Mineral trioxide aggregate or calcium hydroxide direct pulp capping: an analysis of the clinical treatment outcome (original) (raw)
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Australian Dental Journal, 2006
Primary teeth pulp exposures have traditionally been treated with formocresol or ferric sulphate pulpotomies or calcium hydroxide pulp capping. The aim of this study was to observe the tissue response when mineral trioxide aggregate (MTA) was used. Ten primary teeth had direct pulp caps and 11 had a pulpotomy with MTA. The teeth were restored and then clinically reviewed monthly for five months and before extraction. Radiographs were taken prior to treatment, after one month and prior to extraction. After extraction, the teeth were examined histologically and the responses to treatment were assessed. One pulpotomy and two pulp capping cases had postoperative pain and signs of pulp degeneration. Radiographs showed no root resorption, no periodontal pockets and no furcation radiolucencies. No cases had draining sinuses or increased mobility. Most pulps responded favourably from a clinical perspective although a variety of responses were noted histologically--normal odontoblasts, irregular odontoblasts, intra-pulpal calcifications, dentinal bridges, cementum formation, internal resorption, inflammatory infiltrate and pulp necrosis. The responses of pulps in primary teeth to MTA pulpotomies and pulp caps were favourable from clinical and radiographic perspectives although a variety of histological responses were noted. MTA may be a favourable material for pulp capping and pulpotomies in primary teeth.
Journal of Clinical Pediatric Dentistry, 2007
Carious pulp exposure in permanent molars of children is a common incident. Mineral trioxide aggregate is a new material that possesses numerous exciting possibilities for pulp therapy. Aim: The purpose of this study was to evaluate the efficiency of MTA as a direct pulp capping agent in young permanent teeth. Methods: Thirty asymptomatic permanent molars with pulp exposures were treated by pulp capping using MTA. At each recall (6, 12, 18 and 24 months), the teeth were assessed clinically, through pulpal sensitivity tests, as well as radiographically to evaluate periapical healing. Results: None of the cases reported spontaneous pain at the six months follow up and the pulp showed signs of vitality and absence of periapical radiolucency. At 24 months, the clinical and radiographic success rate was 93% with evidence of continued root growth. Conclusion: Pulp capping with MTA is recommended for teeth with carious pulp exposures specially immature teeth with high potential for healing.
Background: Different materials were used in the treatment of deeply decayed vital teeth. For many years, the gold standard for indirect pulp capping procedures was Calcium hydroxide. Nevertheless, the disadvantages reported with its use has led to its replacement with other materials such as mineral trioxide aggregate. Objective: The purpose of this systematic review is to compare the effectiveness of mineral trioxide aggregate (MTA) and calcium hydroxide (CH) in indirect pulp treatment of permanent teeth. Methods: Detailed search on PubMed, Web of science, Cochrane Library, Google and Ebsco databases was performed. Studies meeting the criteria for inclusion were accepted, and necessary information was independently extracted by 2 authors by means of a standardized form. Evaluation was done for the success rate and dentin bridge formation. Results: The inclusion criteria were met in three studies that were processed for data extraction and qualitative assessment. Conclusions: Due to presence of high risk of bias in the included studies, there is no conclusive evidence on the superiority of one material over the other.
Outcome of Direct Pulp Capping with Mineral Trioxide Aggregate: A Prospective Study
Journal of Endodontics, 2015
Introduction: The aim of this experimental study was to assess the outcome of direct pulp capping with mineral trioxide aggregate (MTA) after complete excavation of caries in permanent dentition with a 2-visit treatment protocol. Methods: Sixty-four teeth with deep carious lesions were consecutively selected. The mean age of the patients was 36.1 AE 15 years. An initial diagnosis of deep caries, with no irreversible pulp involvement, was made. Excavation of caries was performed under a rubber dam and operating microscope magnification. White MTA was applied, and a provisional restoration was placed. At the following appointment, positive sensibility testing and the MTA setting were confirmed. Bonded composite restorations were placed afterward. The patient was recalled at least 1 year after treatment for clinical and radiographic control. Outcome was described as success or failure. Success was defined as lack of complaints from the patient, positive reaction to cold testing, no sensitivity to percussion, and no widening of the periodontal ligament on the recall periapical radiograph. Results: Forty-six teeth (77.9%) were recalled after 3.6 years (standard deviation = 1.1 years). The overall success rate was 91.3%. The success rate in occlusal caries was 100% and 89.7% in proximal caries (difference = 10.3%; 95% confidence interval [CI], 8.5-89.1). The success rate in initial caries was 94.7% and 88.9% in secondary caries (difference = 5.8%; 95% CI, À48.1 to 59.7). The success rate in patients younger than 40 years was 100% and 80% in patients aged 40 years or older (difference = 20%; 95% CI, 4.2-35.8). Conclusions: Direct pulp capping with MTA after pulp exposure during excavation of deep caries could maintain pulp vitality in permanent teeth when a 2-visit treatment protocol is observed. (J Endod 2015;-:1-6)
