Clinical evaluation of mineral trioxide aggregate and biodentine as direct pulp capping agents in carious teeth

Hegde, Shruti; Sowmya, B.; Mathew, Sylvia; Bhandi, Shilpa; Nagaraja, Shruthi; Dinesh, K

doi:10.4103/0972-0707.212243

Cited by 43 publications

(17 citation statements)

References 25 publications

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“…The sample size analysis for this study was based on the primary outcome measure, which was pulp survival (clinical and radiographic) one year after intervention. Previous prospective clinical comparative trials of greater than one-year in duration have demonstrated that caries exposure, rinsing with NaOCl, and subsequent pulp capping have reported a 90% success rate [ 18 , 20 , 21 ]. Other carious pulp capping studies using saline [ 8 ] or hydrogen peroxide [ 22 ] as a pupal rinse have reported lower success of 31% and 55%, respectively.…”

Section: Methodsmentioning

confidence: 99%

Sodium Hypochlorite Reduces Postoperative Discomfort and Painful Early Failure after Carious Exposure and Direct Pulp Capping—Initial Findings of a Randomized Controlled Trial

Ballal

Duncan

Rai

et al. 2020

JCM

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In this randomized controlled single-center clinical trial on 96 adult patients with parallel experimental groups (n = 48), the effects of washing a dentin/pulp wound in non-symptomatic teeth with extremely deep caries and pulpal exposure were compared between a 2.5% sodium hypochlorite (NaOCl) solution and a chemically-inert physiological saline control solution. After the allocated wound lavage, the pulps were capped with a mineral trioxide aggregate, covered by a glass-ionomer/resin liner, and the teeth were immediately restored with a resin-bonded-composite. In this first report, the early events were analyzed: postoperative discomfort (on an NRS-11 scale) at day-3 and -7 after intervention, and the occurrence of unbearable pain causing patients to contact the principal investigator to perform a root canal treatment (pulpectomy) during the first three months. The NaOCl solution caused a highly significant reduction in post-operative discomfort (p = 0.0010 day 3; p = 0.0007 day 7) and early painful failures (p = 0.0008) compared with the control. These novel findings highlight the importance of infection control in teeth with extremely deep carious lesions. Based on these observations, the use of an NaOCl solution to wash the exposed dentin/pulp wound in the vital pulp treatment is highly recommended in order to reduce pain and early failure.

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Section: Methodsmentioning

confidence: 99%

Sodium Hypochlorite Reduces Postoperative Discomfort and Painful Early Failure after Carious Exposure and Direct Pulp Capping—Initial Findings of a Randomized Controlled Trial

Ballal

Duncan

Rai

et al. 2020

JCM

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“…Pulp protection therapies aim to maintain the vitality of the tooth in which pulp tissue has been exposed due to trauma, carious lesions, or restorative procedures. Treatment options in this situation include direct pulp capping, pulpotomy, or pulpectomy [1,2].…”

Section: Introductionmentioning

confidence: 99%

Direct Pulp Capping: Which is the Most Effective Biomaterial? A Retrospective Clinical Study

et al. 2019

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(1) Background: Recently, tricalcium silicate cements, such as Biodentine™, have emerged. This biomaterial has a calcium hydroxide base and characteristics like mineral aggregate trioxide cements, but has tightening times that are substantially more suitable for their application and other clinical advantages. (2) Methods: A retrospective clinical study was conducted with 20 patients, which included a clinical evaluation of the presence or absence of pulp inflammation compatible symptoms, radiographic evaluation of the periapical tissues, and structural alterations of the coronary restoration that supports pulp capping therapies with Biodentine™ and WhiteProRoot®MTA. (3) Results: This clinical study revealed similar success rates between mineral trioxide cement and tricalcium silicates cements at 6 months, with 100% and 95% success rates, respectively. There were no statistically significant differences between both biomaterials and between these and the various clinical circumstances, namely the absolute isolation of the operating field, exposure size, the aetiology of exposure, and even the type of restorative material used. (4) Conclusions: Biodentine™ demonstrated a therapeutic effect on the formation of a dentin bridge accompanied by slight inflammatory signs, with a high clinical success rate, indicating the possibility of its effective and safe use in dental pulp direct capping in humans, similar to the gold standard material.

