• Journal of Yeungnam Medical Science
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• v.37 no.3
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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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• v.43 no.4
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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.

• Restorative Dentistry and Endodontics
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• v.46 no.3
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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.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.3
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• pp.280-290
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• 2021

Color stability of pulp-capping material is considered vital to the final aesthetic result since the material is placed in the coronal area. The purpose of this study was to compare the color stability of various pulp-capping materials by analyzing color change of tooth over time. A cavity was formed in the crown of the extracted premolar, and 4 types of pulp-capping materials were filled. Color assessment was performed with a spectrophotometer at different intervals: before placement; immediately after material placement; 1 day, 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks, and 16 weeks after placement. Proroot white MTA^® and TheraCal LC^® showed a significant decrease in the L^* value and an increase in the ∆E^* value over time. In contrast, Biodentine^® and Well-Root^TM PT showed no significant change in the L^* value and maintained a steady ∆E^* value. The application of pulp-capping materials containing bismuth oxide as a radiopacifier may result in a color change of teeth. Long-term color stability of pulp-capping materials should be considered when treating teeth with thin enamel thickness or in aesthetically important area.

• Biomaterials Research
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• v.22 no.4
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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.

• Restorative Dentistry and Endodontics
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• v.37 no.4
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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).

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.2
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• pp.200-209
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• 2017

The aim of this study was to evaluate the shear bond strength (SBS) of three typical restorative materials - glass ionomer cement (GIC), resin-modified glass ionomer (RMGIC) and composite resin (CR) - to different pulp capping materials, i.e., Theracal $LC^{TM}$ (TLC), $Biodentine^{TM}$ (BD), and $ProRoot^{TM}$ white MTA (WMTA). 90 acrylic blocks with a center hole were prepared. The holes were completely filled with three pulp capping materials (TLC, BD, and WMTA), with 30 specimens per capping material. The samples were then randomly divided into 3 subgroups of 10 specimens each and were overlaid with GIC, RMGIC, or CR. A total 9 specimen groups were prepared. The SBS was assessed using a universal testing machine. Kruskal-Wallis test and Mann-Whitney's test were performed to compare the SBS among the subgroups (p < 0.05). After the SBS test, the fractured surfaces were examined under a stereomicroscope at a magnification of $25{\times}$. The highest and lowest SBS values were recorded for TLC-CR and TLC-GIC, respectively. With regard to the SBS to the three pulp capping materials, CR was found to be superior to RMGIC and GIC. BD showed a higher SBS compared to TLC and WMTA when used with GIC.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.3
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• pp.518-536
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• 1997

The purpose of the present study was to analyze the pulpal tissue reactions to several capping materials. 8 adult Mongrel dogs and 4 different capping materials (G I : Calcium hydroxide, G II : Bonding resin, G III : Glass ionomer liner, G IV : Bioactive ceramic) we-reused in the study. The results can be summarized as follows : 1. The formation of hard tissue barrier was observed to begin after 2 weeks in all groups with various forms or positions. 2. According to the result of statistical analysis, G I and G IV showed significantly higher degree of inflammation than G II, G III in 1-week samples(p<.05). And in 2-week samples, G I showed higher degree of inflammation than G II, G IV with statistical significance(p<.05). Howere, these inflammatory reactions have gradually dimiished with time resulting in negligible difference between groups. 3. No bacterial penetration was observed in any group. 4. Hard tissue formation was evident in all groups after 2 weeks regardless of material type in this experiment. Conclusion can be drawn from the above-mentioned results that the perfect marginal sealing after pulp capping procedure is thought to be the most important factor in determining the propgnosis of direct pulp capping.

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.1
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• pp.76-84
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• 2019

This study evaluated the microleakage of three restorative materials and three tricalcium silicate-based pulp capping agents. The restorative materials were composite resin (CR), resin-reinforced glass ionomer cement (RMGI), and traditional glass ionomer cement (GIC) and the pulp capping agents were TheraCal $LC^{(R)}$ (TLC), $Biodentine^{(R)}$ (BD), and $ProRoot^{(R)}$ white MTA (WMTA). Additionally, shear bond strengths between the pulp-capping agents and dentine were compared. Class V cavities were made in bovine incisors and classified into nine groups according to the type of pulp-capping agent and final restoration. After immersion in 0.5% fuchsin solution, each specimen was observed with a stereoscopic microscope to score microleakage level. The crowns of the bovine incisors were implanted into acrylic resin, cut horizontally, and divided into three groups. TLC, BD and WMTA blocks were applied on dentine, and the shear bond strengths were measured using a universal testing machine. The microleakage was lowest in TLC + GIC, TLC + RMGI, TLC + CR, and BD + GIC groups and highest in WMTA + RMGI and WMTA + CR groups. The shear bond strength of BD group was the highest and that of WMTA group was significantly lower than the others.

• Journal of the korean academy of Pediatric Dentistry
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• v.51 no.2
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• pp.176-184
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• 2024

This study aimed to compare color matching between single-shade composite resin-restored teeth with various pulp capping materials and the dentin surrounding the restoration through instrumental analysis and visual evaluation of the color difference. Fifty maxillary right central incisor acrylic resin teeth were prepared with standardized Class III cavities on the proximal surfaces. These teeth were divided into five groups: restored with single-shade composite resin only; Ultra-Blend^TM plus followed by single-shade composite resin; TheraCal PT^TM followed by single-shade composite resin; Endocem^® MTA premixed followed by single-shade composite resin; and Well-root PT^TM followed by single-shade composite resin. The color difference (ΔE_ab^*) between the restored area and the center of the resin teeth was measured using a spectrophotometer. No significant color difference was observed in groups restored with only single-shade composite resin, Ultra-Blend^TM plus, and TheraCal PT^TM. The visual evaluation revealed that Ultra-Blend^TM plus exhibited the best color matching score, whereas the Endocem^® MTA premixed and Well-root PT^TM groups showed significantly lower color matching scores than the single-shade composite resin-only group. When opting for single-shade composite resin usage for anterior tooth restorations with the aim of reducing chair time, pulp capping materials Ultra-Blend^TM plus and TheraCal PT^TM provide esthetically pleasing results.