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Response of human pulps capped with a self-etching adhesive system
C A de Souza Costa1, A B Lopes do Nascimento, H M Teixeira
1Department of Physiology and Pathology, School of Dentistry, University of São Paulo State/UNESP, Rua Humaita 1680, CEP: 1480-903, Araraquara, São Paulo, Brazil. casouzac@foar.unesp.br
Summary
Calcium hydroxide (CH) promotes pulp repair and dentin bridge formation in direct pulp capping. A self-etching bonding agent (CLB-2) caused chronic inflammation and prevented healing, making CH the preferred choice for exposed human pulps.
Area of Science:
- Dentistry
- Biomaterials Science
- Regenerative Medicine
Background:
- Direct pulp capping is a dental procedure to preserve pulp vitality.
- Evaluating new biomaterials for pulp capping is crucial for successful treatment.
- Self-etching bonding agents are increasingly used in restorative dentistry.
Purpose of the Study:
- To compare the human pulp response to direct pulp capping using calcium hydroxide (CH) versus a current self-etching bonding agent (Clearfil Liner Bond 2 - CLB-2).
Main Methods:
- Mechanically exposed human premolar pulps were capped with either CH or CLB-2.
- Cavities were restored with resin composite.
- Teeth were extracted at 5, 30, and 120-300 days for microscopic analysis.
Main Results:
- CLB-2 induced short-term inflammation, progressing to chronic inflammation with foreign body reaction to resin particles, inhibiting dentin bridging.
- CH promoted initial pulp cell organization and led to complete dentin bridge formation in long-term evaluations.
- CLB-2 failed to achieve connective tissue repair, whereas CH facilitated it.
Conclusions:
- Calcium hydroxide (CH) remains the gold standard for direct pulp capping of mechanically exposed human pulps.
- The self-etching bonding agent Clearfil Liner Bond 2 (CLB-2) is unsuitable for pulp therapy due to inflammatory responses and impaired healing.
- CH facilitates effective pulp repair and dentin bridge formation, unlike CLB-2.