An in vivo evaluation of hemorrhage control using sodium hypochlorite and direct capping with a one- or two-component adhesive system in exposed nonhuman primate pulps.
OBJECTIVE
This study evaluated the biologic ability of sodium hypochlorite to control hemorrhage via chemical amputation of the coagulum, to remove dentin chips, to assist healing, and to facilitate formation of a dentinal bridge under two adhesive systems.


METHODS
Ninety Class V cavities with mechanical pulpal exposures were placed in the teeth of five adult monkeys and histologically observed. All exposures were prepared with a No. 330 bur, and hemorrhage was controlled with 3% sodium hypochlorite. Twenty-two exposures were capped with All-Bond 2 and AElitefil, and 26 exposures were capped with One-Step (OS) and Resinomer (RS). Two pulps were excluded from the final data. Forty-two exposures were capped with calcium hydroxide and amalgam as controls. At 7, 27, and 90 days, tissues were obtained by perfusion fixation, demineralized, sectioned, stained, and histologically graded according to published qualitative criteria.


RESULTS
For both adhesives, at 7 days, 12 of 16 pulps showed no coagulum remnants or dentin chips at the material interface. No necrotic pulps were observed. At 27 and 97 days, 26 of 30 capped pulps had dentinal bridges at the adhesive interface. Reparative dentin was present in 28 pulps. Four 97-day pulps exhibited necrosis associated with stained bacteria. One 97-day pulp contained dentin chips throughout the pulp and demonstrated no healing, no reparative dentin, and no stained bacterial profiles.


CONCLUSIONS
Normal soft tissue reorganization and dentinal bridge formation were observed in 86% of pulps treated with sodium hypochlorite and either adhesive system.
Hafez
Abeer A
AA
International Student Program, University of Southern California, School of Dentistry, Los Angeles, California, USA.
Cox
Charles F
CF
Tarim
Berna
B
Otsuki
Masayuki
M
Akimoto
Naotake
N
D000818:Animals; D017438:Bisphenol A-Glycidyl Methacrylate; D002126:Calcium Hydroxide / Q000627:therapeutic use; D003188:Composite Resins; D003723:Dental Amalgam; D003785:Dental Pulp Capping / Q000379:methods*; D003788:Dental Pulp Diseases / Q000517:prevention & control*; D003789:Dental Pulp Exposure / Q000628:therapy*; D003790:Dental Pulp Necrosis / Q000145:classification / Q000382:microbiology; D003793:Dental Restoration, Permanent; D003809:Dentin, Secondary / Q000139:chemically induced; D017220:Dentin-Bonding Agents / Q000627:therapeutic use*; D006470:Hemorrhage / Q000517:prevention & control; D006490:Hemostatics / Q000627:therapeutic use*; D008253:Macaca mulatta; D008689:Methacrylates / Q000627:therapeutic use; D019279:Resin Cements; D012388:Root Canal Irrigants / Q000627:therapeutic use; D012821:Silanes; D012822:Silicon Dioxide; D012973:Sodium Hypochlorite / Q000627:therapeutic use*; D013997:Time Factors; D014945:Wound Healing
C098721:Aelitefil; C103506:Bis-GMA, BPDM, HEMA dental-bonding resin; D003188:Composite Resins; D017220:Dentin-Bonding Agents; D006490:Hemostatics; D008689:Methacrylates; D019279:Resin Cements; D012388:Root Canal Irrigants; D012821:Silanes; C110709:resinomer; C100742:All-Bond 2; D017438:Bisphenol A-Glycidyl Methacrylate; D012822:Silicon Dioxide; D003723:Dental Amalgam; D012973:Sodium Hypochlorite; D002126:Calcium Hydroxide