Direct pulp capping with novel nanostructural materials based on calcium silicate systems and hydroxyapatite

Abstract

Introduction Direct pulp capping is an important therapeutic method that has goal to provide formation of dentin bridge and healing process of the pulp. The aim of this study was to investigate the effects of new nanostructural materials based on calcium silicate systems and hydroxyapatite on exposed dental pulp in Vietnamese pigs. Material and Methods The study was conducted on 30 teeth of two Vietnamese pigs (Sus scrofa verus). On buccal surfaces of incisors, canines and first premolars, class V cavities were prepared with a small round bur and pulp horn was exposed. In the first experimental group (10 teeth) the perforation was covered with new nanostructural material based on calcium silicate systems (CS). In the second experimental group, the perforation was covered with compound of calcium silicate systems and hydroxyapatite (HA-CS) (10 teeth). In the control group, exposed pulp was covered with Pro Root MTA® (Dentsply Tulsa Dental, Johnson City, TN, USA) (10 teeth). All cavities were restored with glass ionomer cement (GC Fuji VIII, GC Corporation, Tokyo, Japan). Observation period was 28 days. After sacrificing the animals, histological preparations were done to analyze the presence of dentin bridge, inflammatory reaction of the pulp, pulp tissue reorganization and the presence of bacteria. Results Dentin bridge was observed in all teeth (experimental and control groups). Inflammation of the pulp was mild to moderate in all groups. Neoangiogenesis and many odontoblast like cells responsible for dentin bridge formation were detected. Necrosis was not observed in any case, neither the presence of Gram-positive bacteria in the pulp. Conclusion Histological analysis indicated favorable therapeutic effects of new nanostructural materials based on calcium silicate systems and hydroxyapatite for direct pulp capping in teeth of Vietnamese pigs.

Uvod Direktno prekrivanje pulpe je važan terapijski postupak koji ima zadatak da obezbedi zatvaranje pulpne komore i omogući proces zarastanja. Cilj ovog rada je bio da se ispita efekat novih nanostrukturnih materijala na bazi kalcijum-silikatnih sistema i hidroksiapatita na eksponiranu pulpu zuba vijetnamskih svinja. Materijal i metode rada Istraživanje je sprovedeno na 30 zuba kod dve vijetnamske svinje (Sus scrofa verus). Na vestibularnim površinama sekutića, očnjaka i prvih premolara urađene su preparacije kaviteta V klase, pri čemu je malim okruglim svrdlom napravljena namerna eksploracija komore pulpe. U prvoj eksperimentalnoj grupi (10 zuba) perforacija je prekrivana novim nanostrukturnim materijalom na bazi kalcijum-silikatnih sistema (CS). U drugoj eksperimentalnoj grupi (10 zuba) perforacija je prekrivana smešom kalcijum-silikatnog sistema i hidroksiapatita (HA-CS). U kontrolnoj grupi (10 zuba) perforacija je prekrivana sa MTA® (Dentsply Tulsa Dental, Džonson Siti, Tenesi, SAD). Svi kaviteti su restaurirani glas-jonomer cementom (GC Fuji VIII, GC Corporation, Tokio, Japan). Opservacioni period iznosio je 28 dana. Nakon žrtvovanja životinja napravljeni su histološki preparati na kojima su analizirani postojanje dentinskog mostića, inflamatorna reakcija pulpe, reorganizacija pulpnog tkiva i prisustvo bakterija. Rezultati Na svim zubima eksperimentalnih grupa i kontrolne grupe zabeleženo je stvaranje dentinskog mostića. Zapaljenje pulpe je bilo blago do umereno i u eksperimentalnim i u kontrolnoj grupi. Uočeni su znaci neoangiogeneze i mnoštvo ćelija sličnih odontoblastima koje su odgovorne za stvaranje dentinskog mostića. Nekroza nije zabeležena ni u jednom slučaju, kao ni prisustvo gram-pozitivnih bakterija u pulpi. Zaključak Histološka analiza je ukazala na povoljne terapijske efekte novih nanostrukturnih materijala na bazi kalcijum-silikatnih sistema i hidroksiapatita u direktnom prekrivanju pulpe zuba vijetnamskih svinja.