Journal of …, 2008
This study evaluated the histomorphologic response of human dental pulps capped with mineral trioxide aggregate (MTA) and Ca(OH) 2 cement (CH). Pulp exposures were performed on the occlusal floor of 40 human permanent premolars. After that, the pulp was capped either with CH or MTA and restored with composite resin. After 30 and 60 days, teeth were extracted and processed for histologic exam and categorized in a histologic score system. The data were subjected to Kruskal-Wallis and Conover tests (␣ ϭ .05). All groups performed well in terms of hard tissue bridge formation, inflammatory response, and other pulpal findings. However, a lower response of CH30 was observed for the dentin bridge formation, when compared with MTA30 and MTA60 groups. Although the pulp healing with calcium hydroxide was slower than that of MTA, both materials were successful for pulp capping in human teeth. (J Endod 2008;34:1-6)
Pakistan Journal of Medical and Health Sciences
Aim: To compare the effectiveness of Biodentine versus mineral trioxide aggregate as direct pulp capping agent in carious exposed permanent tooth Study Design: Randomized controlled trial Placeand duration: Operative Dentistry, Department of de’Montmorency College of Dentistry / Punjab Dental Hospital, Lahore From 29-07-16 to 30-01-17 Methods: Sample size of 75 in each group (using non-probability) calculated using 80 percent power, 5% level of significance with expected percentage of effectiveness (lack of periapical radiolucency) among groups i.e. 92.68%19 in Biodentine group vs. 78%20 in mineral trioxide group aggregate as direct pulp capping agent. Data was entered and analyzed with IBM SPSS 20. Level of significance was kept at p-value ≤ 0.05. Results: Total 150 patients, 82 are male and 68 are female. The age of patients was 18-45 years. The Mean and SD of age of patients is 30±7.916. In group I, 57(75%) showed efficacy and 18(25%) showed failure of efficacy while in group II ...
Evaluation of two mineral trioxide aggregate compounds as pulp-capping agents in human teeth
International Endodontic Journal, 2009
Aim The present randomized, controlled prospective study evaluated the histomorphological response of human dental pulps capped with two grey mineral trioxide aggregate (MTA) compounds. Methodology Pulp exposures were performed on the occlusal floor of 40 human permanent pre-molars. The pulp was capped either with ProRoot (Dentsply) or MTA-Angelus (Angelus) and restored with zinc oxide eugenol cement. After 30 and 60 days, teeth were extracted and processed for histological examination and the effects on the pulp were scored. The data were subjected to Kruskal-Wallis and Conover tests (a = 0.05). Results In five out of the 40 teeth bacteria were present in pulp tissue. No significant difference was observed between the two materials (P > 0.05) in terms of overall histological features (hard tissue bridge, inflammatory response, giant cells and particles of capping materials). Overall, 94% and 88% of the specimens capped with MTA-Angelus and ProRoot, respectively, showed either total or partial hard tissue bridge formation (P > 0.05). Conclusions Both commercial materials ProRoot (Dentsply) and MTA-Angelus (Angelus) produced similar responses in the pulp when used for pulp capping in intact, caries-free teeth.
Journal of Conservative Dentistry, 2017
Background: Root canal treatment has been a routine treatment option for carious exposure of the dental pulp. In the context of minimally invasive dentistry, direct pulp capping (DPC) procedure with a reliable biomaterial may be considered as an alternative provided the pulp status is favorable. Mineral trioxide aggregate (MTA), a bioactive cement with excellent sealing ability and biocompatibility is capable of regenerating relatively damaged pulp and formation of dentin bridge when used as DPC agent. Biodentine is comparatively a new biomaterial claimed to possess properties similar to MTA and is currently explored for vital pulp therapy procedures. Aim: The aim of the present study was to evaluate the clinical response of pulp-dentin complex after DPC with MTA and biodentine in carious teeth. Subjects and Methods: Twenty-four permanent molars with carious exposure having no signs and symptoms of irreversible pulpitis were selected and assigned to one of the two groups, Group I-MTA and Group II-biodentine. Patients were recalled at 3 weeks, 3 months, and 6 months for clinical and radiographic evaluation. Fisher's exact test was used along with Chi-square test for statistical analysis. Results: Over a period of 6 months, MTA and biodentine showed 91.7% and 83.3% success rate, respectively, based on the subjective symptoms, pulp sensibility tests, and radiographic appearance. Conclusion: MTA and biodentine may be used as DPC agents when the pulpal diagnosis is not more than reversible pulpitis.