Response of human pulps capped with a self-etching adhesive system.
OBJECTIVE
The aim of this study was to evaluate the human pulp response following direct pulp capping with a current self-etching bonding agent and calcium hydroxide (CH).


METHODS
Thirty-three sound human premolars had their pulp tissue mechanically exposed. Sterile distilled water was used to control the hemorrhage and exudation from the pulp exposure site. The pulps were capped with Clearfil Liner Bond 2 (CLB-2) or CH and the cavities were filled with a resin composite (Z-100) according to the manufacturer's instructions. After 5, 30 and 120-300 days, the teeth were extracted and processed for microscopic examination.


RESULTS
At short-term, CLB-2 elicited a mild to moderate inflammatory pulp response with dilated and congested blood vessels adjacent to pulp exposure site. With time, macrophages and giant cells engulfing globules and particulates of resinous material displaced into the pulp space were observed. This chronic inflammatory pulp response triggered by fragments of bonding agent displaced into the pulp space did not allow pulp repair interfering with the dentin bridging. On the other hand, pulps capped with CH exhibited an initial organization of elongated pulp cells underneath the coagulation necrosis. Pulp repair and complete dentin bridge formation was observed at long-term evaluation.


CONCLUSIONS
The present study demonstrated that CH remains the pulp capping agent of choice for mechanically exposed human pulps. CLB-2 did not allow complete connective tissue repair adjacent to the pulp exposure site. Consequently, this bonding agent cannot be recommended for pulp therapy of sound human teeth.
de Souza Costa
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Department of Physiology and Pathology, School of Dentistry, University of São Paulo State/UNESP, Rua Humaita 1680, CEP: 1480-903, Araraquara, São Paulo, Brazil. casouzac@foar.unesp.br
Lopes do Nascimento
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Teixeira
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Fontana
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UF
D000134:Acid Etching, Dental; D000293:Adolescent; D000704:Analysis of Variance; D001641:Bicuspid; D002126:Calcium Hydroxide / Q000627:therapeutic use; D002648:Child; D003188:Composite Resins; D003238:Connective Tissue / Q000187:drug effects / Q000473:pathology; D003782:Dental Pulp / Q000098:blood supply / Q000187:drug effects* / Q000473:pathology; D003785:Dental Pulp Capping; D003789:Dental Pulp Exposure / Q000628:therapy; D003793:Dental Restoration, Permanent; D003809:Dentin, Secondary / Q000187:drug effects / Q000473:pathology; D017220:Dentin-Bonding Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D015726:Giant Cells / Q000473:pathology; D006801:Humans; D008264:Macrophages / Q000473:pathology; D008689:Methacrylates / Q000627:therapeutic use; D009336:Necrosis; D009804:Odontoblasts / Q000473:pathology; D011671:Pulpitis / Q000473:pathology; D012822:Silicon Dioxide; D013223:Statistics as Topic; D014664:Vasodilation / Q000187:drug effects; D014945:Wound Healing / Q000187:drug effects; D015040:Zirconium
C112274:Clearfil Liner Bond 2; D003188:Composite Resins; D017220:Dentin-Bonding Agents; D008689:Methacrylates; C083568:Z100 composite resin; D012822:Silicon Dioxide; D015040:Zirconium; D002126:Calcium Hydroxide