Clinical and Radiographic Assessment of the Efficacy of Calcium Silicate Indirect Pulp Capping

Abstract

The aims of this study were to assess the effectiveness of calcium silicate cement (Biodentine) versus glass ionomer cement (GIC; control group) as indirect pulp capping materials in patients with reversible pulpitis and to compare the effectiveness of cone beam computed tomography (CBCT) versus periapical (PA) radiographs in detecting PA changes at baseline (T0) and at 12 mo (T12) postoperatively. Seventy-two restorations (36 Biodentine, 36 Fuji IX) were placed randomly in 53 patients. CBCT/PA radiographs were taken at T0 and T12. Two calibrated examiners assessed the presence/absence and increase/decrease in the size of existing PA radiolucencies under standardized conditions. The Kappa coefficient evaluated statistically the effectiveness of CBCT versus PA radiographs in detecting PA changes. Chi-square/Mann-Whitney tests were used to evaluate the association between PA changes in CBCT with various clinical measures. Significance was predetermined at α = 0.05. Clinical success rates for Biodentine and Fuji IX GIC were 83.3%. CBCT was significantly more effective in detecting PA radiolucencies compared with radiographs (P = 0.0069). Of the teeth, 65.4% and 90.4% were deemed healthy using CBCT and PA radiographs, respectively, at T12. Healing/healed rates were 17.3%/0%, while new/progressed radiolucency were 30.8%/9.6% with CBCT/PA radiographs, respectively. Seventy-one percent of healed lesions had received Biodentine; 88% of new/progressed lesions received Fuji IX GIC. Teeth presenting with an initial CBCT PA lesion had a failure rate of 63%, whereas teeth with no initial lesion had a failure rate of 16%. Although no statistically significant difference was detected in the clinical efficacy of Biodentine/Fuji IX when used as indirect pulp capping materials in patients with reversible pulpitis, CBCT showed a significant difference in that most healed CBCT lesions had received Biodentine while most that did not heal received Fuji IX. Longer-term follow-up is needed to establish their effect on the healing dynamics of PA tissues (ClinicalTrials.gov NCT02201641).

Shear bond strength of a novel light cured calcium silicate based-cement to resin composite using different adhesive systems

“…Glass ionomer cements have been used as liners, particularly under resin composites, because of their ability to chemically bond to enamel and dentin in addition to their ability to release fluoride 15) . They are also used as liners in indirect pulp capping procedures with similar clinical efficacy to contemporary pulp capping materials 16) . The bond strength of restorative materials to pulp capping agents has been an issue of concern, since placement of a restoration following VPT procedures is crucial to ensure their success 17) .…”

BiodentineTM is cytocompatible with human primary osteoblasts

“…Therefore, these results should be complementary to further in vivo and clinical studies, necessary to confirm the adequacy and advantages of the use of Biodentine in diverse applications, such as an indirect pulp-capping material. 31 In fact, further in vitro assessments may also be performed, aiming to contribute to the understanding of the underlying mechanisms of Biodentine biocompatibility in its broader sense, including the use of the human primary cell model in the investigation of cell proliferation, differentiation, and mineralization, along with the study of protein expression and release of cytokines and growth factors, as well as other in vitro assays for assessment of bone cell behavior.…”

Revisión del estado actual de resinas compuestas bulk-fill

“…The study analyzed 72 restorations (36 made with Biodentine TM and 36 with glass ionomer), with a follow-up of up to one year, finding out no differences between the materials when measuring the clinical efficacy of pulp vitality conservation. 44 However, the authors noted that most teeth with apical radiotransparency (which was not detected at baseline with periapical x-rays but later with computed tomography) that decreased in size or were eliminated were treated with Biodentine TM , 44 while most recent lesions or their progression were found in teeth treated with glass ionomer.…”

“…En el estudio se evaluaron 72 restauraciones (36 realizadas con Biodentine TM y 36 con vidrio ionómero), con seguimiento de hasta un año, y no se encontraron diferencias entre los materiales al medir la eficacia clínica de conservación de vitalidad pulpar. 44 Sin embargo, se observó que la mayoría de los dientes con radiolucidez apical (que no fue detectada en un comienzo con radiografía periapical, pero sí posteriormente con tomografía computarizada) que disminuyeron en tamaño o se eliminaron fueron tratados con Biodentine TM , 44 mientras que la mayoría de las nuevas lesiones o su progresión se encontró en dientes tratados con vidrio ionó-mero. 44 Estos resultados fueron atribuidos a las características bioactivas de Biodentine TM , que se han reportado a partir de estudios in vitro.…”

“…44 Sin embargo, se observó que la mayoría de los dientes con radiolucidez apical (que no fue detectada en un comienzo con radiografía periapical, pero sí posteriormente con tomografía computarizada) que disminuyeron en tamaño o se eliminaron fueron tratados con Biodentine TM , 44 mientras que la mayoría de las nuevas lesiones o su progresión se encontró en dientes tratados con vidrio ionó-mero. 44 Estos resultados fueron atribuidos a las características bioactivas de Biodentine TM , que se han reportado a partir de estudios in vitro. [6][7][8]45 Revista Facultad de Odontología Universidad de Antioquia -Vol.…”