Direct Pulp-Capping with Calcium Enriched Mixture in Primary Molar Teeth: A Randomized Clinical Trial Immunohistochemical expression of fibronectin and tenascin in human tooth pulp capped with mineral trioxide aggregate and a novel endodontic cement. Response of human dental pulp capped with biodentine and mineral trioxide aggregate. Human pulpal response to direct pulp capping with an adhesive system. Treatment Outcomes of Primary Molars Direct Pulp Capping after 20 Months: A Randomized Controlled Trial Histological evaluation of mineral trioxide aggregate and calcium hydroxide in direct pulp capping of human immature permanent teeth. A comparative study on dental pulp response to calcium hydroxide, white and grey mineral trioxide aggregate as pulp capping agents Direct Pulp Capping with Calcium Hydroxide, Mineral Trioxide Aggregate, and Biodentine in Permanent Young Teeth with Caries: A Randomized Clinical Trial A Randomized Controlled Study of the Use of ProRoot Mineral Trioxide Aggregate and Endocem as Direct Pulp Capping Materials: 3-month versus 1-year Outcomes. A randomized controlled study of the use of ProRoot mineral trioxide aggregate and Endocem as direct pulp capping materials. Evaluation of indirect pulp capping using three different materials: A randomized control trial using cone-beam computed tomography Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions. Surgical protocols for ridge preservation after tooth extraction. A systematic review. Clinical assessment of mineral trioxide aggregate (MTA) as direct pulp capping in young permanent teeth. Alveolar ridge preservation with guided bone regeneration and a synthetic bone substitute or a bovine-derived xenograft: a randomized, controlled clinical trial. Evaluation of two mineral trioxide aggregate compounds as pulp-capping agents in human teeth. Treatment outcomes of pulpotomy in primary molars using two endodontic biomaterials. A 2-year randomised clinical trial. Mineral Trioxide Aggregate vs. Calcium Hydroxide in Primary Molar Pulpotomy: A Systematic Review Clinical and Histological Evaluation of Direct Pulp Capping on Human Pulp Tissue Using a Dentin Adhesive System Pulpotomy in caries-exposed immature permanent molars using calcium-enriched mixture cement or mineral trioxide aggregate: a randomized clinical trial.
INTRODUCTION The aim of this trial was to compare clinical and radiographic success rates of direct pulp capping ( DPC ) using a novel bio material called Calcium Enriched Mixture ( CEM ) cement versus Mineral Trioxide Aggregate ( MTA ) in primary molar teeth . MATERIAL S AND METHODS In this r and omized clinical trial 42 deciduous molars in 21 patients who had at least two teeth requiring DPC , were treated . The enrolled patients were between 5 - 8 years . The molar teeth were r and omly divided into two experimental groups . Patients and operators were blinded . The teeth were anaesthetized , caries were removed and after pinpoint exposure of dental pulp , haemostasis was achieved . The exposure points were capped with MTA or CEM cement . All teeth were restored with amalgam . Patients were recalled for the 6-month follow up . Statistical analysis was carried out using McNemar test . RESULTS Thirty-eight teeth were available for follow up ( 19 in each group ) . The radiographic evaluations did not show failure in experimental groups ; however , in clinical examinations one sinus tract was found in CEM cement group . Clinical success rates in CEM cement and MTA groups were 94.8 % and 100 % , respectively . Dentinal bridge formation was not observed in the two experimental groups . CONCLUSION There is no significant difference between treatment outcomes of direct pulp capping with either CEM cement or MTA ; therefore , both bio material s can be used successfully for DPC in primary molar teeth INTRODUCTION The purpose of the present study was the immunohistochemical study of fibronectin ( FN ) and tenascin ( TN ) in human tooth pulp capped with  mineral trioxide aggregate ( MTA )  and novel endodontic cement ( NEC ) ( calcium enriched mixture cement ) after 2 and 8 weeks . METHODS Thirty-two premolar teeth that were scheduled for extraction for orthodontic reasons were exposed and capped with either MTA or NEC . The teeth were r and omly divided into 4 groups : group 1 ( NEC for 2 weeks ) , group 2 ( NEC for 8 weeks ) , group 3 ( MTA for 2 weeks ) , and group 4 ( MTA for 8 weeks ) . After capping the exposed pulps with either NEC ( groups 1 and 2 ) or MTA ( groups 3 and 4 ) , half of the specimens underwent extraction and were prepared