silicate-cement and Pulpitis

Standards presently used to evaluate the biologic compatibility of dental restorative materials are examined and their inherent shortcomings are noted in this report. Studies citing the alleged effects of dental materials on the pulp are reviewed and compared to new theories, which suggest that the principal cause of pulpal inflammation is bacterial infiltration. Thus, studies that are not able to exclude bacteria as a variable cannot be used to draw conclusions as to the cause of inflammatory changes. This paper presents a proposal to alter the current biocompatibility testing methods to methods that can distinguish between the effects of materials and the effects of bacteria on the pulp.

Topics: Biocompatible Materials; Composite Resins; Dental Leakage; Dental Pulp; Dental Restoration, Permanent; Materials Testing; Pulpitis; Silicate Cement; Zinc Oxide-Eugenol Cement

Topics: Adolescent; Adult; Aged; Child; Clinical Trials as Topic; Composite Resins; Dental Cavity Lining; Dental Pulp; Dental Pulp Test; Dentin; Dentin Sensitivity; Dentin, Secondary; Evaluation Studies as Topic; Humans; Middle Aged; Odontoblasts; Pulpitis; Silicate Cement; Zinc Oxide-Eugenol Cement

Topics: Adolescent; Adult; Animals; Child; Clinical Trials as Topic; Dental Cavity Lining; Dental Cavity Preparation; Dental Pulp; Dogs; Humans; Middle Aged; Pulpitis; Silicate Cement; Time Factors

The aim of this study was to analyze the effects of different calcium silicate-based cements (CSCs) for pulp capping materials including MicroMega MTA (MMTA; MicroMega, Besanchon, France), RetroMTA (RMTA; BioMTA, Seoul, Korea), ProRoot MTA (PMTA; Dentsply, Tulsa, OK), and experimental CSC (ECSC) on odontoblastic differentiation, in vitro angiogenesis, and the inflammatory response in human dental pulp cells.. Differentiation was evaluated by alkaline phosphatase activity, alizarin red staining, and reverse-transcriptase polymerase chain reaction (RT-PCR) for the marker genes. The levels of inflammatory mediators and cytokines were measured by RT-PCR and an enzyme-linked immunosorbent assay. In vitro angiogenesis was assessed by RT-PCR for angiogenic genes and an endothelial tube formation assay.. PMTA, MMTA, and ECSC increased the alkaline phosphatase activity and mineralization nodule formation and up-regulated messenger RNA (mRNA) expression of odontoblastic markers compared with RMTA. In addition, PMTA, MMTA, and ECSC up-regulated the mRNA of angiogenic genes in human dental pulp cells and increased the capillary tube formation of endothelial cells compared with RMTA. However, all CSCs showed similar expression levels of inducible nitric oxide synthase and cyclooxygenase-2 protein as well as proinflammatory mediators such as nitric oxide, prostaglandin E2, tumor necrosis factor alpha, interleukin (IL)-1β, IL-6, and IL-8 mRNA.. Taken together, our experimental results suggest that all CSCs are favorable materials for pulp capping, but PMTA, MMTA, and ECSC may be recommended over RMTA.

Topics: Cell Differentiation; Cells, Cultured; Dental Pulp; Humans; Neovascularization, Physiologic; Odontoblasts; Pulp Capping and Pulpectomy Agents; Pulpitis; Silicate Cement

Pulp capping in carious teeth has been considered unpredictable and therefore contraindicated. A recently developed material, mineral trioxide aggregate (MTA), resists bacterial leakage and may provide protection for the pulp, allowing repair and continued pulp vitality in teeth when used in combination with a sealed restoration.. Forty patients aged 7 to 45 years accepted pulp-capping treatment when they received a diagnosis no more severe than reversible pulpitis after undergoing cold testing and radiographic examination. The primary author removed caries using a caries detector dye and sodium hypochlorite solution for hemostasis and placed MTA over the exposures and all surrounding dentin. The operator then restored the teeth provisionally with unbonded Clearfil Photocore (Kuraray Medical, Okayama, Japan). During a second visit, the operator restored the teeth with bonded composite after sensibility testing and confirmed MTA curing. At recall appointments, patients were evaluated for reparative dentin formation, pulpal calcification, continued normal root development and evidence of pathosis.. Over an observation period of nine years, the authors followed 49 of 53 teeth and found that 97.96 percent had favorable outcomes on the basis of radiographic appearance, subjective symptoms and cold testing. All teeth in younger patients (15/15) that initially had open apexes showed completed root formation (apexogenesis).. MTA can be a reliable pulp-capping material on direct carious exposures in permanent teeth when a two-visit treatment protocol is observed.. Vital pulp therapy using MTA is a treatment option for teeth diagnosed with a condition no more severe than reversible pulpitis.

