a certain period and each capping agent was applied experimentally to pulp tissue after vital pulpotomy. Histological observations are as follows. 1) In comparison between methods of vital pulpotomy, one and two appointment method, different courses of healing were observed. In one appointment method, the granulation tissue formation at the amputation sur face of pulp tissue had a tendency to be transformed to scar tissue formation. In two appointment method, more transformation than that of one appointment method from scar tissue to dentin matrix formation were observed. 2) Histologic changes that have appeared in pulp tissue are a) fixation at outer layer b) degeneration at middle layer c) hyperemia and round cell infiltration at inner layer 3) With use of formocresol mixed zinc oxide powder in two appointment method complete formation of dentin matrix were observed. 4) Among the methods and aagents described above formocresol mixed zinc oxide powder in two appointment method appeared to be relatively effective.

• Restorative Dentistry and Endodontics
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• 제45권1호
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• pp.3.1-3.10
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• 2020

Objectives: This study investigated the indirect effect of calcium-enriched mixture (CEM) cement and mineral trioxide aggregate (MTA), as 2 calcium silicate-based hydraulic cements, on human dental pulp stem cells (hDPSCs) through different dentin thicknesses. Materials and Methods: Two-chamber setups were designed to simulate indirect pulp capping (IPC). Human molars were sectioned to obtain 0.1-, 0.3-, and 0.5-mm-thick dentin discs, which were placed between the 2 chambers to simulate an IPC procedure. Then, MTA and CEM were applied on one side of the discs, while hDPSCs were cultured on the other side. After 2 weeks of incubation, the cells were removed, and cell proliferation, morphology, and attachment to the discs were evaluated under scanning electron microscopy (SEM). Energy-dispersive X-ray (EDXA) spectroscopy was performed for elemental analysis. Alkaline phosphatase (ALP) activity was assessed quantitatively. The data were analyzed using the Kruskal-Wallis and Mann-Whitney tests. Results: SEM micrographs revealed elongated cells, collagen fibers, and calcified nucleations in all samples. EDXA verified that the calcified nucleations consisted of calcium phosphate. The largest calcifications were seen in the 0.1-mm-thick dentin subgroups. There was no significant difference in ALP activity across the CEM subgroups; however, ALP activity was significantly lower in the 0.1-mm-thick dentin subgroup than in the other MTA subgroups (p < 0.05). Conclusions: The employed capping biomaterials exerted biological activity on hDPSCs, as shown by cell proliferation, morphology, and attachment and calcific precipitations, through 0.1- to 0.5-mm-thick layers of dentin. In IPC, the bioactivity of these endodontic biomaterials is probably beneficial.

• 대한치과의사협회지
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• 제57권8호
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• pp.464-473
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• 2019

For dental pulp treatment of immature permanent teeth, direct pulp capping or partial/cervical pulpotomy (apexogenesis) procedures can be used if the dental pulp is vital. MTA (Mineral Trioxide Aggregate) is regarded as the first choice dressing material for these procedures because its higher success rate. It can be also used successfully for devitalized dental pulp which has been treated by calcium hydroxide. This apexification procedure with MTA has a few advantage such as short treatment period and increase of resistance against root fracture. Recently, regenerative endodontic treatment was introduced for devitalized immature pulp. It can maintain pulp vitality and lead to continuing root development although the dental pulp was devitalized.

• Restorative Dentistry and Endodontics
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• 제46권2호
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• pp.17.1-17.9
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• 2021

Objectives: In recent in vitro study, it was reported that osteostatin (OST) has an odontogenic effect and synergistic effect with mineral trioxide aggregate (MTA) in human dental pulp cells. Therefore, the aim of this study was to evaluate whether OST has a synergistic effect with MTA on hard tissue formation in vivo. Materials and Methods: Thirty-two maxillary molars of Spraque-Dawley rats were used in this study. An occlusal cavity was prepared and the exposed pulps were randomly divided into 3 groups: group 1 (control; ProRoot MTA), group 2 (OST 100 μM + ProRoot MTA), group 3 (OST 10 mM + ProRoot MTA). Exposed pulps were capped with each material and cavities were restored with resin modified glass ionomer. The animals were sacrificed after 4 weeks. All harvested teeth were scanned with micro-computed tomography (CT). The samples were prepared and hard tissue formation was evaluated histologically. For immunohistochemical analysis, the specimens were sectioned and incubated with primary antibodies against dentin sialoprotein (DSP). Results: In the micro-CT analysis, it is revealed that OST with ProRoot MTA groups showed more mineralized bridge than the control (p < 0.05). In the H&E staining, it is showed that more quantity of the mineralized dentin bridge was formed in the OST with ProRoot MTA group compared to the control (p < 0.05). In all groups, DSP was expressed in newly formed reparative dentin area. Conclusions: OST can be a supplementary pulp capping material when used with MTA to make synergistic effect in hard tissue formation.

• 대한소아치과학회지
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• 제46권1호
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• pp.76-84
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• 2019

이 연구의 목적은 3종의 수복재료와 3종의 tricalcium-silicate 기반 치수복조제의 미세누출을 평가하고, 이들 치수복조제와 상아질 사이의 전단결합강도를 비교하는 것이다. 수복재료로는 복합레진(CR), 레진강화형 글래스아이오노머 시멘트(RMGI), 그리고 전통적인 글래스아이오노머 시멘트(GIC)를, 치수복조제로는 TheraCal $LC^{(R)}$(TLC), $Biodentine^{(R)}$ (BD), 그리고 $ProRoot^{(R)}$ white MTA (WMTA)을 사용했다. 소의 절치에 5급와동을 형성하여 이를 적용하는 치수복조제와 수복재료에 따라 9개의 그룹으로 분류하고 0.5% fuchsin 용액을 이용한 염색침투법을 시행했다. 각 표본을 절단하고 입체현미경으로 관찰해 미세누출 정도를 평가했다. 아크릴 레진에 소 절치의 임상적 치관을 매몰한 후 수평으로 절단해 준비한 표본을 임의로 3그룹으로 나누었다. 표본의 상아질에 그룹별로 TLC, BD, 그리고 WMTA 블록을 적용한 후 universal testing machine을 이용해 전단결합강도를 측정했다. 미세누출은 TLC + GIC, TLC + RMGI, TLC + CR, 그리고 BD + GIC 그룹에서 가장 적었고, WMTA + RMGI와 WMTA + CR 그룹에서 가장 많았다. 전단결합강도는 WMTA 그룹에서 다른 그룹보다 통계적으로 유의하게 낮은 것으로 나타났다.