Histological evaluation of human pulp capped with light-cured calcium based cements: a randomized controlled clinical trial

Abstract

INTRODUCTIONDirect pulp capping (DPC) is defined as the treatment of a mechanical or traumatic vital pulp exposure by sealing the pulpal wound with a biomaterial placed directly on exposed pulp to facilitate formation of reparative dentin and maintenance of the vitality of pulp.1 Calcium hydroxide has been the gold standard for this purpose.The alkalinity of calcium hydroxide causes superficial necrosis of exposed pulp. This necrosis acts as mild irritation and thus stimulates the pulp to form a reparative dentin bridge. The success rate of calcium hydroxide direct capping was 80.1% after 1 year, 68.0% after 5 years, and 58.7% after 9 years.2 The reason for failure over time is attributed to tunnel defects that form in the bridge. This fails to provide a permanent barrier and a ABSTRACT Background: Calcium hydroxide has traditionally been used as the pulp capping material for pulpal exposures in permanent teeth. The tunnel defects in the barrier and the tendency for dissolution, however, fails to provide permanent protection to the pulp. Light curable resin based cements have been introduced to enable a better marginal seal and lesser dissolution. The purpose of this study was to compare and evaluate the response of human pulp following direct pulp capping with the new resin based Calcium silicate (TheraCal LC) and Calcium hydroxide with hydroxyapatite (Septocal LC) cements compared with calcium hydroxide (Dycal). Methods: 72 intact human premolars scheduled for orthodontic extractions were exposed to direct pulp capping procedures using three different pulp capping agents. Teeth were randomly divided into 3 groups, Group A: Dycal, Group B: TheraCal LC, Group C: Septocal LC. The teeth were extracted at the end of 15 and 40 days' and were evaluated histologically. They were scored for reparative dentin formation and inflammatory response. Inferential statistics was done using Chi square test. Results: Majority of the specimens in all three groups at the end of 15 days' showed partial to lateral deposition of hard tissue. There was continuous deposition of hard tissue and severe inflammatory response at the end of 40 days' in Dycal. There was partial deposition of hard tissue and reduced inflammatory response at the end of 40 days' in TheraCal LC and Septocal LC. However, the results were not statistically significant between the three groups at two different time periods. Conclusions: Light cured, Calcium silicate (TheraCal LC) and Calcium hydroxide with hydroxyapatite (Septocal LC) cements were as effective as calcium hydroxide (Dycal) in inducing the formation of reparative dentin and evoking inflammatory response.

Hot air stream reduces cytotoxicity of light-cured calcium hydroxide based cements

“…Light-curing pulp-capping materials were developed with the goal of simplifying the operating technique by facilitating material application. Due to their resin base, these materials are associated with increased mechanical resistance (4) and improved marginal seal as a result of lower dissolution rates (25). The present study showed that treatment of these materials with a jet of warm air just before their application resulted in cytotoxicity rates similar to those reported for chemically activated cements, most widely used at present.…”

TheraCal LC: From Biochemical and Bioactive Properties to Clinical Applications

“…However, they reported that the light-cured TheraCal LC groups had significantly more frequent hard tissue bridge formation, a greater thickness of the dentinal bridge and better dentinal bridge qualities than the Glass ionomer and VLC Dycal groups. Gopika et al [ 45 ] compared and evaluated the response of the human pulp following direct pulp capping with TheraCal LC, Septocal LC, and Dycal. Their study found that TheraCal LC and Septocal LC (Calcium hydroxide with hydroxyapatite) cements were as effective as Dycal in inducing the formation of reparative dentin and evoking an inflammatory response.…”

Bio active materials in pediatric dentistry: A review

“…Gopika et al compared and evaluated the response of the human pulp following direct pulp capping with TheraCal LC, Septocal LC, and Dycal. Their study found that TheraCal LC and Septocal LC (Calcium hydroxide with hydroxyapatite) cements were as effective as Dycal in inducing the formation of reparative dentin and evoking an inflammatory response [63] .…”