Topics: Adolescent; Adult; Aluminum Compounds; Calcium Compounds; Child; Dental Caries; Dental Pulp Capping; Dental Restoration, Permanent; Dentin, Secondary; Drug Combinations; Hemostatics; Humans; Kaplan-Meier Estimate; Life Tables; Middle Aged; Oxides; Pulpitis; Silicate Cement; Silicates; Sodium Hypochlorite; Treatment Outcome

Pulpal response to marginal enamel etching or both enamel and dentine etching with 37% phosphoric acid for adhesive composite restorations was studied in the teeth of the Japanese monkey (Macaca fuscata). Dentine etching irritated the pulp and caused moderate to severe initial changes along the odontoblastic layer at 3 days. When no bacteria were present along the cavity walls, the subsequent pulpal reactions at 30 and 90 days decreased with time and large amounts of irritation dentine were formed. These inflammatory reactions were less than those caused by enamel etching only, or zinc oxide/eugenol cement. Significant correlation (P less than 0.01) was found between the intensity of the inflammatory reactions and the degree of bacterial infection. The pulpal irritation caused by acid etching of dentine for composite restorations is transitory only when the fillings have a good marginal seal and wall adaptation.

Topics: Acid Etching, Dental; Adhesives; Animals; Bacteria; Composite Resins; Dental Bonding; Dental Enamel; Dental Pulp; Dental Restoration, Permanent; Dentin; Dentin, Secondary; Macaca; Odontoblasts; Phosphoric Acids; Pulpitis; Resin Cements; Silicate Cement; Time Factors; Zinc Oxide-Eugenol Cement

Topics: Animals; Bacteria; Biocompatible Materials; Composite Resins; Dental Amalgam; Dental Materials; Dental Pulp; Dental Pulp Capping; Dental Pulp Necrosis; Dental Restoration, Permanent; Macaca mulatta; Pulpitis; Silicate Cement; Zinc Oxide-Eugenol Cement; Zinc Phosphate Cement

Data from several studies performed during the last 15 years indicate that bacteria and their products are the main etiological factor for dental pulp inflammation. The present series of investigations was conducted in order to determine the irritating effect from various oral bacterial components and restorative measures on dental pulpal tissue and to ascertain reaction patterns of inflamed pulp tissue. The different bacterial materials were tested in an experimental model where the test substance was applied and enclosed in buccal class V cavities prepared in human or monkey teeth. The pulp tissue response was evaluated from tooth specimens after both short (8 hours) and long time (150 days) challenge with the test substance. Intra and extra cellular components from pure bacterial species, cell wall material and a crude mixture of 8 bacterial species were used as representative test materials for oral bacteria associated with growth on or in dentin. Silicate cement restorations were also used as a pulp irritating restorative procedure. The degree of pulpal inflammation was classified according to a descriptive method. In order to obtain a better evaluation method for pulp tissue reactions, a stereo morphometric technique was developed. This method was used in the last study to evaluate the pulp tissue reactions to silicate cement restorations after dentin treatment with calcium hydroxide. The chemotactic effect of the different bacterial materials were also tested in wound chambers implanted in the back of rats. Results from these studies showed that components from different bacterial species had varying capacity to induce pulpal inflammation over cut dentin. The severity of the early inflammatory response was not altered after decomplementation. The tested bacterial products had a similar chemotactic effect on the pulp tissue as on ordinary connective tissue. If the pulp was challenged with bacterial products for a long time period, healing and repair were frequently found, although if the pulp tissue was primary severely inflamed. The inflammatory reactions and repair patterns in human teeth were similar to those of monkey teeth. Treatment of exposed dentin with calcium hydroxide reduced the pulp irritating effect of silicate cement restorations, but induced only limited volumes of irregular secondary dentin formation.

Topics: Animals; Bacterial Physiological Phenomena; Child; Dental Pulp; Dentin; Humans; Lipopolysaccharides; Macaca fascicularis; Pulpitis; Rats; Silicate Cement; Subcellular Fractions; Time Factors; Zinc Oxide-Eugenol Cement

The pulpal response to Protemp (ESPE Gmbh) was compared to zinc oxide-eugenol, Super Syntrex (de Trey) and Protemp plus zinc oxide-eugenol liner in 144 vervet monkey (Cercopithecus pygerythus) incisor teeth, according to ADA Specification No. 41. Cellular displacement into dentinal tubules, superficial and deep inflammation were present only in the 3-day specimens in all materials. Mean scores for the test material were lower than both negative and positive controls. In the 30-day specimens the prevalence of reparative dentine under the test material was similar to the negative control, while at 90 days it was less than the negative control, although the severity in affected specimens was more than the positive control. Use of a zinc oxide-eugenol liner reduced the severity of reparative dentine formation.

