3.New advances in vital pulp therapy and pulp regeneration for the treatment of pulpitis: from basic to clinical application.
Chinese Journal of Stomatology 2022;57(1):16-22
In recent years, great progress has been made in research on the treatment of pulpitis, mainly due to the rapid development of basic and clinical researches in this field, and some achievement from basic research has been applied in clinical practice. Advances in the diagnostic methods for pulpitis can help the clinicians to recognize the true state of pulpitis more accurately and to adopt the corresponding treatment methods including indirect/direct pulp capping, pulpotomy, pulp regeneration and root canal therapy. The new theory of pulpitis diagnosis and the studies on immune defense, repair function of dental pulp and new pulp capping materials have significantly improved the success rate of vital pulp therapy. For diffuse coronary pulpitis or radicular pulpitis, which is difficult to achieve vital pulp therapy successfully, methods of pulp revascularization, cell homing and pulp stem cells-mediated pulp regeneration can also be used as treatment options in addition to root canal therapy. The present article focuses on the research progress on pulpitis treatments and related clinical transformation practices, in order to provide reference on vital pulp therapy and pulp regeneration for clinicians.
Dental Pulp
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Dental Pulp Capping
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Humans
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Pulpitis/therapy*
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Pulpotomy
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Regeneration
4.Confusion and solution for vital pulp therapy.
West China Journal of Stomatology 2017;35(3):227-231
Dental pulp tissue plays a role in forming dentin, providing nutrition, conducting pain, and generating protective responses to environmental stimuli. Bacterial infection is the main cause of pulp disease, where histopathological changes are the histological basis for determining the choice of treatment and the evaluation of therapeutic effect. Thus, particular attention should be given to eliminate infection, as well as preserve and maintain pulpal health in teeth that show reversible or limited pulpal injuries. Vital pulp therapy, especially its indications and prognostic factors, has been a research hotspot that often causes confusion among clinicians. In this paper, we briefly introduce the confusion and solution for vital pulp therapy in terms of indications, pulp condition assessment, infection elimination, and capping material selection. In addition, we develop a clinical pathway and an operation normalization of vital pulp therapy to better perform the therapy.
Dental Care
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Dental Pulp
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Dental Pulp Capping
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Dental Pulp Diseases
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Dentin, Secondary
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Humans
5.A bioactivity study of Portland cement mixed with beta-glycerophosphosphate on human pulp cell.
Young Hwan OH ; Young Joo JANG ; Yong Bum CHO
Journal of Korean Academy of Conservative Dentistry 2009;34(5):415-423
The purpose of this study is to investigate the response of human pulp cell on Portland cement mixed with beta-glycerophosphate. To investigate the effect of beta-glycerophosphate and/or dexamethasone on human pulp cell, ALP activity on various concentration of beta-glycerophosphate and dexamethasone was measured and mineral nodule of human pulp cell was stained with Alizarin red S. MTS assay and ALP activity of human pulp cell on Portland cement mixed with various concentration of beta-glycerophosphate (10 mM, 100mM, 1M) was measured and the specimens were examined under SEM. Addition of beta-glycerophosphate or dexamethasone alone had no effect however, the addition of 5 mM beta-glycerophosphate and 100 nM dexamethasone had the largest increasement in ALP activity. There was no toxicity in all samples and the data showed that Portland cement mixed with 10 mM beta-glycerophosphate had more increase in ALP activity compared with control. In conclusion, Portland cement mixed with beta-glycerophosphate has no toxicity and promotes differentiation and mineralization of pulp cell compared with additive-free Portland cement. This implicated that application of Portland cement mixed with beta-glycerophosphate might form more reparative dentin and in turn it would bring direct pulp capping to success.
Anthraquinones
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Dental Pulp Capping
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Dentin
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Dexamethasone
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Glycerophosphates
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Humans
6.Histological Study of Reparative Dentin Formation after Direct Pulp Capping and Pulpotomy using MTA.
Seul Hee PARK ; Ho Keel HWANG ; Heung Joong KIM ; Joo Cheol PARK
Korean Journal of Anatomy 2006;39(3):235-243
The ultimate goal of a regenerative pulp treatment strategy is to reconstitute normal tissue continuum at the pulp-dentin border, regulating tissue-specific processes of reparative dentinogenesis. However, little is known about the molecular mechanism of reparative dentinogenesis. The purpose of this study was to investigate the pulpal response after direct pulp capping and pulpotomy with mineral trioxide aggregate (MTA) by histological and immunohistochemical studies. There was continuous reparative dentin bridge formation at 2 weeks after treatment with MTA in both the pulp capping and the pulpotomy groups. The cells in the pulp capping group showed typical odontoblast characteristics, while the cells of reparative dentin in pulpotomy group were round in shape, lost their polarity, organized as a sheet of cells, and trapped in osteodentin-like mineralized tissue. In pulp capping group, upper layer of the reparative dentin showed cell lacunae indicating osteoblastic characteristics, whereas lower layer of the reparative dentin contained predentin and dentinal tubule-like structures as normal dentin. However, there was osteodentin formation in pulpotomy group. DSP protein was expressed at 4 weeks in odontoblasts of pulp capping group, while BSP was expressed at 4 weeks after pulpotomy. These results suggest that two different types of reparative dentin formation, dentin-like and bone-like dentin, may depend on the type and extent of the injury and the effect of the associated defense reaction on the structural and functional integrity at the dentin-pulp border.
