Direct pulp capping in an immature incisor using a new bioactive material

Abstract

Preservation of the pulp in a traumatized immature fractured incisor tooth is of prime importance in order to achieve apexogenesis, a natural apical closure. The main factor influencing this is pulpal protection by a bioactive material proving optimum marginal seal in preventing any microleakage. This case report presents an 8-year-old female diagnosed with Ellis Class 3 fracture of immature tooth 11 involving the mesial pulp horn. Under rubber dam isolation, a partial pulpotomy was performed and the pulp was sealed using a new bioactive material BIODENTINE to stimulate apexogenesis, dentine replacement and pulp protection. The fractured segment was reattached for optimum esthetics, which was a concern for the patient. The patient was followed-up for 1, 3, 6 and 12 months, which revealed continued apical closure and maintenance of pulp vitality. The patient remained asymptomatic. This case report provides evidence for the potential use of Biodentine as an effective pulp capping material in the future.

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

“…Other studies mention success rates of 85%, 91.7%, and 97.1% for MTA-based cements after 3, 1, and 9 years of follow up, respectively; and 83.3% and 85.37% for 1-year follow-up with tricalcium silicate cements [1,10,24,25,26,27,28]. Some authors report similar success rates between the two types of biomaterials in immature permanent teeth [29,30,31].…”

A chemical activity evaluation of two dental calcium silicate-based materials

“…The success of any biological treatment greatly depends on the adherence of the filling material to dental tissue. Indeed, the quality of the interface is the key factor for the durability and effectiveness of the material [1]. Furthermore, it is important the applied material used in biological treatment, when come into contact with dental tissues, should not show any toxic, irrigating, inflammatory, allergic, genotoxic or carcinogenic action [12].…”

Factors affecting the outcomes of direct pulp capping using Biodentine

“…Several in vitro studies have evaluated Biodentine [ 14 – 17 ]; however, few histologic studies have been conducted to evaluate the pulp response of this calcium silicate cement in animal teeth [ 18 – 20 ] and in human teeth [ 21 , 22 ]. A survey of the available literature shows that a few isolated clinical investigations have been published that include the use of Biodentine for direct pulp capping in permanent teeth, but no studies have an adequate sample size or long-term data [ 23 – 26 ].…”