Advertisement

European Archives of Paediatric Dentistry

, Volume 14, Issue 2, pp 65–71 | Cite as

Clinical, radiographic and histologic analysis of the effects of pulp capping materials used in pulpotomies of human primary teeth

  • T. M. OliveiraEmail author
  • A. B. S. Moretti
  • V. T. Sakai
  • N. Lourenço Neto
  • C. F. Santos
  • M. A. A. M. Machado
  • R. C. C. Abdo
Original Scientific Article

Abstract

Aim

To compare the clinical, radiographic and histological responses of the pulp to mineral trioxide aggregate (MTA), calcium hydroxide (CH) and Portland cement (PC) when used as a pulpotomy agent in human primary teeth.

Study design

Forty-five mandibular primary molar teeth were randomly 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

Clinically 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 materials for pulpotomies of primary teeth as compared to CH. Although our results are very encouraging, further studies and longer follow-up assessments are needed in order to determine the safe clinical indication of Portland cement.

Keywords

Mineral trioxide aggregate Calcium hydroxide Portland cement Primary teeth Pulpotomy 

References

  1. Aeinehchi M, Dadvand S, Fayazi S, Bayat-Movahed S. Randomized controlled trial of mineral trioxide aggregate and formocresol for pulpotomy in primary molar teeth. Int Endod J. 2007;40:261–7.PubMedCrossRefGoogle Scholar
  2. Ansari G, Ranjpour M. Mineral trioxide aggregate and formocresol pulpotomy of primary teeth: a 2-year follow-up. Int Endod J. 2010;43:413–8.PubMedCrossRefGoogle Scholar
  3. Cardoso-Silva C, Barbería E, Maroto M, García-Godoy F. Clinical study of mineral trioxide aggregate in primary molars. Comparison between grey and white MTA-a long term follow-up (84 months). J Dent. 2011;39:187–93.PubMedCrossRefGoogle Scholar
  4. Chacko V, Kukirose S. Human pulpal response to mineral trioxide aggregate (MTA): a histologic study. J Clin Pediatr Dent. 2006;30:203–10.PubMedGoogle Scholar
  5. Conti TR, Sakai VT, Fornetti AP, et al. Pulpotomies with Portland cement in human primary molars. J Appl Oral Sci. 2009;17:66–9.PubMedCrossRefGoogle Scholar
  6. De-Deus G, Coutinho Filho T. The use of white Portland cement as an apical plug in a tooth with a necrotic pulp and wide-open apex: a case report. Int Endod J. 2007;40:653–60.PubMedCrossRefGoogle Scholar
  7. Erdem AP, Guven Y, Balli B, et al. Success rates of mineral trioxide aggregate, ferric sulfate, and formocresol pulpotomies: a 24-month study. Pediatr Dent. 2011;33:165–70.PubMedGoogle Scholar
  8. Fuks AB. Pulpotomy in primary teeth. Eur Arch Paediatr Dent. 2006;7:124.PubMedGoogle Scholar
  9. Fuks AB, Papagiannoulis L. Pulpotomy in primary teeth: review of the literature according to standardized criteria. Eur Arch Paediatr Dent. 2006;7:64–71.PubMedCrossRefGoogle Scholar
  10. Holan G, Eidelman E, Fuks AB. Long-term evaluation of pulpotomy in primary molars using mineral trioxide aggregate or formocresol. Pediatr Dent. 2005;27:129–36.PubMedGoogle Scholar
  11. Holland R, de Souza V, Murata SS, et al. Healing process of dog dental pulp after pulpotomy and pulp covering with mineral trioxide aggregate or Portland cement. Braz Dent J. 2001;12:109–13.PubMedGoogle Scholar
  12. Islam I, Chng HK, Yap AUJ. Comparison of the physical and mechanical properties of MTA and Portland cement. J Endod. 2006;32:193–7.PubMedCrossRefGoogle Scholar
  13. Maroto M, Barberia E, Planells P, Garcia Godoy F. Dentin bridge formation after mineral trioxide aggregate (MTA) pulpotomies in primary teeth. Am J Dent. 2005;18:151–4.PubMedGoogle Scholar
  14. Menezes R, Bramante CM, Letra A, Carvalho VGG, Garcia RB. Histologic evaluation of pulpotomies in dog using two types of mineral trioxide aggregate and white Portland cements as wound dressings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98:376–9.PubMedGoogle Scholar
