No abstract

Considering the favorable outcomes of 6- to 60-month follow-ups, as an evidence-based/simple/affordable/effective/biologic approach in cases of irreversible pulpitis, VPT/CEM is highly recommended for universal clinical practice.

The effect of different storage solutions on surface topography of mineral trioxide aggregate (MTA) and new experimental cement (NEC) as root-end fillings was investigated. Twenty-four single-rooted teeth were cleaned, shaped and obturated in a same manner. After root-end resection, 3-mm deep root-end cavities were ultrasonically prepared. Samples were randomly divided into four test groups (A1-A2-B1-B2, n = 6). Root-end cavities in groups A and B were filled with MTA and NEC, respectively, and were then stored in 100% humidity for 24 h. The samples of groups 1 and 2 were, respectively, immersed in normal saline (NS) and phosphate buffer saline solutions for 1 week. The samples were imaged under stereomicroscope before and after immersion and were then investigated and analysed by scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDXA). Results showed significant difference among studied groups. Surface topography of all samples was altered by crystal formation and precipitation on root-end fillings except for group A1 (MTA-NS). SEM and EDXA results showed that the composition and structure of precipitated crystals were comparable with that of standard hydroxyapatite. It was concluded that biocompatibility, sealing ability, and cementogenic activity of MTA and probably NEC may be attributed to this fundamental bioactive reaction.

The histological success of mineral trioxide aggregate (MTA) pulpotomy for treatment of irreversible pulpitis in human teeth as an alternative treatment was investigated in this study. Fourteen molars which had to be extracted were selected from patients 16-28 years old. The selection criteria include carious pulp exposure with a history of lingering pain. After isolation, caries removal and pulp exposure, MTA was used in pulpotomy treatment. Patients were evaluated for pain after 24 h. Two patients were lost from this study. Twelve teeth were extracted after 2 months and were assessed histologically. Recall examinations confirmed that none of the patients experienced pain after pulpotomy. Histological observation revealed that all samples had dentin bridge formation completely and that the pulps were vital and free of inflammation. Although the results favour the use of MTA as a pulpotomy material, more studies with larger samples and a longer recall period are suggested to justify the use of MTA for treatment of irreversible pulpitis in human permanent teeth.

Vital pulp therapy with CEM is a cost-effective and reliable biological technique for endodontic treatment of permanent molar teeth with irreversible pulpitis and can be recommended for general clinical practice.