for histologic and immunohistochemical evaluation for FN and TN after 2 weeks , and the remaining half were assessed after 8 weeks . FN and TN expression was scored by a blinded pathologist on a scale of I-IV , and the results were analyzed by the Wilcoxon and Mann-Whitney U statistical tests . RESULTS FN and TN staining was observed in all 4 experimental groups , and there was no significant difference between expression of FN and TN in any groups . FN and TN staining was observed in the dentinal bridge matrix after 2 weeks under MTA . Expression of both markers reduced significantly after 8 weeks under MTA , and staining was observed only in unmineralized parts of dentinal bridge . FN and TN expression was observed in the matrix of the dentinal bridge after 2 weeks under NEC , and staining of both markers was reduced after 8 weeks compared with 2 weeks . The staining pattern of TN in NEC groups was higher than in MTA groups in both time intervals . However , the difference was not significant . CONCLUSIONS The present study demonstrated that both MTA and NEC are suitable bio material s for direct pulp capping and are able to stimulate dentinal bridge formation . Moreover , the role of FN and TN as 2 major components of the matrix of a reparative dentinal bridge was observed INTRODUCTION Biodentine is a new bioactive cement that is similar to the widely used mineral trioxide aggregate ( MTA ) . It has dentin-like mechanical properties , which may be considered a suitable material for clinical indications of dentin-pulp complex regeneration such as direct pulp capping . The purpose of the present study was to compare the response of the pulp-dentin complex in human teeth after direct capping with this new tricalcium silicate-based cement with that of MTA . METHODS Pulps in 28 caries-free maxillary and m and ibular permanent intact human molars scheduled for extraction for orthodontic reasons were mechanically exposed and assigned to 1 of 2 experimental groups , Biodentine or MTA , and 1 control group . Assay of periapical response and clinical examination were performed . After 6 weeks , the teeth were extracted , stained with hematoxylin-eosin , and categorized by using a histologic scoring system . RESULTS The majority of specimens showed complete dentinal bridge formation and an absence of inflammatory pulp response . Layers of well-arranged odontoblast and odontoblast-like cells were found to form tubular dentin under the osteodentin . Statistical analysis showed no significant differences between the Biodentine and MTA experimental groups during the observation period . CONCLUSIONS Within the limitations of this study , Biodentine had a similar efficacy in the clinical setting and may be considered an interesting alternative to MTA in pulp-capping treatment during vital pulp therapy PURPOSE To evaluate clinical ly and microscopically the human pulp response when directly capped with an adhesive system or calcium hydroxide over short ( 9 - 12 days ) and long ( 53 - 204 days ) experimental periods . MATERIAL S AND METHODS Fifty-one sound human premolars scheduled for orthodontic extraction , had their pulp horns gently exposed with a diamond point . Debris in the pulp wound was washed out with a sterile saline solution . The pulps were then capped with either an adhesive system ( Scotchbond Multi- Purpose Plus ) or calcium hydroxide . All teeth were subsequently restored with resin-based composite ( Z-100 ) according to the manufacturer 's instructions . After the experimental periods , the teeth were extracted and processed for light microscopic examination . RESULTS Short-term : the pulp tissue capped with SBMP-P exhibited dilated and congested blood vessels associated with a moderate inflammatory response and blanching of pulp cell nuclei . Long-term : no evidence of healing and bridge formation was observed . A persistent mild inflammatory pulp response was present . Micro-abscesses were detected in three cases associated with bacterial infiltration . Calcium hydroxide stimulated early pulp repair and dentin bridging which extended into the longest period Introduction The aim of this r and omized controlled trial was to compare the radiographic and clinical success rates of direct pulp capping ( DPC ) using ProRoot mineral trioxide aggregate ( MTA ) or calcium enriched mixture ( CEM ) . Methods and Material s A total of 42 symptom-free carious vital primary molars ( 21 pairs ) were selected in this split mouth trial and r and omly pulpotomized in two experimental groups . Pinpoint pulp exposures were covered by the same blinded operator with MTA or CEM , and then restored by amalgam .  