end odontology

8/12/2019 End Odontology

1/7

EndodontologyHistologic evaluation of pulpotomies in dog using twotypes of mineral trioxide aggregate and regular and

white Portland cements as wound dressingsRenato Menezes DDS, MS , ,a,Clvis Monteiro Bramante DDS, MS, PhDb, Ariadne Letra DDS,MSc,anessa !raciela !omes CarvalhodandRoberto Brand"o !arcia DDS, MS, PhDe

aPhD student, Department of Endodontics, Bauru Dental School, University of So Paulo, Brail!Head Professor, Department of Endodontics, Bauru Dental School, University of So Paulo, BrailcPhD student, Bauru Dental School, University of So Paulo, SP, Braild"S student, #ollege of $eterinary "edicine, University of So Paulo, BraileProfessor, Department of Endodontics, Bauru Dental School, University of So Paulo, Brail

%eceived &' (cto!er &))*+

%evised &' anuary &))'+

accepted - "arch &))'.Bauru and /iter0i, Brail

U/1$E%S123 (4 S5( P6U7( 6/D 47U"1/E/SE 4EDE%67 U/1$E%S123.

6vaila!le online 88 Septem!er &))'.

Abstract

#b$ective

2he purpose of this study was to investigate the pulpal response of dogs9 teeth after pulpotomy and direct

pulp protection with "26 6ngelus, Pro%oot, Portland cement and white Portland cement.

St%dy design

Seventy:six teeth were treated with these materials. (ne hundred twenty days after treatment, the animals

were sacrificed and the specimens removed and prepared for histological analysis.

Res%lts

6ll the materials demonstrated similar results when used as pulp:capping materials. Pulp vitality was

maintained in all specimens and the pulp had healed with a hard tissue !ridge.

Concl%sion

2he materials used in this study were e;ually effective as pulp protection materials following pulpotomy.

Article #%tline

8. "aterial and methods

&. %esults*. Discussion and conclusion

%eferences2he procedure of pulp capping or pulpotomy relies primarily on the a!ility of pulpal tissue to heal.

$arious factors affect this process including age, periodontal condition, and stage of root formation.

Procedural factors such as the sie of exposure, its nature 8.?
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reported good sealing a!ility>&.and*.? and tissue healing. >'.,@.and A.?4ormation of new cementum over

the material was reported in repair of experimentally perforated furcations, >.? after root end filling, >&., C.

and-.? and in root canal filling of dogs9 teeth. >8).? Bridge:lie dentin was o!served in cases of pulp

capping >A., 88.and8&.? and pulpotomy >'.and8*.? in money and dog teeth.

ucherpfenning and Freen>8'.?reported that "26 and Portland cement seem almost identical

macroscopically, microscopically, and !y x:ray diffraction analysis. 2hey reported that !oth su!stances

support matrix formation in a similar fashion in cultures of osteo!last:lie cells, and also in apposition of

reparative dentin when used as direct pulp capping material in rat teeth. (ther studies >[email protected] 8A.?affirm

that Portland cements contain the same chemical elements as "26. Some of these ingredients are

calcium phosphate, calcium oxide, and silica. "26 also contains !ismuth oxide, which increases its

radiopacity. 2his is a!sent in Portland cement.

Portland cement has great similarity to "26 and offers significant economical incentives if applica!le in

!iological systems. 2herefore, the purpose of this study was to evaluate the pulp response of dog9s teeth

to & forms of "26, regular Portland cement, and white Portland cement when used as wound dressings

after pulpotomy.

&' Material and methods

Seventy:six teeth from ' mongrel dogs 8&:8C months of age were used in this experiment. Under general

anesthesia with 2elaol


3/7

4ig 8. #lass $ access cavities in canine. Pulp tissue covered with Portland cement.

4ig &. #lass 1 access cavity in a premolar.(ne hundred twenty days after treatment, the animals were illed and perfused with 8)M !uffered

formalin. Sections of the mandi!les were removed and placed in 8)M !uffered formalin !efore

demineraliation in sodium citrate !uffered formic acid. 2issue !locs were dehydrated and em!edded in

paraffin. Serial sections were cut at a setting of A Nm in a !uccolingual direction and stained with

hematoxylin and eosin. 2he sections were examined !y & o!servers who were not aware of the source ofthe specimens. Every sample was evaluated for severity of tissue reactions. 2he type and location of

inflammation, presence of necrosis, hyperemia, calcification other than in the area of the !ridge, and

regrowth of odonto!lasts. 2he presence and ;uality of the hard tissue !ridge


4/7

4ig *. Pulpotomy with "26 6ngelus.A, Dentin !arrier+ B, "26 6ngelus material used for the pulpotomy+ C,pulp tissue appears normal without inflammatory infiltrate. Htx:eosin


5/7

4ig @. Pulpotomy with "26 6ngelus. Higher magnification of 4ig *.A, Pulp tissue healed with a continuousdentin !arrier without tissue inclusions+ B, "26 6ngelus+ C, normal pulp tissue free of inflammation. Htx:eosin 8'.?and dogs. >'.?(ur results are in agreement with these studies. 2his is the first report

on white Portland cement.

2he tissue reaction patterns and cell reactions were identical for Pro%oot, "26 6ngelus, Portland

cement, and white Portland cement. 2his is not unexpected, !ecause the high surface pH, especiallywhen these materials are freshly mixed, will cause denaturation of adJacent cells and tissue proteins.>8.?

2his denaturation includes a few !acteria present in the wound area. 6s the materials set, the pH

changes and the cell inJuries su!side.

(ur study suggests that "26, Portland cement, and white Portland cement represent !iocompati!le

su!strates to which formative cells can attach and produce new soft or hard tissue, preserving pulp

vitality. 2his is in agreement with previous data>'.? showing them to !e effective materials for pulp

protection.

1t is nown that the presence of !acteria is a significant inhi!iting factor for healing of pulp exposures.>8C.?

1n this study, no sections were stained for !acterial presence. 2he Portland cements were sterilied !y

gamma radiation to avoid !acterial contamination and yet preserve characteristics of the materials. 2hismight not have !een necessary owing to the high pH of the materials, in which microorganisms are less

liely to survive.

2he a!ility of "26 and Portland cement to support the formation of a dentin !ridge may !e attri!uted to

excellent sealing a!ility and fast setting. 2his prevents the diffusion of the material into the tissues, and

reduces microleaage during the healing period.
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1t should !e emphasied that these pulpotomies were done under ideal conditions+ ie, all teeth were free

of caries and pulp inflammation, which may impair the healing. 2herefore, studies under such

compromised conditions would !e of great value.

1n a recent study, 6!dullah et al>8-.? o!served that one type of accelerated Portland cement


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-.". 2ora!ineJad, 2.4. atson and 2.%. Pitt 4ord, Sealing a!ility of a mineral trioxide aggregate when used

as a root end filling material. J Endod&.