• Restorative Dentistry and Endodontics
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• v.38 no.4
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• pp.227-233
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• 2013

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.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.2
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• pp.318-332
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• 2000

The purpose of this study was to investigate the effects of demineralized freeze-dried bone (DFDB) on mechanically exposed pulp of dog by evaluating the pulpal inflammation and healing process, formation of dental hard tissue, and structural changes of fibroblasts of the remaining pulp tissue. Teeth of 4 dogs, weighing 10kg, were used in this study. Class V cavities were prepared followed by exposed the pulp tissue mechanically by sterilized round bur. In control group, exposed pulps were capped with calcium hydroxide paste followed by sealed with IRM. In experimental groups, the exposed pulps of one group were capped with the collagen and those of the other group were capped with DFDB. All cavities were sealed with same manor as control group. The animals were sacrificed at the intervals of 3, 7, 14, and 28 days for histopathlogic evaluation. The specimens were observed by the light microscope and trans-electron microscope. The results were as follows: 1. Pulp necrosis was not observed in all groups. Inflammatory response was disappeared from 1 week in control group and group 2. But it was not disappeared until 2 weeks and also irregular arrangement of odontoblasts was showed at the lateral walls of root canal just beneath the amputated site of the pulp in group 1. 2. Dentinal bridge was formed incompletely at 2 weeks but it was formed completely at 4 weeks in control group. Odontoid tissue was also found in control group at 4 weeks from treatment. Amputated site of pulp was encapsulated with fibrous tissue and odontoblast and dentinal bridge was not found in group 1. Preodontoid tissue and reparative dentin which were formed by odontoblast differentiated around DFDB were found, but dentinal bridge was not found in group 2. 3. Cell with large basophillic-stained nuclei infiltrated to amputated site and DFDB at 1 week from treatment in control group and group 2. They were found more in group 2 than in control group. Odontoblasts arranged more regularly and reparative dentin was found more as time elapsed. 4. Dentin-formative odontoblasts which showed ultramicrostructure of cytoplasm with polarized nucleus, rEM, Golgi complex, secretory granules, secretion of organic matrix in control of group and group 2. In regards to above results, the demineralized freeze-dried bone(DFDB) induce odontoblastic differentiation and further come up to the dentin formation in amputated pulp.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.2
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• pp.146-158
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• 2002

The purpose of this study was to investigate the effects of Nd:YAG laser on mechanically exposed pulp of dog by the observation of pulpal inflammatory change and heal process including dentinal bridge, structural changes of fibroblasts of thr remaining vital pulp tissue. In experimental group 1, the exposed pulps were irradiated with Nd:YAG laser(3W, 30Hz, 0.2sec) for $2{\sim}3$ second followed by capped with aluminium tin foil. In group 2 and group 3, the exposed pulps were irradiated with Nd:YAG laser via contact(Group 2) and non-contact(Group 3) methods followed by capped with calciumhydroxide paste. The animal were sacrificed at the intervals of 3, 7, 14 and 30days for histologic evaluation. The results were as follows : 1. The dentinal bridges were formwd more fast and broadly in the experimental group 1 and 2 than other groups, but there were no histologic differences in the degree of their formation among control group, experimental group 1. 2. Odontoblastic activities at amputated pulp was increased in the experimental group 2, 3 than other group but there no histologic difference in the odontblastic activitiy among control group, experimental group 1. 3. The infalmmation was severe at the postoperative 1 week of all groups, but its condition subsideed with time elapsed. At the postoperative 3, 7 days, its condition in experimental group 2, 3 were less severe than in the group 1. 4. There were no histologic differences between the experimental group 2 and 3 according to the degree of dentin bridge formation.