Dental Pulp Capping*
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Dentin*
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Dentinogenesis
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Odontoblasts
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Osteoblasts
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Pulpotomy*
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Pemetrexed
7.Histological evaluation of direct pulp capping with a self-etching adhesive and calcium hydroxide.
Yu LU ; Tian-jia LIU ; Xiu-qun LI ; Gen-li PI ; Hao-lai LI ; Jin-bo YANG
West China Journal of Stomatology 2005;23(5):438-441
OBJECTIVETo evaluate the beagles' pulp response following direct pulp capping with Clearfil SE BOND (SB).
METHODS130 sound teeth were used. 120 had their pulps mechanically exposed and were divided in two groups. In group A, teeth were capped with SB. In group B, teeth were capped with calcium hydroxide (CH). The left 10 teeth were used as control. After 7, 30 and 90 days, the teeth were extracted and processed for light microscopical examination.
RESULTSIn 7 day observation period, inflammatory reaction in SB group was slighter than that of CH group, but the difference was statistical insignificant. In the 30 day and 90 day observation period, inflammatory reaction was slight in both groups, but specimens with dentin bridge formation was significantly less in SB group than in CH group (P < 0.05).
CONCLUSIONSB showed acceptable biocompatibility with pulp, but its ability to induce hard tissue barrier on pulp exposure is weaker than CH.
Adhesives ; Calcium Hydroxide ; Dental Pulp ; Dental Pulp Capping ; Dentin, Secondary ; Humans ; Resin Cements ; Root Canal Therapy
8.Comparison of the Microleakage and Shear Bond Strength to Dentine of Different Tricalcium Silicate-based Pulp Capping Materials
Miri KIM ; Wansun JO ; Myeongkwan JIH ; Sangho LEE ; Nanyoung LEE
Journal of Korean Academy of Pediatric Dentistry 2019;46(1):76-84
This study evaluated the microleakage of three restorative materials and three tricalcium silicate-based pulp capping agents. The restorative materials were composite resin (CR), resin-reinforced glass ionomer cement (RMGI), and traditional glass ionomer cement (GIC) and the pulp capping agents were TheraCal LC® (TLC), Biodentine® (BD), and ProRoot® white MTA (WMTA). Additionally, shear bond strengths between the pulp-capping agents and dentine were compared.Class V cavities were made in bovine incisors and classified into nine groups according to the type of pulp-capping agent and final restoration. After immersion in 0.5% fuchsin solution, each specimen was observed with a stereoscopic microscope to score microleakage level. The crowns of the bovine incisors were implanted into acrylic resin, cut horizontally, and divided into three groups. TLC, BD and WMTA blocks were applied on dentine, and the shear bond strengths were measured using a universal testing machine.The microleakage was lowest in TLC + GIC, TLC + RMGI, TLC + CR, and BD + GIC groups and highest in WMTA + RMGI and WMTA + CR groups. The shear bond strength of BD group was the highest and that of WMTA group was significantly lower than the others.
Crowns
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Dental Pulp Capping
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Dentin
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Glass Ionomer Cements
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Immersion
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Incisor
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Pemetrexed
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Pulp Capping and Pulpectomy Agents
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Rosaniline Dyes
9.Recent advances in direct pulp capping materials.
Meng-Lin FAN ; Li-Bang HE ; Ji-Yao LI
West China Journal of Stomatology 2018;36(6):675-680
The long-term effect of direct pulp capping and pulpotomy is closely related to the type of pulp capping materials. Various kinds of direct pulp capping materials are available, such as calcium hydroxide and mineral trioxide aggregates. Diverse new pulp capping materials have been reported recently. The excellent performance of calcium silicates has attracted much attention in previous studies. Moreover, enamel matrix derivative (Emdogain), which is capable of regeneration and remineralization, and other materials with similar capabilities have shown potential for use in pulp capping.
Aluminum Compounds
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Calcium Compounds
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Calcium Hydroxide
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Dental Pulp
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Dental Pulp Capping
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Drug Combinations
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Oxides
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Pulp Capping and Pulpectomy Agents
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Pulpotomy
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Root Canal Therapy
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Silicates
10.Evaluation of chemomechanical and traditional mechanical caries removal in indirect pulp capping of symmetric primary molars.
Ping CHANG ; Li-jin YAN ; Rui LI ; Li-ying LU ; Bei LI
Journal of Southern Medical University 2011;31(9):1568-1570
OBJECTIVETo evaluate the difference between chemomechanical and traditional mechanical caries removal in indirect pulp capping of the symmetric primary molars.
METHODSA total of 192 children with deep caries in the two symmetric primary molars were studied. The two symmetric primary molars were divided into two groups for treatment with chemomechanical method with Carisolv(TM) system or traditional mechanical method. After caries removal, calcium hydroxide agent was placed as the protective base, and glass ionomer cement was used to restore the teeth. The patients were followed up every 1 month within one year after the operation.
RESULTSThe percentage of healthy primary molar pulp was 95.3% with chemomechanical method and 87.0% with traditional method, showing a significant difference between the two methods.
CONCLUSIONChemomechanical caries removal is more effective in preserving the healthy pulp than the traditional method.
Child ; Dental Caries ; therapy ; Dental Pulp Capping ; methods ; Follow-Up Studies ; Humans ; Molar ; Tooth, Deciduous