ORIGINAL ARTICLE

 

Response of human dental pulp to calcium hydroxide paste preceded by a corticosteroid/antibiotic dressing agent

 

 

Elisa Maria Aparecida Giro^I; Juliana Oliveira Gondim^II; Josimeri Hebling^I; Carlos Alberto de Souza Costa^III

^IDDS, MSc, PhD, Professor, Department of Orthodontics and Pediatric Dentistry, School of Dentistry of Araraquara, Universidade Estadual Paulista - UNESP, Araraquara, SP, Brazil
^IIDDS, MSc, Assistant Professor, Department of Dentistry, School of Dentistry, Federal University of Ceará, Sobral, Fortaleza, CE, Brazil; Graduate Student, Department of Orthodontics and Pediatric Dentistry, School of Dentistry of Araraquara, Universidade Estadual Paulista - UNESP, Araraquara, SP, Brazil
^IIIDDS, MSc, PhD, Professor, Department of Physiology and Pathology, School of Dentistry of Araraquara, Universidade Estadual Paulista -UNESP, Araraquara, SP, Brazil

Correspondence to

 

 

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ABSTRACT

AIM: To evaluate the treatment with corticosteroid/antibiotic dressing in pulpotomy with calcium hydroxide.
METHODS: Forty-six premolars were pulpotomized and randomly assigned into 3 groups. In Group I pulpal wound was directly capped with calcium hydroxide, and Group II and Group III received corticosteroid/antibiotic dressing for 10 min or 48 h, respectively, before pulp capping. Teeth were processed for histological analysis after 7, 30 or 60 days to determine inflammatory cell response, tissue disorganization, dentin bridge formation and presence of bacteria. Attributed scores were analyzed by Kruskal-Wallis and Mann-Whitney tests (α=0.05).
RESULTS: On the 7th day, all groups exhibited dilated and congested blood vessels in the tissue adjacent to pulpal wound. The inflammatory cell response was significantly greater in Group III (p<0.05). On the 30th day, in all groups, a thin dentin matrix layer was deposited adjacent to the pulpal wound and a continuous odontoblast-like cell layer underlying the dentin matrix was observed. On the 60th day, all groups presented a thick hard barrier characterized by an outer zone of dystrophic calcification and an inner zone of tubular dentin matrix underlined by a defined odontoblast-like cell layer.
CONCLUSIONS: Within the limitations of present study, considering that the treatment was performed in healthy teeth, it may be concluded that the use of a corticosteroid/antibiotic dressing before remaining tissue protection with calcium hydroxide had no influence on pulp tissue healing.

Keywords: calcium hydroxide, corticosteroid, dental pulp capping, permanent dentition, pulpotomy.

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References

1.Dachi SF, Ross A, Stigers RW. Effects of prednisolone on the thermal sensitivity and pulp reactions of amalgam restored teeth. J Am Dent Assoc. 1964; 69: 565-71.         [ Links ]

2.Van Hassel HJ, McHugh JW. Effect of prednisolone on intrapulpal pressure [abstract 499]. J Dent Res. 1972; 51: 172.         [ Links ]

3.Souza V, Holland R. Treatment of the inflamed dental pulp. Aust Dent J. 1974; 19: 191-6.         [ Links ]

4.Paterson RC. Corticosteroids and the exposed pulp. Br Dent J. 1976; 140: 174-7.         [ Links ]

5.Paterson RC. Bacterial contamination and the exposed pulp. Br Dent J. 1976; 140: 231-6.         [ Links ]

6.Holland R, Okabe JA, Souza V, Saliba O. Diffusion of corticosteroid-antibiotic solutions through human dentine. Rev Odontol UNESP. 1991; 20: 17-23.         [ Links ]

7.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.         [ Links ]

8.Fry AE, Watkins RF, Phatak NM. Topical use of corticosteroids for the relief of pain sensitivity of dentine and pulp. Oral Surg Oral Med Oral Pathol. 1960; 13: 594-7.         [ Links ]

