Restor Dent Endod.  2013 Nov;38(4):227-233.

A preliminary report on histological outcome of pulpotomy with endodontic biomaterials vs calcium hydroxide

• Nosrat A
• Peimani A
• Asgary S

Abstract

OBJECTIVES
The purpose of the study was to evaluate human dental pulp response to pulpotomy with calcium hydroxide (CH), mineral trioxide aggregate (MTA), and calcium enriched mixture (CEM) cement.
MATERIALS AND METHODS
A total of nine erupted third molars were randomly assigned to each pulpotomy group. The same clinician performed full pulpotomies and coronal restorations. The patients were followed clinically for six months; the teeth were then extracted and prepared for histological assessments. The samples were blindly assessed by an independent observer for pulp vitality, pulp inflammation, and calcified bridge formation.
RESULTS
All patients were free of clinical signs/symptoms of pulpal/periradicular diseases during the follow up period. In CH group, one tooth had necrotic radicular pulp; other two teeth in this group had vital uninflamed pulps with complete dentinal bridge formation. In CEM cement and MTA groups all teeth had vital uninflamed radicular pulps. A complete dentinal bridge was formed beneath CEM cement and MTA in all roots. Odontoblast-like cells were present beneath CEM cement and MTA in all samples.
CONCLUSIONS
This study revealed that CEM cement and MTA were reliable endodontic biomaterials in full pulpotomy treatment. In contrast, the human dental pulp response to CH might be unpredictable.

Keyword

Calcium enriched mixture cement; Calcium hydroxide; MTA; Pulpotomy; Vital pulp therapy

MeSH Terms

Aluminum Compounds
Biocompatible Materials*
Calcium Compounds
Calcium Hydroxide*
Calcium*
Dental Pulp
Dentin
Drug Combinations
Follow-Up Studies
Glutamates
Guanine
Humans
Hydroxides
Inflammation
Molar, Third
Oxides
Pulpotomy*
Silicates
Tooth
Pemetrexed
Aluminum Compounds
Biocompatible Materials
Calcium
Calcium Compounds
Calcium Hydroxide
Drug Combinations
Glutamates
Guanine
Hydroxides
Oxides
Silicates

Figure

• 

  Figure 1 Preoperative and postoperative periapical radiographs of clinically erupted third molars; postoperative radiographs were taken immediately after operation to confirm the quality of pulpotomies and coronal restorations. CH, calcium hydroxide; MTA, mineral trioxide aggregate; CEM, calcium enriched mixture.

• 

  Figure 2 Composite photomicrograph of radicular pulps of healthy maxillary/mandibular erupted third molars six months after full pulpotomy with (a) calcium hydroxide (CH); (b) calcium enriched mixture (CEM) cement; (c) mineral trioxide aggregate (MTA) (Hematoxylin and Eosin staining, The magnifications of the micrographs in the left and right columns are ×100 and ×400, respectively). Clinically, all teeth were functional without sensitivity to percussion/palpation during the time period after pulpotomy. Note the continuous dentinal bridges (DB) beneath pulpotomy agents with regular tubular pattern and presence of odontoblast-like cells adjacent to dentinal bridges.

• 

  Figure 3 Necrotic radicular pulp in one of the teeth after pulpotomy with calcium hydroxide (CH). Note the resorptive lacunas on root canal dentinal walls.

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