Immediate response of human dental pulp capped with mineral trioxide aggregate, portland cement and biodentin

Abstract

Background: The initial inflammatory reaction of pulp capping materials on the dental pulp has an intimate relation in promoting the future cellular differentiation and biomaterial mineralization. So, analysis of immediate pulpal tissue reaction in vivo, is also important for evaluation of ultimate efficacy any pulp capping agent. To observe immediate inflammatory response of Human Dental Pulp capped with Mineral Trioxide Aggregate (MTA), Biodentin and Portland Cement (PC). Methods: A total of 70 permanent premolars teeth planned to be extracted for orthodontic alignment of occlusion were used as study sample. The teeth were divided into 3 experimental groups, MTA (n=20), Biodentin (n=20) Portland cement (n=20) and control group (n=10). After having an occlusal exposure of approximately 1.5 mm in diameter; in group A, pulp of teeth was capped with 2-mm-thick layer of ProRoot White MTA (Dentsply) and in group B, with sterile Biodentin (Septodont) according to the manufacturer's recommendations. Whereas in group C, pulp of teeth was capped with sterile Portland Cement (PC). After placing the experimental material in each group, all teeth restored with glass ionomer cement. After 24 hours the teeth were extracted, fixed in 10% buffered formalin solution, then decalcified by 10% nitric acid and embedded in paraffin. Finally, sectioned into 2 to 3-micron-thick serial sections in the linguo-buccal plane and stained with hematoxylin-eosin. After then the amount of pulp inflammation (type, intensity, and extension) were determined by using a predetermined evaluation criterion under an optical microscope at 40* magnification. Ten intact teeth, which received no exposure and pulp capping but extracted due to orthodontic purpose were also collected and treated as the control group (group D); undergone same histologic preparation and evaluation. Significantstatistical differences among the experimental groups were to be found (p<0.05). Results: Histologically, all the three tested materials produced immediate pulpal tissue reaction. 'Biodentin' found to be most immediate pulpal tissue reactive (reactive in 100% cases) and 'Portland Cement' showed least immediate tissue reaction (only in 30.0% cases), whereas, MTA produced immediate tissue reaction only in 50.0% cases. Immediate pulpal inflammatory reaction in response to tested material found to be statistically significant different between 'Biodentin' and 'Portland cement' (p=0.01), also between 'Biodentin' and 'MTA' and (p=0.001); but there was no statistically significant difference between 'MTA' and 'Portland cement' (p =0.197). Conclusion: Considering the maximum immediate pulpal tissue reaction (Inflammation), Biodentin is expected to produce most favorable ultimate bioactivity (biomaterial mineralization) after pulp capping.