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Related Experiment Video

Updated: Jul 12, 2025

Development of a Direct Pulp-capping Model for the Evaluation of Pulpal Wound Healing and Reparative Dentin Formation in Mice

Development of a Direct Pulp-capping Model for the Evaluation of Pulpal Wound Healing and Reparative Dentin Formation in Mice

Published on: January 12, 2017

4-Year Pulp Survival in a Randomized Trial on Direct Pulp Capping.

Nidambur Vasudev Ballal¹, Henry F Duncan², Daniel B Wiedemeier³

¹Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Journal of Endodontics

|October 27, 2023

Summary

Sodium hypochlorite (NaOCl) lavage significantly improved pulp survival after direct pulp capping compared to saline. This vital pulp therapy method also reduced painful treatment failures in posterior teeth with carious exposure.

Keywords:

Biomarkers dental caries endodontics matrix metalloproteinases pain pulpitis

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Last Updated: Jul 12, 2025

Development of a Direct Pulp-capping Model for the Evaluation of Pulpal Wound Healing and Reparative Dentin Formation in Mice

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Published on: January 12, 2017

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Published on: October 27, 2023

Isolation, Culture, and Characterization of Dental Pulp Stem Cells from Human Deciduous and Permanent Teeth

Isolation, Culture, and Characterization of Dental Pulp Stem Cells from Human Deciduous and Permanent Teeth

Published on: May 17, 2024

Area of Science:

Endodontics
Restorative Dentistry
Dental Materials

Background:

Assessing pulp survival in adult posterior teeth with carious pulp exposure undergoing direct pulp capping.
Evaluating the efficacy of pulp lavage solutions in conjunction with mineral trioxide aggregate (MTA) direct pulp capping.

Purpose of the Study:

To compare the pulp survival rates and treatment outcomes of direct pulp capping using mineral trioxide aggregate (MTA) following lavage with either physiological saline or 2.5% sodium hypochlorite (NaOCl).

Main Methods:

Randomized controlled trial involving 96 patients with nonpainful posterior teeth and carious pulp exposure.
Complete caries excavation, direct pulp capping with MTA, and immediate composite resin restoration.
Pulp lavage with physiological saline or 2.5% NaOCl.
Assessment of matrix metalloproteinase-9 (MMP-9) and total protein in pulpal fluid.
Clinical and radiographic evaluation at 1 and 3 years post-intervention.

Main Results:

Pulp survival at 1500 days was significantly higher with 2.5% NaOCl lavage (55%) compared to saline (7%).
NaOCl lavage substantially reduced painful treatment failures (33% vs. 62% in the saline group).
High MMP-9/total protein values indicated early, painful failures but did not predict later failures.

Conclusions:

The study challenges the high success rates expected from direct pulp capping in cases of deep caries.
Sodium hypochlorite (NaOCl) lavage significantly enhances pulp survival and reduces painful failures in direct pulp capping procedures.
MMP-9 assessment is not a reliable predictor of treatment failures beyond the early stages.