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“…The other four studies recorded the postoperative pain of patients included using visual analog scale after 7 days, 1 month, 3 months, and 6 months. In addition, postoperative radiographs were taken on 3-month and 6-month recall visits to detect any apical radiolucency,[ 19 ] assessed the pulpal health after 3 weeks, 3 months, 6 months, and 1 year using thermal and electrical pulp sensitivity testing, and in addition, 6-month follow-up radiographs were taken,[ 20 ] analyzed the clinical and radiographic recall data at intervals of 1, 3, 6, 12, and 18 months. The data were comprised pain, sensibility status of the teeth, radiographic signs of periapical pathology, and dentin bridge formation[ 21 ] and were performed clinical and radiological examination after 1-year recall.…”

Section: Resultsmentioning

confidence: 99%

“…Heterogeneity was found between the previous studies. [ 16 17 18 19 20 21 22 ] as they used different methods of evaluation (histological, clinical, and radiological), and in addition, different scores for the amount of dentin bridge formation were used in histological and radiological assessments. Pulp vitality was assessed with different parameters; moreover, dichotomous data were sometimes used, and in other instances, continuous data were the main outcome.…”

Section: Resultsmentioning

confidence: 99%

Biodentine versus mineral trioxide aggregate as a direct pulp capping material for human mature permanent teeth – A systematic review

et al. 2018

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Background:Biodentine is comparatively a new biomaterial claimed to have properties comparable to mineral trioxide aggregate (MTA). Biodentine and MTA are effectively used for direct pulp capping (DPC), and they are capable of regenerating relatively damaged pulp and formation of hard dentine bridge.Objectives:The aim of this systematic review was to test the null hypothesis of no difference between Biodentine and MTA as DPC materials for human permanent mature teeth, against the alternative hypothesis of a difference.Data Sources:Clinical trials were identified by electronic databases searches of Midline, CENTRAL Cochrane Library, Latin American and Caribbean Health Sciences Literature, Scopus, Scientific Electronic Library Online, evidence-based endodontics literature, KoreaMed, and Google Scholar. The literature search was performed from January 2010 to February 2018. Hand searches were also performed for relevant abstracts, books, and reference lists. Titles and abstracts of studies identified using the above-described protocol were independently screened by two authors. Full texts of studies judged by title and abstracts to be relevant were independently evaluated by two authors for stated eligibility criteria.Study Eligibility Criteria:The eligibility criteria included randomized clinical trials (RCTs) and non-RCTs.Participants:Patients with permanent mature molars indicated for surgical extraction or molars that have symptomless exposure of vital pulp tissue by caries or trauma. In both cases, the molars were subjected to DPC.Interventions:The pulp exposures were directly treated by Biodentine or MTA.Study Appraisal:To assess article quality, two authors independently used the risk of bias in nonrandomized studies – of interventions.Methods:Qualitative metasynthesis was used to analyze data across qualitative studies.Results:The initial search identified 8725 unique references through the search process. No additional studies were identified through handsearching. After filtering, 915 references were recorded and screened. After the eligibility criteria were applied, seven unduplicated prospective and retrospective cohort studies were included in the qualitative metasynthesis.Limitations:Further RCTs with much larger sample size and proper methodology with longer observational time are still in need to adequately address the questions of the present systematic review.Conclusion and Implications of Key Findings:Within the limitations of this review, it may be concluded that Biodentine had a similar effect on dentin bridge formation likely to MTA. However, this conclusion is based on only very few well-conducted prospective and retrospective cohort studies.Systematic Review Registration Number:The review had been registered with PROSPERO (registration number CRD42018089302).

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Clinical evaluation of mineral trioxide aggregate and biodentine as direct pulp capping agents in carious teeth

Cited by 43 publications

References 25 publications

Sodium Hypochlorite Reduces Postoperative Discomfort and Painful Early Failure after Carious Exposure and Direct Pulp Capping—Initial Findings of a Randomized Controlled Trial

Sodium Hypochlorite Reduces Postoperative Discomfort and Painful Early Failure after Carious Exposure and Direct Pulp Capping—Initial Findings of a Randomized Controlled Trial

Direct Pulp Capping: Which is the Most Effective Biomaterial? A Retrospective Clinical Study

Biodentine versus mineral trioxide aggregate as a direct pulp capping material for human mature permanent teeth – A systematic review

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