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.
Accorinte
Maria de Lourdes Rodrigues
Mde L
Department of Dental Materials, School of Dentistry, University of São Paulo, SP, Brazil.
Loguercio
Alessandro D
AD
Reis
Alessandra
A
Muench
Antonio
A
de Araújo
Vera Cavalcanti
VC
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