Radiographic and clinical successes were evaluated at 20 month follow-up . Data were statistically analyzed using McNemar test . Results Nineteen patients were available for 20-month follow-up ; only one failed tooth was extracted in the CEM group . All available teeth were symptom-free , however , the final evaluated success rate was 89 % in CEM ( CI 95 % : 0.82 - 0.96 ) and 95 % in MTA ( CI 95 % : 0.85 - 1 ) groups without statistical difference ( P=0.360 ) . Worst case scenario was applied for missing value analysis ; assuming that the 2 lost cases in CEM group had failed and the only lost case in MTA group was due to treatment success , as a result the success of CEM and MTA were 81 % ( CI 95 % : 0.72 - 0.90 ) and 95 % ( CI 95%:0.85 - 1 ) , respectively , with no statistical difference ( P=0.078 ) . In the reverse scenario , the success of MTA and CEM were 86 % ( CI 95 % : 0.78 - 0.94 ) and 90 % ( CI 95 % : 0.82 - 0.98 ) , respectively ; again with no statistical difference ( P=0.479 ) . Conclusion Effectiveness of MTA and CEM bio material s for primary molars ’ DPC was similar ; CEM can be a suitable alternative for MTA PURPOSE To evaluate histological findings in human immature permanent premolars scheduled for extraction for orthodontic reasons , in which mechanical pulp exposures were capped with white ProRoot Mineral Trioxide Aggregate ( WMTA ) or calcium hydroxide ( CH ) . METHODS Forty-eight human immature premolars in 23 patients ( age 10 - 18 years ) were r and omly treated with  WMTA or CH . After rubber dam isolation Cl I cavities were prepared and the pulps exposed . After hemostasis the pulps were capped with either material . The preparations were restored using an acid etch , bonding agent , flowable composite and composite resin technique . The teeth were extracted after 47 to 609 days and processed for routine histological examination , stained with hematoxylin and eosin and Brown and Brenn for recognition of bacteria . Statistical analyses of inflammation , bridge formation and bacterial leakage were performed using a Chi-square test and ANOVA . RESULTS Forty-four of 48 teeth were suitable for microscopic evaluation , 30 with WMTA , 14 with CH . Of the WMTA group , 29 teeth were vital , 28 had formed a bridge , and one specimen had failed . Twelve of 14 teeth with CH were vital , while three teeth failed to form a bridge . No statistically significant differences between WMTA and CH were found , except for superficial and deep inflammatory cell response ( P < or = 0.05 ) . Pulp capping of intentionally exposed human immature premolars performed slightly better when using MTA Context : Vital pulp therapy has been known as one of the treatment options to preserve pulp after being exposed by trauma or caries . Aim : To investigate human pulpal response to white and grey mineral trioxide aggregate ( WMTA , GMTA ) and Dycal ( MTA ) as pulp capping agents . Setting and Design : Human volunteers were participated in this r and omized clinical trial . Material s and Methods : This study was conducted on 90 intact first and second premolars of human maxillary and m and ibular teeth . The teeth were r and omly assigned into three groups of 30 each . Under local anesthesia , teeth were exposed and capped either with GMTA , WMTA , or Dycal . After 30 , 60 , and 90 days 10 teeth of each group were extracted and prepared for histologic observation . Statistical Analysis : Histopathologic data were analyzed by χ2 , Kruskal Wallis and Mann Whitney tests . Results : the calcified bridge in teeth that were capped with GMTA was significantly thicker than Dycal at 30 and 60 days ( P= 0.015 and P=0.002 , respectively ) ; whereas WMTA showed significantly thicker calcified bridge than Dycal at 90 days ( P=0.02 ) . In addition , GMTA specimens showed significantly less inflammation compared to Dycal sample s at 90 days interval ( P=0.019 ) . No significant difference was found between GMTA and WMTA in terms of calcified bridge thickness and pulp inflammatory response to the capping material s ( P>0.05 ) . Conclusions : Based on the result of this study , both types of MTA can be suggested as the material s of choice for direct pulp capping procedure instead of Dycal as hard setting calcium hydroxide cement Introduction Direct pulp capping treatment is intended to preserve pulp vitality , to avoid or retard root canal treatment , and , in cases with an open apex , to allow continued root development . Historically , calcium hydroxide ( CH ) was the