The Effect of Calcium-Silicate Cements on Reparative Dentinogenesis Following Direct Pulp Capping on Animal Models

Abstract

Dental pulp vitality is a desideratum for preserving the health and functionality of the tooth. In certain clinical situations that lead to pulp exposure, bioactive agents are used in direct pulp-capping procedures to stimulate the dentin-pulp complex and activate reparative dentinogenesis. Hydraulic calcium-silicate cements, derived from Portland cement, can induce the formation of a new dentin bridge at the interface between the biomaterial and the dental pulp. Odontoblasts are molecularly activated, and, if necessary, undifferentiated stem cells in the dental pulp can differentiate into odontoblasts. An extensive review of literature was conducted on MedLine/PubMed database to evaluate the histological outcomes of direct pulp capping with hydraulic calcium-silicate cements performed on animal models. Overall, irrespective of their physico-chemical properties and the molecular mechanisms involved in pulp healing, the effects of cements on tertiary dentin formation and pulp vitality preservation were positive. Histological examinations showed different degrees of dental pulp inflammatory response and complete/incomplete dentin bridge formation during the pulp healing process at different follow-up periods. Calcium silicate materials have the ability to induce reparative dentinogenesis when applied over exposed pulps, with different behaviors, as related to the animal model used, pulpal inflammatory responses, and quality of dentin bridges.

Mineral Trioxide Aggregate (MTA) Upregulates the Expression of DMP1 in Direct Pulp Capping in the Rat Molar

“…Our results showed a similar tendency to those of previous studies on direct pulp capping, but the combination of MTA and PRP seemed to promote the differentiation of IPMSCs into odontoblasts and dentin bridge hard-tissue formation in the early stage of treatment [ 35 ]. Various novel materials, including MTA, for direct pulp capping have been summarized [ 36 ]. The development of dental pulp regenerative therapy requires improving materials and unique ideas for the clinical approach.…”

Application of β-Tricalcium Phosphate in Adhesive Dentin Bonding

“…β-TCP is a biocompatible material that is of particular interest for various clinical applications as it can be synthesized with consistent batch quality because it has well-defined properties [ 15 ]. In the last two decades, their use in dentistry has increased and β-TCP has shown its efficacy in many applications, especially in the vital pulp therapy as a direct pulp-capping agent [ 16 , 17 ], in treating periodontal infra-bony defects [ 18 ], and in alveolar ridge preservation for implant placement [ 19 ]. Schiroky et al formerly incorporated TCP nanoparticles in their experimental adhesive (EA) and reported higher Knoop hardness and polymerization rate as compared with the controls [ 13 ].…”

Response of dental pulp capped with calcium-silicate based material, calcium hydroxide and adhesive resin in rabbit teeth

“…We have used the Calcium hydroxide because it was the gold standard material due to its biocompatibility, highly alkaline pH, bactericidal effect and capability to induce tertiary dentin formation 3 . This material created an alkaline environment favorable to the formation of dentinal bridge 4 .…”

“…This procedure induces a local inflammatory process leading to pulp cells recruiting. They proliferate and differentiate into odontoblast cells that produce an extracellular matrix which turns out to be a scaffold for a mineralized dentinal reparative bridge 3 .…”