  15. Min KS, Kim HI, Park HJ, et al. Human pulp cells response to Portland cement in vitro. J Endod. 2007;33:163–6.PubMedCrossRefGoogle Scholar
  16. Moretti AB, Sakai VT, Oliveira TM, et al. Effectiveness of mineral trioxide aggregate, calcium hydroxide and formocresol for pulpotomies in primary teeth. Int Endod J. 2008;41:547–55.PubMedCrossRefGoogle Scholar
  17. Nair PN, Duncan HF, Pitt Ford TR, Luder HU. Histological, ultrastructural and quantitative investigations on the response of healthy human pulps to experimental capping with mineral trioxide aggregate: a randomized controlled trial. Int Endod J. 2008;41:128–50.PubMedGoogle Scholar
  18. Ni Chaollai A, Monteiro J, Duggal MS. The teaching of management of the pulp in primary molars in Europe: a preliminary investigation in Ireland and the UK. Eur Arch Paediatr Dent. 2009;10:98–103.CrossRefGoogle Scholar
  19. Ng FK, Messer LB. Mineral trioxide aggregate as a pulpotomy medicament: an evidence-based assessment. Eur Arch Paediatr Dent. 2008;9:58–73.PubMedCrossRefGoogle Scholar
  20. Odabaş ME, Alaçam A, Sillelioğlu H, Deveci C. Clinical and radiographic success rates of mineral trioxide aggregate and ferric sulphate pulpotomies performed by dental students. Eur J Paediatr Dent. 2012;13:118–22.PubMedGoogle Scholar
  21. Qudeimat MA, Barrieshi-Nusair KM, Owais AI. Calcium hydroxide vs mineral trioxide aggregates for partial pulpotomy of permanent molars with deep caries. Eur Arch Paediatr Dent. 2007;8:99–104.PubMedCrossRefGoogle Scholar
  22. Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review—Part III: clinical applications, drawbacks, and mechanism of action. J Endod. 2010;36:400–13.PubMedCrossRefGoogle Scholar
  23. Salako N, Joseph B, Ritwik P, et al. Comparison of bioactive glass, mineral trioxide aggregate, ferric sulfate and formocresol as pulpotomy agents in rat molar. Dent Traumatol. 2003;19:314–20.PubMedCrossRefGoogle Scholar
  24. Sakai VT, Moretti AB, Oliveira TM, et al. Pulpotomy of human primary molars with MTA and Portland cement: a randomised controlled trial. Br Dent J. 2009;8:128–9.Google Scholar
  25. Seale NS, Coll JA. Vital pulp therapy for the primary dentition. Gen Dent. 2010;58:194–200.PubMedGoogle Scholar
  26. Shahi S, Rahimi S, Yavari HR, et al. Effect of mineral trioxide aggregates and Portland cements on inflammatory cells. J Endod. 2010;36:899–903.PubMedCrossRefGoogle Scholar
  27. Simancas-Pallares MA, Díaz-Caballero AJ, Luna-Ricardo LM. Mineral trioxide aggregate in primary teeth pulpotomy. A systematic literature review. Med Oral Patol Oral Cir Bucal. 2010;15:942–6.CrossRefGoogle Scholar
  28. Song JS, Mante FK, Romanow WJ, Kim S. Chemical analysis of powder and set forms of Portland cement, gray ProRoot MTA, white ProRoot MTA, and gray MTA-Angelus. Oral Sur Oral Med Oral Pathol Oral Radiol Endod. 2006;102:809–15.CrossRefGoogle Scholar
  29. Steffen R, van Waes H. Understanding mineral trioxide aggregate/Portland-cement: a review of literature and background factors. Eur Arch Paediatr Dent. 2009;10:93–7.PubMedCrossRefGoogle Scholar
  30. Waterhouse PJ, Nunn JH, Withworth JM, Soames JV. Primary molar pulp therapy—histological evaluation of failure. Int J Pediatr Dent. 2000;10:313–21.CrossRefGoogle Scholar

Copyright information

© European Academy of Paediatric Dentistry 2013

Authors and Affiliations

  • T. M. Oliveira
    • 1
    Email author
  • A. B. S. Moretti
    • 2
  • V. T. Sakai
    • 2
  • N. Lourenço Neto
    • 2
  • C. F. Santos
    • 3
  • M. A. A. M. Machado
    • 1
  • R. C. C. Abdo
    • 1
  1. 1.Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of DentistryUniversity of São PauloSão PauloBrazil
  2. 2.Department of Pediatric DentistryFederal University of AlfenasAlfenasBrazil
  3. 3.Department of Biological SciencesBauru School of Dentistry, University of São PauloSão PauloBrazil

Personalised recommendations