Comparison of CaOH with MTA for Direct Pulp Capping A comparative study on dental pulp response to calcium hydroxide, white and grey mineral trioxide aggregate as pulp capping agents Direct Pulp Capping with Calcium Hydroxide, Mineral Trioxide Aggregate, and Biodentine in Permanent Young Teeth with Caries: A Randomized Clinical Trial Clinical assessment of mineral trioxide aggregate (MTA) as direct pulp capping in young permanent teeth. Direct Pulp-Capping with Calcium Enriched Mixture in Primary Molar Teeth: A Randomized Clinical Trial Response of human dental pulp capped with biodentine and mineral trioxide aggregate. Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions. A Randomized Controlled Study of the Use of ProRoot Mineral Trioxide Aggregate and Endocem as Direct Pulp Capping Materials: 3-month versus 1-year Outcomes. Histological evaluation of mineral trioxide aggregate and calcium hydroxide in direct pulp capping of human immature permanent teeth. A randomized controlled study of the use of ProRoot mineral trioxide aggregate and Endocem as direct pulp capping materials. Pulpal Responses to Direct Capping with Betamethasone/Gentamicin Cream and Mineral Trioxide Aggregate: Histologic and Micro-Computed Tomography Assessments. The effectiveness of mineral trioxide aggregate, calcium hydroxide and formocresol for pulpotomies in primary teeth. Immunohistochemical expression of fibronectin and tenascin in human tooth pulp capped with mineral trioxide aggregate and a novel endodontic cement. Mineral Trioxide Aggregate vs. Calcium Hydroxide in Primary Molar Pulpotomy: A Systematic Review Evaluation of two mineral trioxide aggregate compounds as pulp-capping agents in human teeth. Clinical, radiographic and histologic analysis of the effects of pulp capping materials used in pulpotomies of human primary teeth Treatment Outcomes of Primary Molars Direct Pulp Capping after 20 Months: A Randomized Controlled Trial Comparison of mineral trioxide aggregate and formocresol as pulp-capping agents in pulpotomized primary teeth. Clinical and radiological evaluation of calcium sulfate as direct pulp capping material in primary teeth. Clinical and Histological Evaluation of Direct Pulp Capping on Human Pulp Tissue Using a Dentin Adhesive System Calcium Hydroxide vs. Mineral Trioxide Aggregates for Partial Pulpotomy of Permanent Molars with Deep Caries Efficacy of EMD versus calcium hydroxide in direct pulp capping of primary molars: a randomized controlled clinical trial. Clinical and histological evaluation of white ProRoot MTA in direct pulp capping.
This practice -based , r and omized clinical trial evaluated and compared the success of direct pulp capping in permanent teeth with MTA ( mineral trioxide aggregate ) or CaOH ( calcium hydroxide ) .  Thirty-five practice s in Northwest PRECEDENT were r and omized to perform direct pulp caps with either CaOH ( 16 practice s ) or MTA ( 19 practice s ) . Three hundred seventy-six individuals received a direct pulp cap with CaOH ( n = 181 ) or MTA ( n = 195 ) . They were followed for up to 2 yrs at regular recall appointments , or as dictated by tooth symptoms . The primary outcomes were the need for extraction or root canal therapy . Teeth were also evaluated for pulp vitality , and radiographs were taken at the dentist ’s discretion . The probability of failure at 24 mos was 31.5 % for CaOH vs. 19.7 % for MTA ( permutation log-rank test , p = .046 ) . This large r and omized clinical trial provided confirmatory evidence for a superior performance with MTA as a direct pulp-capping agent as compared with CaOH when evaluated in a practice -based research network for up to 2 yrs ( Clinical Trials.gov NCT00812887 ) Context : Vital pulp therapy has been known as one of the treatment options to preserve pulp after being exposed by trauma or caries . Aim : To investigate human pulpal response to white and grey mineral trioxide aggregate ( WMTA , GMTA ) and Dycal ( MTA ) as pulp capping agents . Setting and Design : Human volunteers were participated in this r and omized clinical trial . Material s and Methods : This study was conducted on 90 intact first and second premolars of human maxillary and m and ibular teeth . The teeth were r and omly assigned into three groups of 30 each . Under local anesthesia , teeth were exposed and capped either with GMTA , WMTA , or Dycal . After 30 , 60 , and 90 days 10 teeth of each group were extracted and prepared for histologic observation . Statistical Analysis : Histopathologic data were analyzed by χ2 , Kruskal Wallis and Mann Whitney tests . Results : the calcified bridge in teeth that were capped with GMTA was significantly thicker than Dycal at 30 and 60 days ( P= 0.015 and P=0.002 , respectively ) ; whereas WMTA showed significantly thicker calcified bridge than Dycal at 90 days ( P=0.02 ) . In addition , GMTA specimens showed significantly less inflammation compared to Dycal sample s at 90 days interval ( P=0.019 ) . No significant difference was found between