gold st and ard material , but nowadays calcium silicate material s ( CSMs ) are displacing CH because of their high bioactivity , biocompatibility , sealing ability , and mechanical properties . However , more r and omized clinical trials are needed to confirm the appropriateness of CSMs as replacement material s for CH in direct pulp capping procedures . Methods A r and omized clinical trial was conducted that included 169 patients ( mean age , 11.3 years ) from the Maipo district ( Chile ) . The inclusion criterion was patients with 1 carious permanent tooth with pulpal exposure , a c and i date for a direct pulp capping procedure . The patients were r and omly allocated to one of the experimental groups ( CH , Biodentine , or mineral trioxide aggregate [ MTA ] ) . Clinical follow‐up examinations were performed at 1 week , 3 months , 6 months , and 1 year . The Fisher exact test was performed . Results At the follow‐up examination at 1 week , the patients showed 100 % clinical success . At 3 months , there was 1 failure in the CH group . At 6 months , there were 4 new failures ( 1 in the CH group and 3 in the MTA group ) . At 1 year , there was another failure in the CH group . There were no statistically significant differences among the experimental groups . Conclusions CSMs appear to be suitable material s to replace CH . Although no significant differences were found among the material s studied , Biodentine and MTA offered some advantages over CH . HighlightsThis trial compared the efficacy of calcium hydroxide , MTA , and Biodentine as pulp capping material s in young permanent molars . MTA and Biodentine are suitable material s to replace calcium hydroxide in pulp capping procedures .Pulp capping in carious teeth is a successful treatment when done under good clinical protocol INTRODUCTION The purpose of this study was to assess the long-term clinical outcomes of direct pulp capping ( DPC ) with ProRoot MTA ( Dentsply , Tulsa , OK ) and Endocem ( Maruchi , Wonju , Korea ) as pulp capping material s. To this end , the 1-year cumulative successes of both material s were evaluated and compared with those of the 3-month outcomes in a prospect i ve , r and omized controlled trial . METHODS Patients were recruited from the Department of Conservative Dentistry of the Yonsei University Dental Hospital , Seoul , South Korea , from January to May 2013 . Of the 48 teeth that met the inclusion criteria , 46 teeth were r and omly allocated to either ProRoot MTA or Endocem groups ( n = 23 ) . Direct pulp capping was performed , and clinical and radiographic examinations were conducted over 1 year after the treatment . Survival analyses were conducted to compare the cumulative successes between ProRoot MTA and Endocem and to evaluate other clinical variables . RESULTS Forty-one teeth were recalled 1 year after the treatments ( recall rate = 89.13 % ) . There were no significant differences between the cumulative successes  of ProRoot MTA and Endocem in either log-rank or Cox proportional hazard regression analyses ( P > .05 ) . Among the other clinical variables , cavity type ( class I , II , III vs class V ) was determined to be significant in both the log-rank test ( P = .001 ) and Cox regression analysis ( P = .006 ) . CONCLUSIONS Both ProRoot MTA and Endocem exhibited similar cumulative successes as direct pulp capping material s up to 1 year . The teeth restored with class V cavities exhibited significantly lower cumulative success rates after direct pulp capping compared with the teeth restored with other types of cavities INTRODUCTION The purpose of the present study was to evaluate and compare the short-term clinical outcomes of direct pulp capping using ProRoot MTA ( Dentsply , Tulsa , OK ) or Endocem ( Maruchi , Wonju , Korea ) as capping material s in a prospect i ve r and omized controlled study . MATERIAL S AND METHODS This study was conducted with subjects who were recruited from the pool of patients from the Department of Conservative Dentistry at the Dental College of Yonsei University , Seoul , Korea , between January and May 2013 . Of the 48 teeth confirmed to be eligible for direct pulp capping , a total of 46 teeth were r and omly assigned to either the ProRoot MTA or the Endocem group ( 23 teeth per group ) . Direct pulp capping was performed using these 2 material s , and clinical and radiographic evaluations were performed at 1 , 2 , 4 , and 12 weeks after the treatments . Teeth with no response to pulp vitality test and those exhibiting clinical or radiographic signs and /or symptoms of irreversible