Adverse effects of human pulps after direct pulp capping with the different components from a total-etch, three-step adhesive system.
OBJECTIVE
The objective was to evaluate the response of human pulps capped with different components from a total-etch three-step adhesive system.


METHODS
Direct pulp capping was performed in 25 caries-free human premolars scheduled for extraction due to orthodontic treatment. The teeth were randomly divided in five groups, and capped with the following materials: Group 1-acid+primer+adhesive were used as recommended; Group 2-only primer was applied; Group 3-only bonding resin (light-cured for 10s); Group 4-only composite resin (light-cured for 40s); Group 5-calcium hydroxide. After capping, all teeth were restored with ScotchBond Multi Purpose Plus and Z-100 was placed incrementally. After 60 days, the teeth were extracted and processed for light microscopic examination (H/E) according to a histological score system. These were subjected to non-parametric tests (alpha<0.05).


RESULTS
Overall, the histological features showed that groups 1-4 were quite similar and inferior to group 5. In groups 1-4 the pulp response varied from acute inflammatory cell infiltrate with varying degrees to necrosis. The groups 3 and 4 showed a trend towards better pulp response, since a normal connective tissue could be observed in more than half of the sample. All teeth from group 5 showed normal connective tissue below an amorphous dentin bridge.


CONCLUSIONS
Adhesive components (primer or adhesive) as well as a composite should be avoided for pulp capping. Ca(OH)(2) should be the first choice for pulp capping.
Department of Dental Materials, School of Dentistry, University of São Paulo, SP, Brazil.
Maria de Lourdes Rodrigues
Mde L
Accorinte
Alessandro D
AD
Loguercio
Alessandra
A
Reis
Antonio
A
Muench
Vera Cavalcanti
VC
de Araújo
D000134:Acid Etching, Dental / Q000009:adverse effects; D000269:Adhesives / Q000633:toxicity*; D000293:Adolescent; D000328:Adult; D002126:Calcium Hydroxide / Q000627:therapeutic use; D003188:Composite Resins / Q000633:toxicity; D003782:Dental Pulp / Q000187:drug effects*; D003785:Dental Pulp Capping / Q000009:adverse effects*; D003790:Dental Pulp Necrosis / Q000139:chemically induced; D006801:Humans; D008422:Materials Testing; D006472:Oral Hemorrhage / Q000139:chemically induced; D011671:Pulpitis / Q000139:chemically induced; D019279:Resin Cements / Q000633:toxicity*; D012822:Silicon Dioxide / Q000633:toxicity; D015040:Zirconium / Q000633:toxicity
D000269:Adhesives; D003188:Composite Resins; D019279:Resin Cements; C425844:Scotchbond Multi-Purpose Plus; C083568:Z100 composite resin; D012822:Silicon Dioxide; D015040:Zirconium; D002126:Calcium Hydroxide