GMTA and WMTA in terms of calcified bridge thickness and pulp inflammatory response to the capping material s ( P>0.05 ) . Conclusions : Based on the result of this study , both types of MTA can be suggested as the material s of choice for direct pulp capping procedure instead of Dycal as hard setting calcium hydroxide cement Introduction Direct pulp capping treatment is intended to preserve pulp vitality , to avoid or retard root canal treatment , and , in cases with an open apex , to allow continued root development . Historically , calcium hydroxide ( CH ) was the gold st and ard material , but nowadays calcium silicate material s ( CSMs ) are displacing CH because of their high bioactivity , biocompatibility , sealing ability , and mechanical properties . However , more r and omized clinical trials are needed to confirm the appropriateness of CSMs as replacement material s for CH in direct pulp capping procedures . Methods A r and omized clinical trial was conducted that included 169 patients ( mean age , 11.3 years ) from the Maipo district ( Chile ) . The inclusion criterion was patients with 1 carious permanent tooth with pulpal exposure , a c and i date for a direct pulp capping procedure . The patients were r and omly allocated to one of the experimental groups ( CH , Biodentine , or mineral trioxide aggregate [ MTA ] ) . Clinical follow‐up examinations were performed at 1 week , 3 months , 6 months , and 1 year . The Fisher exact test was performed . Results At the follow‐up examination at 1 week , the patients showed 100 % clinical success . At 3 months , there was 1 failure in the CH group . At 6 months , there were 4 new failures ( 1 in the CH group and 3 in the MTA group ) . At 1 year , there was another failure in the CH group . There were no statistically significant differences among the experimental groups . Conclusions CSMs appear to be suitable material s to replace CH . Although no significant differences were found among the material s studied , Biodentine and MTA offered some advantages over CH . HighlightsThis trial compared the efficacy of calcium hydroxide , MTA , and Biodentine as pulp capping material s in young permanent molars . MTA and Biodentine are suitable material s to replace calcium hydroxide in pulp capping procedures .Pulp capping in carious teeth is a successful treatment when done under good clinical protocol UNLABELLED 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 clinical ly , 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 INTRODUCTION The aim of this trial was to compare clinical and radiographic success rates of direct pulp capping ( DPC ) using a novel bio material called Calcium Enriched Mixture ( CEM ) cement versus Mineral Trioxide Aggregate ( MTA ) in primary molar teeth . MATERIAL S AND METHODS In this r and omized clinical trial 42 deciduous molars in 21 patients who had at least two teeth requiring DPC , were treated . The enrolled patients were between 5 - 8 years . The molar teeth were r and omly divided into two experimental groups . Patients and operators were blinded . The teeth were anaesthetized , caries were removed and after pinpoint exposure of dental pulp , haemostasis was achieved . The exposure points were capped with MTA or CEM cement . All teeth were restored with amalgam . Patients were recalled for the 6-month follow up . Statistical analysis was carried out using McNemar test . RESULTS Thirty-eight teeth were available for follow up ( 19 in each group ) . The radiographic evaluations did not show failure in experimental groups ; however , in clinical examinations one sinus tract was found in CEM cement group . Clinical success rates in CEM cement and MTA groups were 94.8 % and 100 % , respectively . Dentinal bridge formation was not observed in the two experimental groups . CONCLUSION There is no significant difference between treatment outcomes of direct pulp capping with either CEM cement or MTA ; therefore , both bio material s can be used successfully for DPC in primary molar teeth INTRODUCTION Biodentine is a new bioactive cement that is similar to the widely used mineral trioxide aggregate ( MTA ) . It has dentin-like mechanical properties , which may be considered a suitable material for clinical indications of dentin-pulp complex regeneration such as direct pulp capping . The purpose of the present study was to compare the response of the pulp-dentin complex in human teeth after direct capping with this new tricalcium silicate-based cement with that of MTA . METHODS Pulps in 28 caries-free maxillary and m and ibular permanent intact human molars scheduled for extraction for orthodontic reasons were mechanically exposed and assigned to 1 of 2 experimental groups , Biodentine or MTA , and 1 control group . Assay of periapical response and clinical examination were performed . After 6 weeks , the teeth were extracted , stained with hematoxylin-eosin , and categorized by using a histologic scoring system . RESULTS The majority of specimens showed