pulpitis or pulp necrosis were considered to be failures . RESULTS Thirty-two patients ( 43 teeth ) were examined at the 3-month follow-up ( patient recall rate = 91.4 % ) ; 22 of these teeth were in the ProRoot MTA group , and 21 were in the Endocem group . The overall success rate was 93 % , and the success rates in the ProRoot MTA and Endocem groups were 95.5 % ( 21/22 teeth ) and 90.5 % ( 19/21 teeth ) , respectively . Statistical analyses of these success rates did not reveal any significant difference between the groups ( P = .522 ) . CONCLUSIONS In this r and omized controlled study , no significant difference in the short-term clinical outcomes of direct pulp capping using ProRoot MTA or Endocem as the capping material was found . Furthermore , the favorable short-term outcome success rate of 93 % indicates that direct pulp capping may be a reliable treatment for pulp exposure in adult teeth Objective : The objective of this study was to determine the most suitable material for indirect pulp treatment ( IPT ) clinical ly and to determine the thickness ( in mm ) and type of tissue in terms of radiodensity ( in Hounsfield units [ HU ] ) formed after pulp capping using cone-beam computed tomography ( CBCT ) scan . Material s and Methods : A longitudinal interventional single-blind r and omized clinical trial was conducted on 94 children ( 7–12 years ) with a deep carious lesion in one or more primary second molar and permanent first molar without the history of spontaneous pain indicated for indirect pulp capping ( IPC ) procedure . About 109 teeth were treated using three material s , namely , calcium hydroxide ( setting type ) , glass ionomer cement ( Type VII ) , and mineral trioxide aggregate r and omly . The teeth were followed up at an interval of 8 weeks , 6 months , and 1 year for success of IPT as per the American Academy of Pediatric Dentistry clinical criteria . For determining the thickness and type of dentin tissue formed , a CBCT scan was done immediately postoperative and another scan at an interval of 6 months . The scans were compared to evaluate the average thickness of the dentin bridge formed . Results and Conclusions : Success rate for IPC was 96.85 % . A significant difference was obtained in the average thickness of reparative dentin at immediate postoperative and 6-month postoperative values in all three groups suggesting distinct barrier formation . Similar significant findings were obtained in radiodensity of barrier formed ( in HU ) . All three material s were found to be equally suitable as IPC agents suggesting mineral gain PURPOSE This manuscript presents evidence -based guidance on the use of vital pulp therapies for treatment of deep caries lesions in children . A guideline panel convened by the American Academy of Pediatric Dentistry formulated evidence -based recommendations on three vital pulp therapies : indirect pulp treatment ( IPT ; also known as indirect pulp cap ) , direct pulp cap ( DPC ) , and pulpotomy . METHODS The basis of the guideline 's recommendations was evidence from " Primary Tooth Vital Pulp Therapy : A Systematic Review and Meta- Analysis . " ( Pediatr Dent 2017;15;39[1]:16 - 23 . ) A systematic search was conducted in PubMed ® / MEDLINE , Embase ® , Cochrane Central Register of Controlled Trials , and trial data bases to identify r and omized controlled trials and systematic review s addressing peripheral issues of vital pulp therapies such as patient preferences of treatment and impact of cost . Quality of the evidence was assessed through the Grading of Recommendations Assessment , Development , and Evaluation approach ; the evidence -to-decision framework was used to formulate a recommendation . RESULTS The panel was unable to make a recommendation on superiority of any particular type of vital pulp therapy owing to lack of studies directly comparing these interventions . The panel recommends use of  mineral trioxide aggregate ( MTA ) and formocresol in pulpotomy treatments ; these are recommendations based on moderate- quality evidence at 24 months . The panel made weak recommendations regarding choice of medicament in both IPT ( moderate- quality evidence [ 24 months ] , low quality evidence [ 48 months ] ) and DPC ( very-low quality evidence [ 24 months ] ) . Success of both treatments was independent of type of medicament used . The panel also recommends use of ferric sulfate  ( low- quality evidence ) , lasers ( low- quality evidence ) ,  sodium hypochlorite  ( very low- quality evidence ) , and  tricalcium silicate  ( very low- quality evidence ) in pulpotomies ; these are weak recommendations based on low- quality evidence . The panel recommended against the use of calcium hydroxide as pulpotomy medicament in primary teeth with deep caries lesions . Conclusions and practical implication s : The guideline intends to inform the clinical practice s with evidence -based recommendations on vital pulp therapies in primary teeth with deep caries lesions . These recommendations are based upon the best available evidence to- date OBJECTIVE This systematic review aims to evaluate the scientific evidence on the efficacy in the surgical protocol s design ed for preserving the alveolar ridge after tooth extraction and to evaluate how these techniques affect the placement of dental implants and the final implant supported restoration . MATERIAL AND METHODS A thorough search in MEDLINE - PubMed , Embase and the Cochrane Central Register of controlled trials ( CENTRAL ) was conducted up to February 2011 . R and omized clinical trials and prospect i ve cohort studies with a follow-up of at least 3 months reporting changes on both the hard and soft tissues ( height and /or width ) of the alveolar process ( mm or % ) after tooth extraction were considered for inclusion . RESULTS The screening of titles and abstract s result ed in 14 publications meeting the eligibility criteria . Data from nine of these 14 studies could be grouped in the meta-analyses . Results from the meta-analyses showed a statistically significant greater ridge reduction in bone height for control groups as compared to test groups ( weighted mean differences , WMD = -1.47 mm ; 95 % CI [ -1.982 , -0.953 ] ; P < 0.001 ; heterogeneity : I(2 ) = 13.1 % ; χ(2 ) P-value = 0.314 ) and a significant greater reduction in bone width for control groups compared to the test groups ( WMD = -1.830 mm ; 95 % CI [ -2.947 , -0.732 ] ; P = 0.001 ; heterogeneity : I(2 ) = 0 % ; χ(2 ) P-value = 0.837 ) . Subgroup analysis was based on the surgical protocol used for the socket preservation ( flapless/flapped , barrier membrane/no membrane , primary intention healing/no primary healing ) and on the measurement method utilized to evaluate morphological changes . Meta-regression analyses demonstrated a statistically significant difference favoring the flapped subgroup in terms of bone width ( meta-regression ; slope = 2.26 ; 95 % IC [ 1.01 ; 3.51 ] ; P = 0.003 ) . CONCLUSIONS The potential benefit of socket preservation therapies was demonstrated result ing in significantly less vertical and horizontal contraction of the alveolar bone crest . The scientific evidence does not provide clear guidelines in regards to the type of bio material , or surgical procedure , although a significant positive effect of the flapped surgery was observed . There are no data available to draw conclusions on the consequences of such benefits on the long-term outcomes of implant therapy UNLABELLED Carious pulp exposure in permanent molars of children is a common incident . Mineral trioxide aggregate is a new material that possesses numerous exciting possibilities for pulp therapy . AIM The purpose of this study was to evaluate the efficiency of MTA as a direct pulp capping agent in young permanent teeth . METHODS Thirty asymptomatic permanent molars with pulp exposures were treated by pulp capping using MTA . At each recall ( 6 12 , 18 and 24 months ) , the teeth were assessed clinical ly , through pulpal sensitivity tests , as well as radiographically to evaluate periapical healing . RESULTS None of the cases reported spontaneous pain at the six months follow up and the pulp showed signs of vitality and absence of periapical radiolucency . At 24 months , the clinical and radiographic success rate was 93 % with evidence of continued root growth . CONCLUSION Pulp capping with MTA is recommended for teeth with carious pulp exposures specially immature teeth with high potential for healing OBJECTIVES The aim of this r and omized , controlled clinical trial was to compare the potential of a synthetic bone substitute or a bovine-derived xenograft combined with a collagen membrane to preserve the alveolar ridge dimensions following tooth extraction . METHODS Twenty-seven patients were r and omized into two treatment groups following single tooth extraction in the incisor , canine and premolar area . In the test group , the alveolar socket was grafted with Straumann Bone Ceramic ( SBC ) , while in the control group , Bio-Oss deproteinized bovine bone mineral ( DBBM ) was applied . In both groups , a collagen barrier was used to cover the grafting material . Complete soft