Histological Tissue Response to Calcium Silicate-Based Cements Assessed in Human Tooth Culture Models: A Systematic...

Area of Science:

• Biomaterials Science
• Dental Research
• Histology

Background:

• Ex vivo human tooth culture models are valuable for studying dentine-pulp complex responses to biomaterials.
• Pulp capping aims to preserve pulp vitality and promote dentin bridge formation after exposure.

Purpose of the Study:

• To systematically review histological pulp tissue responses to calcium silicate-based cements (CSCs) used for direct pulp capping in ex vivo human tooth culture models.

Main Methods:

• Systematic review following PRISMA 2020 guidelines.
• Inclusion of studies using ex vivo human tooth cultures with direct pulp exposure treated with CSCs and reporting histological outcomes.
• Risk of bias assessment using the QUIN tool.

Main Results:

• Thirteen studies were included, primarily using immature human third molars with culture periods up to 90 days.
• Hydraulic CSCs (e.g., Biodentine, ProRoot MTA) consistently demonstrated biocompatibility and induced mineralization (osteodentin-like tissue).
• Resin-modified CSCs (e.g., TheraCal LC) showed variable and often less prominent mineralization compared to hydraulic CSCs.

Conclusions:

• Hydraulic CSCs exhibit reproducible biocompatibility and promote reparative dentinogenesis in human tooth culture models.
• Resin-modified CSCs present more variable histological performance in these models.
• Ex vivo human tooth cultures provide a translational platform for evaluating pulp-capping biomaterials.