Pulpal Response to Nano Hydroxyapatite, Mineral Trioxide Aggregate and Calcium Hydroxide when Used as a Direct Pulp Capping Agent: An in Vivo study

Abstract

Nano hydroxyapatite (Nano-HA) and Mineral Trioxide Aggregate (MTA) because of its better qualities can be used as an alternative to calcium hydroxide in direct pulp capping procedures. The aim of the study was to compare the response of exposed human pulp to Nano-HA, Mineral Trioxide Aggregate and calcium hydroxide. Study design: The study was done on 30 premolars, ranging from patients between 11-15 years. Intentional pulp capping was done using one of the experimental materials. The extracted teeth were then subjected to staining procedure and evaluated for dentin bridge and pulpal response after 15 and 30 days. Intragroup comparisons of the observed values were analyzed using Chi-square test. Results: Nano-HA and MTA produced continuous dentin bridges. Dentin bridge that was formed in MTA group had regular pattern of dentinal tubules but no tubules were seen in the nano-HA group. Dentin bridge was not observed in Dycal group for the 15 days period in majority of the sample and by 30 days dentin bridge was observed that were both continuous and interrupted in equal number of samples. The initial inflammatory response and necrosis was more with Nano-HA and calcium hydroxide which reduced with time. Conclusion: MTA showed no inflammatory changes in majority of the samples in both the study periods. Necrosis was least observed in MTA group followed by Nano-HA. Vascularity increased in Nano-HA group in the initial periods which reduced with increasing time. Based on the ability of nano-HA to produce complete dentinal bridges, favorable cellular and vascular response, the material could be considered as an substitute and could be tried used as a direct pulp capping agent.

Cytotoxicity and biocompatibility of resin-free and resin-modified direct pulp capping materials: A state-of-the-art review

“…After 1 week, 2, 3, 4, and 6 months, MTA groups presented less inflammation, less hyperaemia, less necrosis, more frequent odontoblastic layer formation, and thicker dentinal bridging (0.19-0.43 mm for ProRoot, and 0.02-0.15 mm for Dycal from 3-6 months) than the calcium hydroxide group 23) . Another in vivo study also demonstrated that MTA caused less inflammation, less necrosis, and faster dentin bridge formation, than calcium hydroxide Dycal 28) . An in vitro study from the same paper demonstrated that calcium hydroxide (29.4% decrease of cell metabolic activity) caused higher cytotoxic effects to the MDPC-23 cells than MTA (9.9% decrease) 27) .…”

Effect of an experimental adhesive resin containing multi-ion releasing fillers on direct pulp-capping

“…Previous studies have introduced various direct pulp-capping agents, such as hydroxyapatite 7) , tri-calcium phosphate (TCP) 8) , mineral trioxide aggregate (MTA) 7,9,10) , and emdogain (EMD) 9) . MTA, in particular, has been shown to promote complete dentin bridge formation without inducing inflammatory response in the pulp 7,9,10) . However, it also has limitations, such as high cost and difficult in handling compared to other pulp capping materials.…”

The Role of Cell Autophagy in Toxicity Caused by Dental Nanomaterials

“…In clinical endodontics especially root canal and restorative treatments we can see the near future potential of nanoparticles from the application of nanoparticles in the form of solutions for irrigation, medication and as an additive within sealers/restorative materials [6]. GICs can be applied to base plates of Orthodontic and modified denture base well, as which contain chlorhexidine hexametaphosphate nanoparticles and characterize the nanoparticle size shows a stronger antimicrobial activity [7].…”

“…J Nanotechnol Nanomed Nanobiotechnol 4: 011. Nano HA which was used as a direct pulp capping agent, showed no inflammatory changes in majority of the samples in both the study periods, based on the ability of nano HA to produce complete dentinal bridges, favorable cellular and vascular response [6]. …”

“…Diatomite-based nanocomposite ceramics are good potential candidates for ceramic-based dental materials [4]. Nano silicon dioxide can also give polymers the characteristics of better viscosity, thermal stability, high strength, less volume shrinkage and of course, durability [5].In clinical endodontics especially root canal and restorative treatments we can see the near future potential of nanoparticles from the application of nanoparticles in the form of solutions for irrigation, medication and as an additive within sealers/restorative materials [6]. GICs can be applied to base plates of Orthodontic and modified denture base well, as which contain chlorhexidine hexametaphosphate nanoparticles and characterize the nanoparticle size shows a stronger antimicrobial activity [7].…”