Human pulpal response to direct pulp capping with an adhesive system.
OBJECTIVE
To evaluate clinically and microscopically the human pulp response when directly capped with an adhesive system or calcium hydroxide over short (9-12 days) and long (53-204 days) experimental periods.


METHODS
Fifty-one sound human premolars scheduled for orthodontic extraction, had their pulp horns gently exposed with a diamond point. Debris in the pulp wound was washed out with a sterile saline solution. The pulps were then capped with either an adhesive system (Scotchbond Multi-Purpose Plus) or calcium hydroxide. All teeth were subsequently restored with resin-based composite (Z-100) according to the manufacturer's instructions. After the experimental periods, the teeth were extracted and processed for light microscopic examination.


RESULTS
Short-term: the pulp tissue capped with SBMP-P exhibited dilated and congested blood vessels associated with a moderate inflammatory response and blanching of pulp cell nuclei. Long-term: no evidence of healing and bridge formation was observed. A persistent mild inflammatory pulp response was present. Micro-abscesses were detected in three cases associated with bacterial infiltration. Calcium hydroxide stimulated early pulp repair and dentin bridging which extended into the longest period.
Pereira
J C
JC
Departamento de Dentística, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Brazil. jcper@zaz.com.br
Segala
A D
AD
Costa
C A
CA
D000038:Abscess / Q000382:microbiology; D000293:Adolescent; D001641:Bicuspid; D002126:Calcium Hydroxide / Q000627:therapeutic use; D002467:Cell Nucleus / Q000187:drug effects; D003188:Composite Resins; D003782:Dental Pulp / Q000098:blood supply / Q000187:drug effects* / Q000382:microbiology / Q000473:pathology; D003785:Dental Pulp Capping; D003788:Dental Pulp Diseases / Q000382:microbiology; D003789:Dental Pulp Exposure / Q000628:therapy; D003793:Dental Restoration, Permanent; D003809:Dentin, Secondary / Q000187:drug effects; D017220:Dentin-Bonding Agents / Q000627:therapeutic use*; D004108:Dilatation, Pathologic / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D011671:Pulpitis / Q000382:microbiology / Q000473:pathology; D019279:Resin Cements / Q000627:therapeutic use; D012822:Silicon Dioxide; D014945:Wound Healing / Q000187:drug effects; D015040:Zirconium
D003188:Composite Resins; D017220:Dentin-Bonding Agents; D019279:Resin Cements; C425844:Scotchbond Multi-Purpose Plus; C083568:Z100 composite resin; D012822:Silicon Dioxide; D015040:Zirconium; D002126:Calcium Hydroxide