• Restorative Dentistry and Endodontics
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• v.14 no.1
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• pp.109-118
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• 1989

The purpose of this study was to investigate the bio-stimulating effect of low power density laser radiation on the mechanically exposed pulp. Class V cavities on dog's teeth were prepared and the pulps were mechanically exposed with a round bur. In control group, the exposed pulps were capped with $Ca(OH)_2$ powder and the cavities were sealed with Z.O.E.. In experimental group A, the pulps were irradiated with GaA1As laser for 5 minutes and then they were treated the same as control group. In experimental group B, the exposed pulps were covered by aluminum foil and sealed with Z.O.E. after they were irradiated with the laser as the experimental group A. In the all groups, the pulps were histopathologically observed at the time intervals of 1, 2 and 3 week after experiment and the results were statistically evaluated. The results were as follows: 1) In control and experimental groups, mild vascular congestion and bleeding was found in most of the specimens and for the new formation of dentin bridge, experimental group A had the most cases. The dentin bridge had discontinuous osteodentin like appearance without any dentinal tubules. Inflammatory cell infiltration consisted of acute and chronic inflammatory cell, and the formation of microabscess was also observed. 2) The degree of inflammatory cell infiltration was not significantly different among control group and experimental groups at 1 week, 2 week and 3 week. 3) The formation of new dentin bridge was not significantly different between control group and experimental group A at 1 week, but at 2 week and 3 week, experimental group A showed significantly more cases of new dentin formation than control groups. (P < 0.05). 4) Between control group and experimental group B, there was no significant difference in formation of the new dentin bridge at 1, 2 and 3 week. (P> 0.05). 5) There was no significant difference in formation of the new dentin bridge at 1 and 2 week between experimental group A and experimental group B, but at 3 week, the former significantly had more cases of new dentin bridge formation than the latter.(P < 0.05).

• Restorative Dentistry and Endodontics
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• v.20 no.2
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• pp.399-422
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• 1995

The purpose of this study was to investigate a fragment of possibility of pulpotomy with the Nd-YAG laser by the observation of pulpal healing process and the fine structural changes of the fibroblasts of the remaining pulpal tissues. Class V cavities on !55 teeth from 4 adult dogs were prepared and the pulp chambers were opened with a sterilized round bur. In the control group(19 teeth), the exposed coronal pulps were excised by a sharp excarvator. After bleeding was controlled with the sterilized cotton pellets, calcium hydroxide powder was applied on the remaining pulpal tissues and the cavities were sealed with Z.O.E. In the experimental group 1 : the pulpotomy with laser-calcium hydroxide powder application group(l9 teeth), the exposed coronal pulps were excised by Nd-YAG laser(10 watts power, 2 psi water, 20 psi air) for 2 or 3 seconds and calcium hydroxide powder was applied on the remaining pulpal tissues and the cavities were sealed with Z.O.E. In the experimental group 2 : the pulpotomy with laser-no calcium hydroxide powder application group(17 teeth), after amputating the coronal pulps with Nd-YAG laser as the experimental group 1, the remaining pulpal tissues were covered with stenilized aluminum foil and the cavities were filled with Z.O.E. The animals were sacrificed at the intervals of 1, 2, 3 and 4 weeks. All the teeth were rouutinely processed and the remaining pulpal tissues were observed by the light microscope and electron microscope. The results were as follows : 1. In light microscopic findings, there was no significant difference of the inflammatory response in the remaining pulpal tissues between the control group and the experimental groups. In both of the experimental group 1 : pulpotomy with laser-calcium hydroxide powder application group and the control group, the dentin bridges were observed after 2 weeks and the structure of the dentin bridge was almost same. In the experimental group 2 : pulpotomy with laser-no calcium hydroxide powder application group, the fibrous layers instead of dentin bridge were observed on the superficial portion of the remaining pulpal tissues after 2 weeks and they were consisted with densely crowded active fibroblasts. 2. In the electronmicroscopic findings, the active fibroblasts in the experimental groups were more frequently observed than in the control group at 1 week. But active fibroblasts were found with same frequency after 2 weeks in all of the control group and the experimental groups. 3. General distortions of the cell such as loss of the cell membrane, vaculoization of the cell etc. were observed at the suberficial layer of the remaining pulpal tissues and the carbonization was found in the dentinal wall in 1 week of the experimental groups. 4. In the experimental group 2 : pulpotomy with laser-no calcium hydroxide powder application group, the activity and the density of the fibroblasts in the fibrous layer were more than those in the deep portion of the remaining pulpal tissues after 2 weeks. 5. In the control group, bacteria such as cocci and bacilli were observed frequently, but in the experimntal groups, they could not be observed.