complete dentinal bridge formation and an absence of inflammatory pulp response . Layers of well-arranged odontoblast and odontoblast-like cells were found to form tubular dentin under the osteodentin . Statistical analysis showed no significant differences between the Biodentine and MTA experimental groups during the observation period . CONCLUSIONS Within the limitations of this study , Biodentine had a similar efficacy in the clinical setting and may be considered an interesting alternative to MTA in pulp-capping treatment during vital pulp therapy PURPOSE This manuscript presents evidence -based guidance on the use of vital pulp therapies for treatment of deep caries lesions in children . A guideline panel convened by the American Academy of Pediatric Dentistry formulated evidence -based recommendations on three vital pulp therapies : indirect pulp treatment ( IPT ; also known as indirect pulp cap ) , direct pulp cap ( DPC ) , and pulpotomy . METHODS The basis of the guideline 's recommendations was evidence from " Primary Tooth Vital Pulp Therapy : A Systematic Review and Meta- Analysis . " ( Pediatr Dent 2017;15;39[1]:16 - 23 . ) A systematic search was conducted in PubMed ® / MEDLINE , Embase ® , Cochrane Central Register of Controlled Trials , and trial data bases to identify r and omized controlled trials and systematic review s addressing peripheral issues of vital pulp therapies such as patient preferences of treatment and impact of cost . Quality of the evidence was assessed through the Grading of Recommendations Assessment , Development , and Evaluation approach ; the evidence -to-decision framework was used to formulate a recommendation . RESULTS The panel was unable to make a recommendation on superiority of any particular type of vital pulp therapy owing to lack of studies directly comparing these interventions . The panel recommends use of  mineral trioxide aggregate ( MTA ) and formocresol in pulpotomy treatments ; these are recommendations based on moderate- quality evidence at 24 months . The panel made weak recommendations regarding choice of medicament in both IPT ( moderate- quality evidence [ 24 months ] , low quality evidence [ 48 months ] ) and DPC ( very-low quality evidence [ 24 months ] ) . Success of both treatments was independent of type of medicament used . The panel also recommends use of ferric sulfate  ( low- quality evidence ) , lasers ( low- quality evidence ) ,  sodium hypochlorite  ( very low- quality evidence ) , and  tricalcium silicate  ( very low- quality evidence ) in pulpotomies ; these are weak recommendations based on low- quality evidence . The panel recommended against the use of calcium hydroxide as pulpotomy medicament in primary teeth with deep caries lesions . Conclusions and practical implication s : The guideline intends to inform the clinical practice s with evidence -based recommendations on vital pulp therapies in primary teeth with deep caries lesions . These recommendations are based upon the best available evidence to- date INTRODUCTION The purpose of this study was to assess the long-term clinical outcomes of direct pulp capping ( DPC ) with ProRoot MTA ( Dentsply , Tulsa , OK ) and Endocem ( Maruchi , Wonju , Korea ) as pulp capping material s. To this end , the 1-year cumulative successes of both material s were evaluated and compared with those of the 3-month outcomes in a prospect i ve , r and omized controlled trial . METHODS Patients were recruited from the Department of Conservative Dentistry of the Yonsei University Dental Hospital , Seoul , South Korea , from January to May 2013 . Of the 48 teeth that met the inclusion criteria , 46 teeth were r and omly allocated to either ProRoot MTA or Endocem groups ( n = 23 ) . Direct pulp capping was performed , and clinical and radiographic examinations were conducted over 1 year after the treatment . Survival analyses were conducted to compare the cumulative successes between ProRoot MTA and Endocem and to evaluate other clinical variables . RESULTS Forty-one teeth were recalled 1 year after the treatments ( recall rate = 89.13 % ) . There were no significant differences between the cumulative successes  of ProRoot MTA and Endocem in either log-rank or Cox proportional hazard regression analyses ( P > .05 ) . Among the other clinical variables , cavity type ( class I , II , III vs class V ) was determined to be significant in both the log-rank test ( P = .001 ) and Cox regression analysis ( P = .006 ) . CONCLUSIONS Both ProRoot MTA and Endocem exhibited similar cumulative successes as direct pulp capping material s up to 1 year . The teeth restored with class V cavities exhibited significantly lower cumulative success rates after direct pulp capping compared with the teeth restored with other types of cavities PURPOSE To evaluate histological findings in human immature permanent premolars scheduled for extraction for orthodontic reasons , in which mechanical pulp exposures were capped with white ProRoot Mineral Trioxide Aggregate ( WMTA ) or calcium hydroxide ( CH ) . METHODS Forty-eight human immature premolars in 23 patients ( age 10 - 18 years ) were r and omly treated with  WMTA or CH . After rubber dam isolation Cl I cavities were prepared and the pulps exposed . After hemostasis the pulps were capped with either material . The preparations were restored using an acid etch , bonding agent , flowable composite and composite resin technique . The teeth were extracted after 47 to 609 days and processed for routine histological examination , stained with hematoxylin and eosin and Brown and Brenn for recognition of bacteria . Statistical analyses of inflammation , bridge formation and bacterial leakage were performed using a Chi-square test and ANOVA . RESULTS Forty-four of 48 teeth were suitable for microscopic evaluation , 30 with WMTA , 14 with CH . Of the WMTA group , 29 teeth were vital , 28 had formed a bridge , and one specimen had failed . Twelve of 14 teeth with CH were vital , while three teeth failed to form a bridge . No statistically significant differences between WMTA and CH were found , except for superficial and deep inflammatory cell response ( P < or = 0.05 ) . Pulp capping of intentionally exposed human immature premolars performed slightly better when using MTA INTRODUCTION The purpose of the present study was to evaluate and compare the short-term clinical outcomes of direct pulp capping using ProRoot MTA ( Dentsply , Tulsa , OK ) or Endocem ( Maruchi , Wonju , Korea ) as capping material s in a prospect i ve r and omized controlled study . MATERIAL S AND METHODS This study was conducted with subjects who were recruited from the pool of patients from the Department of Conservative Dentistry at the Dental College of Yonsei University , Seoul , Korea , between January and May 2013 . Of the 48 teeth confirmed to be eligible for direct pulp capping , a total of 46 teeth were r and omly assigned to either the ProRoot MTA or the Endocem group ( 23 teeth per group ) . Direct pulp capping was performed using these 2 material s , and clinical and radiographic evaluations were performed at 1 , 2 , 4 , and 12 weeks after the treatments . Teeth with no response to pulp vitality test and those exhibiting clinical or radiographic signs and /or symptoms of irreversible pulpitis or pulp necrosis were considered to be failures . RESULTS Thirty-two patients ( 43 teeth ) were examined at the 3-month follow-up ( patient recall rate = 91.4 % ) ; 22 of these teeth were in the ProRoot MTA group , and 21 were in the Endocem group . The overall success rate was 93 % , and the success rates in the ProRoot MTA and Endocem groups were 95.5 % ( 21/22 teeth ) and 90.5 % ( 19/21 teeth ) , respectively . Statistical analyses of these success rates did not reveal any significant difference between the groups ( P = .522 ) . CONCLUSIONS In this r and omized controlled study , no significant difference in the short-term clinical outcomes of direct pulp capping using ProRoot MTA or Endocem as the capping material was found . Furthermore , the favorable short-term outcome success rate of 93 % indicates that direct pulp capping may be a reliable treatment for pulp exposure in adult teeth INTRODUCTION This clinical trial was conducted to evaluate the response of human dental pulp to direct capping with betamethasone/gentamicin ( BG ) cream and mineral trioxide aggregate ( MTA ) . We hypothesized that the results of direct pulp capping with a topical BG combination would be similar to or better than those with MTA . METHODS Thirty-six human first premolar teeth scheduled for orthodontic extraction were r and omly divided into 4 groups : BG1 group ( n = 9 ) , BG cream with 2-week follow-up ; BG2 group ( n = 10 ) , BG cream with 8-week follow-up ; MTA1 group ( n = 8) , MTA with 2-week follow-up ; and MTA2 group ( n = 9 ) , MTA with 8-week follow-up . Teeth were extracted and evaluated at respective time intervals . Micro-computed tomography scanning and histologic analyses were performed for all specimens . Pulp pathology ( inflammation , pulp abscesses , and pulp necrosis ) and reparative reaction ( formation of dentin bridges ) were recorded . RESULTS Both BG cream and MTA result ed in significantly better pulpal responses at 8 weeks than at 2 weeks . Dentin bridge formation was significantly thicker in the MTA group at 8 weeks than in any other group ( P < .05 ) . Inflammation was of the acute type in all groups ; no statistically significant differences in the distribution of inflammatory cells were found among the groups . Pulpal abscesses and /or necrosis were observed more often in teeth capped with BG than with MTA . CONCLUSIONS Direct pulp capping with both BG cream and MTA was associated with dentin bridge formation . MTA result ed in a significantly better pulpal response , with less inflammation and a thicker dentin bridge at 8 weeks AIM To compare the effectiveness of mineral trioxide aggregate ( MTA ) , calcium hydroxide ( CH ) and formocresol ( FC ) as pulp dressing agents in carious primary teeth . METHODOLOGY Forty-five primary m and ibular molars with dental caries in 23 children [ AUTHOR QUERY : How many children ? ] between 5 and 9 years old were treated by a conventional pulpotomy technique . The teeth were r and omly assigned to the experimental ( CH or MTA ) or control ( FC ) groups . After coronal pulp removal and haemostasis , remaining pulp tissue was covered with MTA paste or CH powder in the experimental groups . In the control group , diluted FC was placed with a cotton pellet over the pulp tissue for 5 min and removed ; the pulp tissue was then covered with zinc oxide-eugenol ( ZOE ) paste . All teeth were restored with reinforced ZOE base and resin modified glass-ionomer cement .  