Direct pulp capping with a dentin bonding system in human teeth: a clinical and histological evaluation.
This study evaluated the pulpal response in human dental pulp to direct pulp capping with the Single Bond Adhesive System (SBAS) after 10% or 37% phosphoric acid etching and after capping with Calcium Hydroxide (CH). The degree of bleeding and hemostasis conditions was considered during the adhesive technique. The pulps of 78 sound premolars were capped with SBAS after 37% phosphoric acid etching (Group I) or 10% phosphoric acid etching (Group II) and CH (Group III-control). The cavities were restored with a resin composite (Charisma). After 1, 3, 7 and 30 days, the teeth were extracted and processed for light microscopical examination (H/E, AgNOR silver stain and Brown-Brenn). The patients were followed for postoperative symptomatology evaluation. Clinical results showed the possibility of hemostasis with saline solution only. There was no statistical difference between bleeding generated by 10% and 37% acid solutions. In some cases, contact of the pulp tissue with SASB started the bleeding process, thus damaging the adhesive technique. The histological response was similar in Groups I and II, without signs of cellular differentiation and dentin neoformation up to 30 days. Bacteria were not observed in any specimens. In the control group (CH) at day 7, the pulps exhibited cells with high synthetic activity (Ag-NOR-positive) underneath the area of coagulation necrosis. Dentin bridging was observed at the thirtieth day. The postoperative period was asymptomatic for all groups. In conclusion, SBAS should be avoided for vital pulp therapy, while CH remains the capping agent of choice for mechanically exposed human dental pulp.
Silva
Gerluza A B
GA
Department of Morphology, Institute of Biological Sciences, Belo Horizonte, Brazil.
Lanza
Lincoln D
LD
Lopes-Júnior
Nelson
N
Moreira
Adriana
A
Alves
Jose Bento
JB
D000134:Acid Etching, Dental; D000293:Adolescent; D000328:Adult; D017438:Bisphenol A-Glycidyl Methacrylate / Q000494:pharmacology; D002126:Calcium Hydroxide / Q000494:pharmacology*; D002454:Cell Differentiation / Q000187:drug effects; D002648:Child; D003188:Composite Resins; D003764:Dental Materials / Q000494:pharmacology; D003782:Dental Pulp / Q000187:drug effects* / Q000473:pathology; D003785:Dental Pulp Capping / Q000379:methods; D003793:Dental Restoration, Permanent; D003809:Dentin, Secondary / Q000187:drug effects / Q000473:pathology; D017220:Dentin-Bonding Agents / Q000494:pharmacology*; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements; D006470:Hemorrhage / Q000209:etiology; D006487:Hemostasis / Q000187:drug effects; D006801:Humans; D009804:Odontoblasts / Q000187:drug effects / Q000473:pathology; D010756:Phosphoric Acids / Q000008:administration & dosage / Q000494:pharmacology; D012965:Sodium Chloride
C084111:Charisma composite resin; D003188:Composite Resins; D003764:Dental Materials; D017220:Dentin-Bonding Agents; D005899:Glass Ionomer Cements; D010756:Phosphoric Acids; C115612:single bond; D012965:Sodium Chloride; D017438:Bisphenol A-Glycidyl Methacrylate; C030242:phosphoric acid; D002126:Calcium Hydroxide