title: Nano-hydroxyapatite and calcium-enriched mixture for pulp capping of sound primary teeth: a randomized clinical trial.
abstract: BACKGROUND
  Nano-hydroxyapatite (NHA) has been used for regeneration of osseous defects. Calcium-enriched mixture (CEM) cement is also used for various dental treatments. This trial compared the efficacy of NHA and CEM cement for direct pulp capping (DPC) of sound primary teeth.
  
  
  METHODS
  In this randomized clinical trial with split-mouth design, after attaining informed consent, 20 sound primary canines scheduled for orthodontic extraction, were selected. After mechanical pulp exposure, the exposed site was capped with either NHA or CEM cement and then immediately restored with glass-ionomer and resin composite. The teeth were extracted after two months and examined histologically. Parameters of hard tissue bridge (HTB) formation, its type and quality as well as pulpal inflammation scores were compared between the two experimental groups. The data were analyzed using the Mann Whitney U and Fisher's exact test. The level of significance was set at 0.001.
  
  
  RESULTS
  All CEM specimens showed inflammation score of 0 (less than 10%). However, in NHA group, inflammation scores of 0 (less than 10%), 1 (10%-30%) and 2 (30%-50%) were observed in 2 (20%), 4 (40%) and 4 (40%) specimens, respectively (P<0.001). HTB was formed in all CEM specimens while it was developed in 2 specimens of NHA (20%; P<0.001). All CEM specimens showed normal pulp; only two cases in NHA group (20%) demonstrated uninflamed normal pulp.
  
  
  CONCLUSIONS
  CEM cement was superior to NHA as a DPC agent in terms of HTB formation and pulp inflammation scores. It is a suitable material for the DPC of primary teeth.
authors.affiliation: Department of Pediatric Dentistry, Dental School, Shahed University, Tehran, Iran;
authors.forename: Roza
authors.initials: R
authors.lastname: Haghgoo
authors.affiliation: Iranian Center for Endodontic Research, Research Institute of Dental Sciences,Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
authors.forename: Saeed
authors.initials: S
authors.lastname: Asgary
authors.affiliation: Department of oral Pathology, Dental school, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Mashhadi Abbas
authors.affiliation: Department of Pediatric Dentistry, Dental School, Qom University of Medical Science, Qom, Iran.
authors.forename: Roshanak
authors.initials: R
authors.lastname: Montazeri Hedeshi
keywords: Calcium-Enriched Mixture; Direct Pulp Capping; Nano-Hydroxyapatite; Primary Teeth; Vital Pulp Therapy
references.citation: Acta Odontol Scand. 2013 Jan;71(1):130-6
references.pmid: 22339289
references.citation: Sichuan Da Xue Xue Bao Yi Xue Ban. 2005 Jan;36(1):43-5
references.pmid: 15702777
references.citation: J Dent. 2010 Oct;38(10):828-37
references.pmid: 20615446
references.citation: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Oct;106(4):609-14
references.pmid: 18718783
references.citation: Iran Endod J. 2013 Fall;8(4):187-90
references.pmid: 24171027
references.citation: Eur Arch Paediatr Dent. 2013 Jun;14(3):191-4
references.pmid: 23595622
references.citation: Iran Endod J. 2015 Winter;10(1):6-15
references.pmid: 25598803
references.citation: Biomaterials. 2001 Jun;22(11):1327-33
references.pmid: 11336305
references.citation: J Conserv Dent. 2013 Mar;16(2):92-8
references.pmid: 23716958
references.citation: J Oral Pathol. 1985 Feb;14(2):156-68
references.pmid: 3920366
references.citation: J Dent Child (Chic). 2010 May-Aug;77(2):77-83
references.pmid: 20819402
references.citation: Eur Arch Paediatr Dent. 2014 Aug;15(4):223-8
references.pmid: 24435546
references.citation: Int J Nanomedicine. 2006;1(3):317-32
references.pmid: 17717972
references.citation: Mediators Inflamm. 2015 ;2015 :564042
references.pmid: 26347311
references.citation: Clin Oral Investig. 2013 Mar;17 (2):431-9
references.pmid: 22431145
references.citation: Caries Res. 2011;45(5):460-8
references.pmid: 21894006
references.citation: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 May;107(5):733-8
references.pmid: 19201627
references.citation: Aust Endod J. 2012 Aug;38(2):70-5
references.pmid: 22827819
references.citation: J Endod. 2011 Dec;37(12):1613-8
references.pmid: 22099892
references.citation: J Prosthet Dent. 1987 Jan;57(1):1-8
references.pmid: 3468243
references.citation: J Endod. 2010 Nov;36(11):1778-81
references.pmid: 20951286
references.citation: J Clin Dent. 2011;22(5):139-43
references.pmid: 22403978
references.citation: J Endod. 2010 Mar;36(3):400-13
references.pmid: 20171353
references.citation: J Br Endod Soc. 1975 Jul;8(2):74-93
references.pmid: 1058189
references.citation: Int Endod J. 2010 Oct;43(10):940-4
references.pmid: 20646078
references.citation: J Oral Sci. 2008 Dec;50(4):469-74
references.pmid: 19106476
references.citation: Iran Endod J. 2006 Winter;1(4):117-23
references.pmid: 24379876
references.citation: J Dent Res Dent Clin Dent Prospects. 2013 Winter;7(1):8-14
references.pmid: 23487477
references.citation: J Dent Res. 1985 Apr;64 Spec No:541-8
references.pmid: 3857254
references.citation: Biomatter. 2013 Apr-Jun;3(2):null
references.pmid: 23719177
references.citation: Int J Paediatr Dent. 2004 Sep;14(5):376-9
references.pmid: 15331004
references.citation: Iran Endod J. 2013 Fall;8(4):149-52
references.pmid: 24171019
references.citation: Int J Paediatr Dent. 2013 Jan;23 (1):56-63
references.pmid: 22309243
references.citation: J Biomed Mater Res A. 2006 Oct;79(1):114-27
references.pmid: 16763987
references.citation: J Biomed Mater Res B Appl Biomater. 2004 Apr 15;69(1):33-7
references.pmid: 15015207
references.citation: Dent Traumatol. 2009 Aug;25(4):413-9
references.pmid: 19519859
references.citation: ASDC J Dent Child. 1987 Nov-Dec;54(6):423-8
references.pmid: 3478371
references.citation: Am J Dent. 2007 Jun;20(3):182-8
references.pmid: 17672261
references.citation: J Endod. 2010 May;36(5):912-4
references.pmid: 20416445
references.citation: Sci Rep. 2014 Jul 07;4:5599
references.pmid: 24998362
references.citation: Eur J Paediatr Dent. 2011 Sep;12(3):189-93
references.pmid: 22077689
references.citation: Oral Surg Oral Med Oral Pathol. 1993 Oct;76(4):485-92
references.pmid: 8233430