Clinical and radiographic successes and failures were recorded at 3 , 6 , 12 , 18 and 24 month follow-up . RESULTS Forty-three teeth were available for follow-up . In the FC and MTA groups , 100 % of the available teeth were clinical ly and radiographically successful at all follow-up appointments ; dentine bridge formation could be detected in 29 % of the teeth treated with MTA . In the CH group , 64 % of the teeth presented clinical and radiographic failures detected throughout the follow-up period , and internal resorption was a frequent radiographic finding . CONCLUSIONS Mineral trioxide aggregate was superior to CH and equally as effective as FC as a pulpotomy dressing in primary m and ibular molars . Internal resorption was the most common radiographic finding up to 24 month after pulpotomies performed with CH INTRODUCTION The purpose of the present study was the immunohistochemical study of fibronectin ( FN ) and tenascin ( TN ) in human tooth pulp capped with  mineral trioxide aggregate ( MTA )  and novel endodontic cement ( NEC ) ( calcium enriched mixture cement ) after 2 and 8 weeks . METHODS Thirty-two premolar teeth that were scheduled for extraction for orthodontic reasons were exposed and capped with either MTA or NEC . The teeth were r and omly divided into 4 groups : group 1 ( NEC for 2 weeks ) , group 2 ( NEC for 8 weeks ) , group 3 ( MTA for 2 weeks ) , and group 4 ( MTA for 8 weeks ) . After capping the exposed pulps with either NEC ( groups 1 and 2 ) or MTA ( groups 3 and 4 ) , half of the specimens underwent extraction and were prepared for histologic and immunohistochemical evaluation for FN and TN after 2 weeks , and the remaining half were assessed after 8 weeks . FN and TN expression was scored by a blinded pathologist on a scale of I-IV , and the results were analyzed by the Wilcoxon and Mann-Whitney U statistical tests . RESULTS FN and TN staining was observed in all 4 experimental groups , and there was no significant difference between expression of FN and TN in any groups . FN and TN staining was observed in the dentinal bridge matrix after 2 weeks under MTA . Expression of both markers reduced significantly after 8 weeks under MTA , and staining was observed only in unmineralized parts of dentinal bridge . FN and TN expression was observed in the matrix of the dentinal bridge after 2 weeks under NEC , and staining of both markers was reduced after 8 weeks compared with 2 weeks . The staining pattern of TN in NEC groups was higher than in MTA groups in both time intervals . However , the difference was not significant . CONCLUSIONS The present study demonstrated that both MTA and NEC are suitable bio material s for direct pulp capping and are able to stimulate dentinal bridge formation . Moreover , the role of FN and TN as 2 major components of the matrix of a reparative dentinal bridge was observed Introduction : The aim of this quantitative systematic review /meta- analysis was to compare the treatment outcomes of mineral trioxide aggregate ( MTA ) and calcium hydroxide ( CH ) in pulpotomy of human primary molars . The focused PICO question was “ in case of pulp exposure in vital primary molars , how does MTA pulpotomy compare to CH in terms of clinical /radiographic success ? ” Methods and Material s : We retrieved published r and omized clinical trials ( RCTs ) of at least 6-month duration ; our search included articles published up to March 2013 in five following data bases : PubMed ( Medline ) , Cochrane data base of systematic review s , Science Citation Index , EMBASE , and Google Scholar . Mantel Haenszel and Inverse Variance-weighted methods were applied by STATA ; the relative risk ( RR ) was calculated with 95 % confidence intervals ( CI ) . Results : A total of 282 English articles were collected . Two authors independently screened the articles and five RCTs were selected ; data extraction and quality assessment were then carried out . Four RCTs were appropriate for meta- analysis according to their follow-up times by Mantel Haenszel method . Statistically significant difference was found between success rate of MTA compared to CH , with RR=0.08 ( 95 % CI , 0.02 - 0.39 ) , RR=0.19 ( 95 % CI , 0.08 - 0.46 ) , and RR=0.38 ( 95 % CI , 0.21 - 0.68 ) for 6- , 12- , and 24-month