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Direct pulp capping with a dentin bonding system in human teeth: a clinical and histological evaluation
Gerluza A B Silva1, Lincoln D Lanza, Nelson Lopes-Júnior
1Department of Morphology, Institute of Biological Sciences, Belo Horizonte, Brazil.
Operative Dentistry
|June 29, 2006
Summary
Single Bond Adhesive System (SBAS) is not recommended for direct pulp capping in human teeth. Calcium Hydroxide (CH) demonstrated superior results, promoting dentin bridging and a favorable pulpal response for vital pulp therapy.
Area of Science:
- Dental Materials Science
- Biomaterials
- Regenerative Dentistry
Background:
- Direct pulp capping aims to preserve pulp vitality using various capping agents.
- The efficacy of adhesive systems in direct pulp capping remains a subject of investigation.
- Phosphoric acid etching and hemostasis are critical factors in adhesive-based pulp capping procedures.
Purpose of the Study:
- To evaluate the pulpal response to direct pulp capping with Single Bond Adhesive System (SBAS) after different concentrations of phosphoric acid etching.
- To compare the effectiveness of SBAS with Calcium Hydroxide (CH) as a pulp capping agent.
- To assess the histological and clinical outcomes of direct pulp capping in human premolars.
Main Methods:
- Seventy-eight human premolars underwent direct pulp capping with SBAS (following 10% or 37% phosphoric acid etching) or CH (control).
- Teeth were extracted at 1, 3, 7, and 30 days for light microscopical examination (H/E, AgNOR, Brown-Brenn staining).
- Postoperative symptomatology was monitored to evaluate clinical outcomes.
Main Results:
- No statistical difference in bleeding was observed between 10% and 37% phosphoric acid etching.
- SBAS application sometimes initiated bleeding, compromising the adhesive technique.
- Histological analysis showed no dentin neoformation with SBAS up to 30 days.
- Calcium Hydroxide (CH) group exhibited cells with high synthetic activity and dentin bridging by day 30.
- No bacteria were detected in any specimens, and all groups remained asymptomatic.
Conclusions:
- Single Bond Adhesive System (SBAS) is unsuitable for vital pulp therapy due to inadequate pulpal healing and dentin formation.
- Calcium Hydroxide (CH) remains the preferred capping agent for mechanically exposed human dental pulp, promoting regenerative responses.
- Careful hemostasis and material selection are crucial for successful direct pulp capping procedures.