Topics: Acrylates; Animals; Chlorocebus aethiops; Crowns; Dental Cavity Lining; Dental Pulp; Denture, Partial; Denture, Partial, Temporary; Methacrylates; Pulpitis; Silicate Cement; Zinc Oxide-Eugenol Cement

Topics: Animals; Bacteria; Dental Pulp; Dental Pulp Cavity; Ferrets; Male; Pulpitis; Root Canal Therapy; Silicate Cement; Zinc Oxide-Eugenol Cement

Topics: Animals; Bacterial Physiological Phenomena; Dental Pulp; Dentin, Secondary; Germ-Free Life; Pulpitis; Rats; Silicate Cement; Zinc Phosphate Cement

Topics: Anti-Infective Agents, Local; Dental Caries; Dental Cavity Preparation; Dental Restoration, Permanent; Dentin; Humans; Polycarboxylate Cement; Pulpitis; Silicate Cement; Zinc Phosphate Cement

Silicate cement was inserted in deep unlined cavities in 70 human teeth; 35 cavities were cleaned with an antibacterial cleanser, and the other 35 cavities in the contralateral teeth were treated with water spray only. In all teeth, invasion of bacteria from the tooth surface was prevented with a surface seal. Histologic examinations after 4 weeks revealed bacterial growth on dentinal walls in 9 of the uncleaned and in 2 cleaned cavities. Only in these 11 teeth was an inflammatory reaction seen in the pulp. Under eight cavities without bacterial growth and with silicate cement placed directly on an exposed pulp, no serious injury and no inflammatory reactions were observed. It was concluded that silicate cement per se does not seriously irritate the pulp. Infection of cavity walls should be avoided, not only by removing grinding debris and antibacterial cleansing, but also by use of a liner to prevent invasion of bacteria from the surface of the tooth.

Topics: Anti-Bacterial Agents; Bacteria; Dental Cavity Preparation; Dental Pulp; Dental Pulp Exposure; Dental Pulp Necrosis; Dental Restoration, Permanent; Dentin; Dentin, Secondary; Humans; Pulpitis; Silicate Cement; Sodium Fluoride

Topics: Adhesives; Dental Cements; Denture Retention; Gingivitis; Humans; Polycarboxylate Cement; Pulpitis; Silicate Cement; Solubility; Zinc Oxide-Eugenol Cement; Zinc Phosphate Cement

Unlined silicate restorations were placed in intact and experimentally altered monkey, teeth. Pulpitis had been induced experimentally by sealing soft carious human dentin in Class V cavities with amalgam for 7 d. These fillings were then removed and healing allowed by inserting zinc oxide/eugenol cement. A protective effect of the secondary dentin in teeth with healing pulpitis could be demonstrated in short-term experiments. After a 1-month observation period no difference in response to silicate cement could be found between intact and experimentally altered pulps, both groups exhibiting no or slight pulp reactions and secondary dentin formations.

Topics: Animals; Cercopithecus; Dental Pulp; Haplorhini; Pulpitis; Silicate Cement; Zinc Oxide-Eugenol Cement

The biological compatibility of a silicophosphate cement (Fluoro-Thin) and a zinc phosphate cement (de Trey's Improved) has been assessed in in vitro (cell culture) and in vivo (monkey teeth) tests. In the in vitro tests both materials were toxic when freshly prepared. In experiments with prolonged cell-material contact time, with set specimens of the materials, the zinc phosphate cement appeared to be non-toxic, whereas the silicophosphate cement was clearly toxic. The in vivo experiments confirmed that a possible pulp reaction cauded by zinc phosphate cement is of a mild nature. The silicophosphate cement, however, cauded a moderate or severe reaction in the pulp after 8 days of observation, and there was chronic inflammation in most teeth after 36 or 72 days. It was concluded, therefore, that Fluoro-Thin should not be used as a luting agent or for restorative purposes in direct contact with vital dentine.

Topics: Animals; Chromium Radioisotopes; Dental Pulp; Fluorides; Haplorhini; Phosphates; Pulpitis; Silicate Cement; Time Factors; Zinc Phosphate Cement

Topics: Dental Pulp; Dental Restoration, Permanent; Dentin, Secondary; Humans; Hyperemia; Microscopy; Odontoblasts; Pulpitis; Silicate Cement; Time Factors; Tooth

Topics: Adult; Dental Pulp; Humans; Male; Middle Aged; Phosphoric Acids; Pulpitis; Silicate Cement

Topics: Animals; Dental Amalgam; Dental Cavity Lining; Dental Materials; Dental Pulp; Dental Restoration, Permanent; Dogs; Plastics; Pulpitis; Silicate Cement; Zinc Phosphate Cement

Topics: Acrylic Resins; Animals; Connective Tissue; Dental Pulp; Dental Pulp Necrosis; Humans; Pulpitis; Rats; Silicate Cement; Zinc Oxide-Eugenol Cement

Topics: Animals; Dental Pulp; Photomicrography; Pulpitis; Rats; Silicate Cement

Topics: Biomedical Research; Cold Temperature; Dentin Sensitivity; Hot Temperature; Humans; Hyperemia; Pathology; Pulpitis; Silicate Cement