follow-ups , respectively . A significant difference was also observed for all included RCTs after analyses using the Inverse Variance-weighted method ( RR=0.44 ; 95 % CI , 0.27 - 0.72 ) . Conclusions : Systematic review /meta- analysis of included RCTs revealed that for pulpotomy of vital primary molars , MTA has better treatment outcomes compared to CH AIM The present r and omized , controlled prospect i ve 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 ( alpha = 0.05 ) . RESULTS In five out of the 40 teeth bacteria were present in pulp tissue . No significant difference was observed between the two material s ( P > 0.05 ) in terms of overall histological features ( hard tissue bridge , inflammatory response , giant cells and particles of capping material s ) . 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 material s ProRoot ( Dentsply ) and MTA-Angelus ( Angelus ) produced similar responses in the pulp when used for pulp capping in intact , caries-free teeth Aim To compare the clinical , radiographic and histological responses of the pulp to mineral trioxide aggregate ( MTA ) , calcium hydroxide ( CH ) and Portl and cement ( PC ) when used as a pulpotomy agent in human primary teeth . Study design Forty-five m and ibular primary molar teeth were r and omly assigned to CH , MTA or PC groups and treated by pulpotomy technique . Methods The teeth were treated by conventional pulpotomy technique , differing only in the capping material for each group . Clinical and radiographic evaluations were recorded at 6- , 12- and 24-month follow-up . Teeth in the regular exfoliation period were further processed for histologic analysis .Statistics Data were tested using parametric tests at a significance level of 5 % . The histological results were expressed descriptively . Results Clinical ly and radiographically , the MTA and PC groups showed 100 % success rates at 6 , 12 and 24 months . In CH group , several teeth presented clinical and radiographic failures detected throughout the follow-up period , and internal resorption was a frequent radiographic finding . Histologic analysis revealed the presence of dentine-like mineralised material deposition obliterating the root canal in the PC and MTA groups . CH group presented , in most of the sections , necrotic areas in the root canals . Conclusions MTA and PC may serve as effective material s for pulpotomies of primary teeth as compared to CH . Although our results are very encouraging , further studies and longer follow-up assessment s are needed in order to determine the safe clinical indication of Portl and cement Introduction The aim of this r and omized controlled trial was to compare the radiographic and clinical success rates of direct pulp capping ( DPC ) using ProRoot mineral trioxide aggregate ( MTA ) or calcium enriched mixture ( CEM ) . Methods and Material s A total of 42 symptom-free carious vital primary molars ( 21 pairs ) were selected in this split mouth trial and r and omly pulpotomized in two experimental groups . Pinpoint pulp exposures were covered by the same blinded operator with MTA or CEM , and then restored by amalgam .  Radiographic and clinical successes were evaluated at 20 month follow-up . Data were statistically analyzed using McNemar test . Results Nineteen patients were available for 20-month follow-up ; only one failed tooth was extracted in the CEM group . All available teeth were symptom-free , however , the final evaluated success rate was 89 % in CEM ( CI 95 % : 0.82 - 0.96 ) and 95 % in MTA ( CI 95 % : 0.85 - 1 ) groups without statistical difference ( P=0.360 ) . Worst case scenario was applied for missing value analysis ; assuming that the 2 lost cases in CEM group had failed and the only lost case in MTA group was due to treatment success , as a result the success of CEM and MTA were 81 % ( CI 95 % : 0.72 - 0.90 ) and 95 % ( CI 95%:0.85 - 1 ) , respectively , with no statistical difference ( P=0.078 ) . In the reverse scenario , the success of MTA and CEM were 86 % ( CI 95 % : 0.78 - 0.94 ) and 90 % ( CI 95 % : 0.82 - 0.98 ) , respectively ; again with no statistical difference ( P=0.479 ) . Conclusion Effectiveness of MTA and CEM bio material s for primary molars ’ DPC was similar ; CEM can be a suitable alternative for MTA PURPOSE The aim of this study was to use clinical , radiographic , and histologic examinations to compare the relative success of gray mineral trioxide aggregate ( MTA ) , white MTA , and formocresol as pulp dressings in pulpotomized primary teeth . METHODS Twenty-four children , each with at least 3 primary molars requiring pulpotomy , were selected for this study 's clinical and radiographic portion . An additional 15 carious primary teeth planned for serial extraction were selected for this study 's histologic portion . All selected teeth were evenly divided into 3 test groups and treated with pulpotomies . Gray MTA was used as the pulp dressing for one third of the teeth , white MTA was the dressing for one third , and the remaining one third were treated with formocresol . The treated teeth selected for the clinical and radiographic evaluations were monitored periodically for 12 months . The treated teeth selected for histologic study were monitored periodically and extracted 6 months postoperatively . RESULTS Four children with 12 pulpotomized teeth failed to return for any follow-up evaluations in the clinical and radiographic study . Of the remaining 60 teeth in 20 patients , 1 tooth ( gray MTA ) exfoliated normally and 6 teeth ( 4 white MTA and 2 formocresol ) failed due to abscesses . The remaining 53 teeth appeared to be clinical ly and radiographically successful 12 months postoperatively . Pulp canal obliteration was a radiographic finding in 11 teeth treated with gray MTA and 1 tooth treated with white MTA . In the histologic study , both types of MTA successfully induced thick dentin bridge formation at the amputation sites , while formocresol induced thin , poorly calcified dentin . Teeth treated with gray MTA demonstrated pulp architecture nearest to normal pulp by preserving the odontoblastic layer and delicate fibrocellular matrix , yet few inflammatory cells or isolated calcified bodies were seen . Teeth treated with white MTA showed a denser fibrotic pattern , with more isolated calcifications in the pulp tissue along with secondary dentin formation . CONCLUSIONS Gray MTA appears to be superior to white MTA and formocresol as a pulp dressing for pulpotomized primary teeth AIM To evaluate the clinical and radiological response of primary molars to direct pulp capping with calcium sulfate hemihydrate . MATERIAL S AND METHODS Forty primary molar teeth in 40 healthy children aged 5 - 9 years were treated by direct pulp capping . Teeth were r and omly assigned to two groups ( n=20 ) according to material used for capping , as follows : Group 1 : calcium hydroxide cement ( Dycal ) ; Group 2 : calcium sulfate hemihydrate ( Dentogen ) . All teeth were restored with a conventional glass ionomer base ( Fuji IX ) and amalgam . RESULTS After 12 months , the overall success rate of direct pulp capping was approximately 75 % ( 24/32 teeth , excluding exfoliations ) . The success rate did not differ significantly between calcium hydroxide and calcium sulfate hemihydrate treatment . CONCLUSION Calcium sulfate hemihydrate was found to be as successful as calcium hydroxide for direct pulp capping of primary molars with Class I cavities . Further histological studies are needed to support these findings Objective . This study presents a clinical and histological evaluation of human pulp tissue responses after direct capping using a new dentin adhesive system . Methods . Twenty-eight caries-free third molar teeth scheduled for extraction were evaluated . The pulps of 22 teeth were mechanically exposed and r and omly assigned to 1 of 2 groups : Single Bond Universal or calcium hydroxide . Another group of 6 teeth acted as the intact control group . The periapical response was assayed , and a clinical examination was performed . The teeth were extracted after 6 weeks , and a histological analysis was performed . The pulp status was assessed , and the thickness of the dentin bridge was measured and categorized using a histological scoring system . Results . The clinical phase was asymptomatic for Single Bond Universal patients . Patients in the calcium hydroxide group reported mild symptoms of pain , although the histological examination revealed that dentin bridges with or without limited pulpitis had begun forming in each tooth . The universal adhesive system exhibited nonsignificantly increased histological signs of pulpitis ( P > 0.05 ) and a significantly weaker thin mineralized tissue layer ( P < 0.001 ) compared with the calcium hydroxide group . Conclusion . The results suggest that Single Bond Universal is inappropriate for human pulp capping ; however , further long-term studies are needed to determine the biocompatibility of this agent Aim : To prospect ively compare the clinical success rate of partial pulpotomy treatment in permanent molars using calcium hydroxide ( CH ) and mineral trioxide aggregates ( MTA ) as pulp dressing agents . Methods : Restorable permanent first molars ( 64 ) with carious pulp exposures were r and omly assigned to two groups ; CH and MTA . A st and ardized operative procedure was followed in both groups . Following isolation and caries removal , the exposed superficial pulp tissue layers were removed with a sterile flame shape diamond bur to a depth of 2–4 mm . Bleeding was controlled and pulp dressed with either a paste of non- setting Ca(OH)2 followed by a setting layer of Ca(OH)2 , or with grey MTA . The dressing material s in both groups were then covered with a layer of light cured glass ionomer cement . The teeth were either restored using amalgam , or where grossly carious with preformed metal crowns . Patients were scheduled for follow-up at 3 , 6 , 12 months and annually thereafter . Results : There were 34 