To explore the clinical efficacy of biomedical ceramic iRoot BP in the treatment of localized acute pulpitis in children, and the effect of iRoot BP on proliferation and osteogenic differentiation of human dental pulp stem cells (hDPSCs), 72 localized acute pulpitis children admitted
to our hospital from September 2018 to September 2019 were selected and divided into group A (treated with MTA pulp capping material) and group B (treated with iRoot BP material), and the clinical effect, pain degree, and adverse reactions (ADR) rate were compared. The effects of iRoot BP
on hDPSCs proliferation and osteogenic differentiation were analyzed; the proliferative activity of cells in iRoot BP group, MTA group, and control group (C group) were measured by cholecystokinin-8 (CCK-8) assay, the ability of cell mineralized nodular formation was observed via alizarin
red staining; and quantitative reverse transcription PCR (qRT-PCR) andWestern blot were adopted to determine the expression of osteogenic related genes of hDPSCs and key proteins of mitogen-activated protein kinase (MAPK) signaling pathway. After 1 week of treatment, the clinical efficacy
of group B was more favorable in contrast with group A (P < 0.05); the pain of children in group B was notably better in contrast with group A, and incidence of ADR was notably lower in contrast with group A (P < 0.05). 5.0 mg/mL, 10.0 mg/mL, and 30 mg/mL iRoot BP or MTA
could improve cell proliferation activity (P < 0.01); the effect of iRoot BP on proliferation of hDPSCs was greater in contrast with MTA (P < 0.05); and the integral optical density (IOD) value of iRoot BP group was notably higher in contrast with MTA group (P <
0.01). The mRNA expression levels of collagen-I (COL-I), bone sialoprotein (BSP), and osteocalcin (OC) in MTA group and iRoot BP group were notably higher in contrast with C group (P < 0.01); the COL-I mRNA expression level of iRoot BP group was notably higher in contrast with MTA
group (P < 0.01); the mRNA expression level of BSP in MTA group was notably higher in contrast with iRoot BP group (P < 0.01); the relative protein expression levels of phosphorylated ERK (p-ERK) and phospho-Jun N-terminal kinase (p-JNK) in MTA group and iRoot BP group
were notably higher in contrast with C group (P < 0.01); and the relative expression level of p-ERK protein in iRoot BP group was higher in contrast with MTA group (P < 0.05). These results indicated that the clinical efficacy of biomedical ceramic iRoot BP was better than
MTA in the preservation of live pulpitis in children, and the patients treated with iRoot BP had better pain recovery effect and lower risk of ADR. The effect of iRoot BP on the proliferation and mineralization of hDPSCs was better than that of MTA, and it may promote the osteogenic differentiation
of hDPSCs by activating MAPK signaling pathway and regulating gene expression of COL-I, BSP, and OC.