tissue coverage of the barriers was not achieved . After 8 months , during re-entry procedures and before implant placement , the horizontal and vertical dimensions of the residual ridge were re-evaluated and trephine biopsies were performed for histological analysis in all patients . RESULTS Twenty-six patients completed the study . The bucco-lingual dimension of the alveolar ridge decreased by 1.1+/-1 mm in the SBC group and by 2.1+/-1 in the DBBM group ( P<0.05 ) . Both material s preserved the mesio-distal bone height of the ridge . No differences in the width of buccal and palatal bone plate were observed between the two groups . The histological analysis showed new bone formation in the apical part of the biopsies , which , in some instances , was in direct contact with both SBC and DBBM particles . The coronal part of the biopsies was occupied by a dense fibrous connective tissue surrounding the SBC and DBBM particles . CONCLUSION Both bio material s partially preserved the width and the interproximal bone height of the alveolar ridge AIM The present r and omized , controlled prospect i ve study evaluated the histomorphological response of human dental pulps capped with two grey mineral trioxide aggregate ( MTA ) compounds . METHODOLOGY Pulp exposures were performed on the occlusal floor of 40 human permanent pre-molars . The pulp was capped either with ProRoot ( Dentsply ) or MTA-Angelus ( Angelus ) and restored with zinc oxide eugenol cement . After 30 and 60 days , teeth were extracted and processed for histological examination and the effects on the pulp were scored . The data were subjected to Kruskal-Wallis and Conover tests ( alpha = 0.05 ) . RESULTS In five out of the 40 teeth bacteria were present in pulp tissue . No significant difference was observed between the two material s ( P > 0.05 ) in terms of overall histological features ( hard tissue bridge , inflammatory response , giant cells and particles of capping material s ) . Overall , 94 % and 88 % of the specimens capped with MTA-Angelus and ProRoot , respectively , showed either total or partial hard tissue bridge formation ( P > 0.05 ) . CONCLUSIONS Both commercial material s ProRoot ( Dentsply ) and MTA-Angelus ( Angelus ) produced similar responses in the pulp when used for pulp capping in intact , caries-free teeth AIM To compare the treatment outcomes of calcium-enriched mixture ( CEM ) cement and mineral trioxide aggregate ( MTA ) as pulp dressing bio material s in vital pulpotomy of carious primary molars . STUDY DESIGN split-mouth r and omised clinical trial . MATERIAL S AND METHODS Forty children aged 4 - 8 years with 2 carious teeth requiring pulpotomy were selected and r and omly assigned to MTA ( n = 40 ) or CEM ( n = 40 ) groups . After coronal pulp removal , the remaining radicular pulp was covered with an appropriate bio material ; the teeth were then permanently restored . Clinical /radiographic success/failures were blindly evaluated at 6- , 12- and 24-month follow-ups . STATISTICS the recorded data were analyzed with McNemar test and GEE . RESULTS A total of 36 , 33 and 35 patients were available for 6- , 12- and 24-month follow-ups , respectively . At the 12-month follow-up only one and three teeth in the CEM and MTA groups had pathologic external root resorption , respectively . The resorbed teeth were then missed due to extraction /exfoliation at the 24-month follow-up ; all other treated teeth were sign/symptom-free . Overall , clinical and radiographic outcomes in both MTA/CEM groups were comparable at the three follow-ups without significant differences . Time had no significant effect on the success . CONCLUSION MTA and CEM demonstrated favourable treatment outcomes for pulpotomy of carious primary molars ; CEM may be an effective pulp dressing bio material Introduction : The aim of this quantitative systematic review /meta- analysis was to compare the treatment outcomes of mineral trioxide aggregate ( MTA ) and calcium hydroxide ( CH ) in pulpotomy of human primary molars . The focused PICO question was “ in case of pulp exposure in vital primary molars , how does MTA pulpotomy compare to CH in terms of clinical /radiographic success ? ” Methods and Material s : We retrieved published r and omized clinical trials ( RCTs ) of at least 6-month duration ; our search included articles published up to March 2013 in five following data bases : PubMed ( Medline ) , Cochrane data base of systematic review s , Science Citation Index , EMBASE , and Google Scholar . Mantel Haenszel and Inverse Variance-weighted methods were applied