patients ( 17 males and 17 females ) with 51 teeth available for evaluation . The age of patients at the time of restoration ranged between 6.8 to 13.3 years ( mean of 10.3 ±1.8 years ) . The follow-up period ranged from 25.4 to 45.6 months with an average of 34.8 ± 4.4 months . There was no statistically significant difference in the success rate of teeth treated with CH ( 91 % ) in comparison to teeth treated with MTA ( 93 % ) . Radiographically , a hard tissue barrier under CH was noticed in 12 ( 55 % ) teeth compared with 18 ( 64 % ) teeth under MTA ( p=0.4 ) . Conclusions : MTA has clinical success rate comparable to CH as a pulp dressing material for partial pulpotomy in permanent molars with carious OBJECTIVE The aim was to compare the clinical and radiographic efficacy of enamel matrix derivative and self-hardening calcium hydroxide as direct pulp capping material s on decayed primary molars , with observation periods of 1 , 6 , and 12 months . STUDY DESIGN A clinical , r and omized , controlled trial was performed , following the " split-mouth " design . A total of 90 primary molars were treated . Assignation of material s and operative initial side were selected in a r and omized manner . Five outcome variables were considered : internal dentin resorption , pain , gingival sinus tract , root external resorption , and pathologic mobility . The appearance of any of these signs or symptoms was considered to be a failure of treatment . RESULTS Significant statistical or clinical differences were not found between the study groups . Two treatments were judged as failures , 1 per study group ; both occurred during the first postoperative month . CONCLUSIONS The technique used for direct pulp capping on primary molars in this study is recommended on the basis of the obtained clinical and radiographic results PURPOSE To evaluate the clinical , radiographical and histological findings in human third molars in which mechanical pulp exposures were capped with white ProRoot mineral trioxide aggregate ( WMTA ) . METHODS Forty-eight human third molars , caries-free or with incipient caries , scheduled to be extracted , were used and r and omly divided into two groups : Group A : ( n= 24 ) received WMTA and control Group B : ( n= 24 ) received chemical set calcium hydroxide ( Dycal ) . The teeth were isolated with rubber dam and Class I cavities prepared . Pulp exposure was performed using a sterile diamond bur and confirmed by frank bleeding . A sterile cotton pellet dipped in saline solution was placed over the exposure for 60 seconds . The preparation was then lightly rinsed with water and gently air-dried . WMTA or CH was placed over the exposure site followed by a small amount of a light-cured compomer . After etching with 35 % phosphoric acid gel for 15 seconds , rinsing and blot drying , Prime and Bond NT adhesive was applied and light-cured . The cavity was then restored with a resin composite and light-cured . Evaluations were performed by phone after 7 days and clinical ly at 30 + /- 5 and 136 + /- 24 days , using st and ardized tests and radiographs . The teeth were extracted after 136 + /- 24 days ; the roots were cut + /- 4 - 5 mm from the apex to allow for rapid fixation in 10 % neutral buffered formalin . They were then processed for routine histological evaluation , embedded in paraffin , sectioned and stained with hematoxylin and eosin and Brown and Brenn for recognition of bacteria . Statistical analyses were performed using a Mann-Whitney U-test , a Chi-square test , a Fisher 's exact test and an ANOVA . RESULTS No significant differences in post-operative sensitivity were reported after 7 days between the two material s ( P > 0.05 ) . Clinical examination demonstrated no significant differences at 30 + /- 5 days ( P > 0.05 ) and at 136 + /- 24 days ( P > 0.05 ) . Histological findings : 45 of 48 teeth were suitable for microscopic evaluation ( 22 with WMTA and 23 with CH ) . Twenty from the WMTA and 18 from the CH group had developed a bridge . No statistically significant differences were found for superficial and deep inflammatory cell response ( P > 0.05 ) , presence of a dentin bridge ( P > 0.01 ) , and pulp vitality ( P > 0.01 ) , between WMTA and calcium hydroxide . A statistically significant difference was found for the diameter of exposure ( P < or = 0.05 ) between WMTA ( x= 0.35 + /- 0.19 mm ) and CH ( x= 0.25 + /- 0.09 mm ) . Only a minimal association between clinical and histological findings could be established for either material
In conclusion , MTA has a higher clinical success rate for direct pulp capping comparing to calcium hydroxide , and might be a suitable replacement for calcium hydroxide
Direct pulp capping is one of the most common dental practice s in endodontic therapy .
This systematic review and meta- analysis aim to determine whether the effect of mineral trioxide aggregate ( MTA ) and calcium hydroxide for direct pulp capping is different , as measured by the clinical and radiographic analysis .