Comparative evaluation of diffused calcium and hydroxyl ion release from three different Indirect pulp capping agents in permanent teeth – An in vitro study

Abstract

Background Indirect pulp capping therapy has gained increased popularity in paediatric dentistry since it is less invasive, and is of low cost. The aim of the present study was to evaluate and to compare the diffusion of calcium (Ca2+) and hydroxyl (OH–) ions through coronal dentin into pulp after indirect pulp capping in vitro using TheraCal LC, ProRoot MTA and Calcimol LC. Materials and methods Total of 60 human caries-free maxillary first premolars were selected for the study. Samples were divided into 4 groups with 15 in each group: Group 1 TheraCal LC; Group 2 ProRoot MTA; Group 3 Calcimol LC; Group 4 Control Group. Indirect pulpcapping on the coronal RDT (remaining dentine thickness) system was performed using pulp-capping materials, such as TheraCal LC, ProRoot MTA and Calcimol LC, on the respective samples. The control group was completely filled with composite. Ca2+ ions (ppm) and OH– ions (pH) were analysed in deionized water using a multimeter connected to a calcium probe (calcium ion electrode) and pH metre connected to a temperature-compensated pH probe after 3 h, 24 h, 7 days, 14 days, 28 days and 60 days. Results Calcium release was significantly higher (P < 0.05) in the TheraCal LC group than in the other groups. Slightly alkaline pH values were observed in all the groups except for the control. Conclusion TheraCal is a new light-curable pulp capping material that initially releases high Ca2+ ions and creates an environmental pH close to physiological pH after 60 days.

Dental Pulp Response to Different Types of Calcium-Based Materials Applied in Deep Carious Lesion Treatment—A Clinical Study

“…There are recent studies that examined whether the lower calcium ion-releasing ability, together with the cytotoxicity because of unpolymerized resin monomers of resin-modified calcium ion-releasing liners, has an influence on its biological and clinical performance [ 30 ]. The pH values evaluated in another study [ 31 ] were slightly alkaline for TheraCal LC and Calcimol LC, compared to the control group. The lower pH values registered were because the ions were dispersed through the different dentine thicknesses that remained.…”

“…TheraCal LC has been demonstrated to discharge higher Ca2+ ions right after application and to make a natural pH, very close to the physiological one in the first two months. Further clinical tests are required to measure the release of different biologically active ions from TheraCal LC, which can contribute to the clinical success of these materials in vital pulp therapies [ 31 , 32 , 34 ].…”

Untitled

“…There was no statistically significant difference between primary and permanent teeth, so any of the three can be considered as a material for IPC [17] . TheraCal is considered as a new light-curing pulp capping material that initially releases high Ca2+ ions and creates an ambient pH close to physiological pH after 60 days [18] . Cases with follow-up periods of 24 months show clinical and radiographic success rates of Dycal, Biodentine and TheraCal LC with high percentages [9] .…”

Micro-shear bond strength of different calcium silicate materials to bulk-fill composite

“…The disadvantages of this material are insufficient adhesion to the dentine, the porosity of the hydroxyapatite bridges it forms ( Liu et al, 2021 ), insufficient sealing ( Hilton, 2009 ), high solubility, and uncontrolled necrotic zone formation as a result of its local effect on the pulp tissue ( Hargreaves, Goodis & Tay, 2012 ). Calcium silicate-based cements (CSC), which eliminate many of these negative features, have started to be included in standard PC procedures ( Beegum et al, 2021 ; Manaspon et al, 2021 ; Nowicka et al, 2013 ). Tricalcium silicate cements (t-CSC) form a homogeneous dentin bridge in the pulp tissue without an inflammatory response ( Nowicka et al, 2013 ; Tran et al, 2012 ).…”

“…TheraCal LC (Bisco Inc., Shaumburg, IL, USA) release calcium ions. In addition, when this material is applied to the pulp cell, the changes in protein expression, metabolism, and morphology of the cell can be tolerated by this pulp cell ( Beegum et al, 2021 ). Today, despite all these features, the use of TheraCal LC is controversial for PC because of cytotoxicity to pulp tissue ( Jeanneau et al, 2017 ; Manaspon et al, 2021 ; Rodríguez-Lozano et al, 2021 ; Sahin, Saygili & Akcay, 2021 ).…”