by STATA ; the relative risk ( RR ) was calculated with 95 % confidence intervals ( CI ) . Results : A total of 282 English articles were collected . Two authors independently screened the articles and five RCTs were selected ; data extraction and quality assessment were then carried out . Four RCTs were appropriate for meta- analysis according to their follow-up times by Mantel Haenszel method . Statistically significant difference was found between success rate of MTA compared to CH , with RR=0.08 ( 95 % CI , 0.02 - 0.39 ) , RR=0.19 ( 95 % CI , 0.08 - 0.46 ) , and RR=0.38 ( 95 % CI , 0.21 - 0.68 ) for 6- , 12- , and 24-month follow-ups , respectively . A significant difference was also observed for all included RCTs after analyses using the Inverse Variance-weighted method ( RR=0.44 ; 95 % CI , 0.27 - 0.72 ) . Conclusions : Systematic review /meta- analysis of included RCTs revealed that for pulpotomy of vital primary molars , MTA has better treatment outcomes compared to CH Objective . This study presents a clinical and histological evaluation of human pulp tissue responses after direct capping using a new dentin adhesive system . Methods . Twenty-eight caries-free third molar teeth scheduled for extraction were evaluated . The pulps of 22 teeth were mechanically exposed and r and omly assigned to 1 of 2 groups : Single Bond Universal or calcium hydroxide . Another group of 6 teeth acted as the intact control group . The periapical response was assayed , and a clinical examination was performed . The teeth were extracted after 6 weeks , and a histological analysis was performed . The pulp status was assessed , and the thickness of the dentin bridge was measured and categorized using a histological scoring system . Results . The clinical phase was asymptomatic for Single Bond Universal patients . Patients in the calcium hydroxide group reported mild symptoms of pain , although the histological examination revealed that dentin bridges with or without limited pulpitis had begun forming in each tooth . The universal adhesive system exhibited nonsignificantly increased histological signs of pulpitis ( P > 0.05 ) and a significantly weaker thin mineralized tissue layer ( P < 0.001 ) compared with the calcium hydroxide group . Conclusion . The results suggest that Single Bond Universal is inappropriate for human pulp capping ; however , further long-term studies are needed to determine the biocompatibility of this agent OBJECTIVE To compare clinical and radiographic outcomes of pulpotomy treatment using calcium-enriched mixture ( CEM ) cement and mineral trioxide aggregate ( MTA ) in carious-exposed vital immature permanent first molars . DESIGN Fifty-one immature molars with clinical carious exposure with symptomatic/asymptomatic pulpitis met the inclusion criteria and r and omly assigned to one of the treatment groups ( CEM [ 26 teeth ; 59 roots ] , MTA [ 25 teeth ; 59 roots ] ) . After performing pulpotomy and covering the radicular pulps with the bio material s , all teeth were permanently restored . Blinded clinical and radiographic evaluations were performed at 6 and 12 months after operation for signs of success or failure . Radiographs were evaluated for complete/partial apical closure . The data were analysed using chi-square test and generalized estimating equation ( GEE ) model . RESULTS There was no significant difference at the baseline between the two experimental groups . All available cases ( 49 teeth ) showed pulp survival and signs of continuous root development after 12 months . Overall , complete apical closure ( apexogenesis ) occurred in 76.8 % and 73.8 % of radiographically interpreted roots in CEM cement and MTA groups , respectively . There was no statistical difference in terms of radiographic outcomes between two groups . CONCLUSIONS Calcium-enriched mixture cement and MTA showed similar performance in pulpotomy of immature caries-exposed permanent molars
Conclusions MTA cements have a higher success rate , with a lower inflammatory response and a more predictable hard dentin barrier formation  than calcium hydroxide cements .
However , there were no differences , in these parameters , when MTA cement was compared with tricalcium silicate cements .
Dental adhesives systems showed the lowest success rates
Introduction Direct pulp capping therapies use bio material s to protect exposed tissues , inducing repair through the production of a mineralized barrier .
The purpose of this study was to compare the effectiveness of bio material s and techniques by means of a systematic review and meta‐ analysis .