• Restorative Dentistry and Endodontics
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• v.35 no.1
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• pp.5-12
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• 2010

The purpose of this study was to evaluate the pulp tissue reaction to direct pulp capping of mechanically exposed beagle dogs' pulp with several capping materials. A total of 36 teeth of 2 healthy beagle dongs were used. The mechanically exposed pulps were capped with one of the followings: (1) Mineral Trioxide Aggregate (MTA: $ProRoot^{(R)}$ MTA. Dentsply, Tulsa, USA), (2) Clearfil SE Bond (Dentin adhesive system: Kuraray, Osaka, Japan), (3) Ultra-Blend (Photo-polymerized Calcium hydroxide: Ultradent, South Jordan, USA), (4) Dycal (Quick setting Calcium hydroxide: LD Caulk Co., Milford, USA) at 7, 30, and 90 days before sacrificing. The cavities were restored with Z350 flowable composite resin (3M ESPE, St. Paul. MN, USA). After the beagle dogs were sacrificed, the extracted teeth were fixed, decalcified, prepared for histological examination and stained with HE stain. The pulpal tissue responses to direct pulp capping materials were assessed. In MTA calcium hydroxide, and photo-polymerized calcium hydroxide groups, initial mild inflammatory cell infiltration, newly formed odontoblast-like cell layer and hard tissue bridge formation were observed. Compared with dentin adhesive system, these materials were biocompatible and good for pulp tissue regeneration. In dentin adhesive system group, severe inflammatory cell infiltration, pulp tissue degeneration and pulp tissue necrosis were observed. It seemed evident that application of dentin adhesive system in direct pulp capping of beagle dog teeth cannot lead to acceptable repair of the pulp tissue with dentine bridge formation.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.92-97
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• 2004

Traumatic injuries in the young peranent dentition are common, but root fractures, defined as fractures in volving dentin, cementum and pulp, are relatively uncommon. Case 1 is a 9-year-old boy who had a horizontal root fracture of his maxillary right central incisor in the apical third. Root canal therapy was performed in coronal segment and calcium hydroxide therapy was initiated. Six months after treatment, a periapical radiograph showed calcific tissue formation and normal root development. 1 year and 3 months later, the canal was permanently obturated with gutta-percha. Case 2 is a 7-year-old girl who had a vertical root fracture of her maxillary right central incisor. Fractured tooth was intentionally extracted atraumatically, and then the separated fragments are bonded with resin cement. the restored tooth was replanted into the original socket. Recalls up to 8 months showed normal mobility and no periapical pathosis. In these cases, we performed conservative treatment. Clinical and radiographic examination showed no pathosis or abnormality of the teeth and periodontal tissue.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.2
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• pp.333-343
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• 2000

The purpose of this study was to compare the effect of ferric sulfate and formocresol as pulp dressing agents in pulpotomized teeth of dogs. 40 teeth of 5 dogs, weighting 10kg. were used in this study. The animals were sacrificed at the intervals of 3, 7, 14, 28 and 56 days for histopathologic evaluation. The specimens were observed by the light microscope. The results were as follows : 1. Inflammatory response was observed in both groups, but pulp tissue of ferric sulfate group was showed lesser inflammatory degree and more rapid recovery than that of formocresol group. 2. In ferric sulfate group odontoblasts showed irregular arrangement pattern at initial stage and returned to regular pattern after 2 weeks. But in formocresol group. continued irregular pattern of odontoblast was observed during experimental period. 3. Reparative dentin was produced widely along the canal in one specimen of formocresol group at 8 weeks and dentinal bridge was formed in two specimens of ferric sulfate group at 8 weeks.