9.Mosteller JH. Use of prednisolone in the elimination of postoperative thermal sensitivity: a clinical study. J Prosthet Dent. 1962; 12: 1176-9.         [ Links ]

10.Schroeder A. Combination of antibiotics and cortisone in the treatment of root canals. Rev Belge Med Dent. 1965; 20: 291-8.         [ Links ]

11.Uitto VJ, Antila R, Ranta R. Effects of topical glucocorticoid medication on collagem biosynthesis in the dental pulp. Acta Odontol Scand. 1975; 33: 287-98.         [ Links ]

12.Sübay RK, Suzuki S, Suzuki S, Kaya H, Cox CF. Human pulp response after partial pulpotomy with two calcium hydroxide products. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995; 80: 330-7.         [ Links ]

13.Aeinehchi M, Eslami B, Ghanbariha M, Saffar AS. Mineral trioxide aggregate (MTA) and calcium hydroxide as pulp-capping agents in human teeth: a preliminary report. Int Endod J. 2003; 36: 225-31.         [ Links ]

14.El-Meligy OA, Avery DR. Comparison of mineral trioxide aggregate and calcium hydroxide as pulpotomy agents in young permanent teeth (apexogenesis). Pediatr Dent. 2006; 28: 399-404.         [ Links ]

15.Pradhan DP, Chawla HS, Gauba K, Goyal A. Comparative evaluation of endodontic management of teeth with unformed apices with mineral trioxide aggregate and calcium hydroxide. J Dent Child. 2006; 7: 79-85.         [ Links ]

16.Hebling J, Giro EMA, Costa CAS. Biocompatibility of an adhesive system applied to exposed human dental pulp. J Endod. 1999; 25: 676-82.         [ Links ]

17.de Albuquerque DS, Gominho LF, Dos Santos RA. Histologic evaluation of pulpotomy performed with ethyl-cyanocrylate and calcium hydroxide. Braz Oral Res. 2006; 20: 226-30.         [ Links ]

18.Santini A. Assessment of the pulpotomy technique in human first permanent mandibular molars. Br Dent J. 1983; 155: 151-4.         [ Links ]

19.Heys DR, Cox CF, Heys RJ, Avery JK. Histological considerations of direct pulp capping agents. J Dent Res. 1981; 60: 1371-9.         [ Links ]

20.Schroeder U. Effects of calcium hydroxide-containing pulp capping agent on pulp cell migration, proliferation and differentiation. J Dent Res. 1985; 64: 541-8.         [ Links ]

21.Stanley HR, Lundy T. Dycal therapy for pulp exposures. Oral Surg Oral Med Oral Pathol. 1972; 34: 818-27.         [ Links ]

22.Mjor IA, Dahl E, Cox CF. Healing of pulp exposures: an ultrastructural study. J Oral Pathol Med. 1991; 20: 496-501.         [ Links ]

23.de Andrade Ferreira FB, Silva e Souza PDEA, Do Vale MS, De Moraes IG, Granjeiro JM Evaluation of pH levels and calcium ion release in various calcium hydroxide endodontic dressings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 97: 388-92.         [ Links ]

24.Gordon TM, Ranly DM, Boyan BD. The effect of calcium hydroxide on bovine pulp tissue: variations in pH and calciumconcentration. J Endod. 1985; 11: 156-60.         [ Links ]

25.Franz FE, Holz J, Baume LJ. Ultrastructure (SEM) of dentin bridging in the human dental pulp. J Biol Buccale. 1984; 12: 239-46.         [ Links ]

26.Yoshiba K, Yoshiba N, Iwaku M. Histological observations of hard tissue barrier formation in amputed dental pulp capped with alpha-tricalcium phosphate containing calcium hydroxide. Endod Dent Traumatol. 1994; 10: 113-20.         [ Links ]

27.Kakehashi S, Stanley HR, Fitzgerald R. The exposed germ-free pulp: effects of topical corticosteroid medication and restoration. Oral Surg Oral Med Oral Pathol. 1969; 27: 60-7.         [ Links ]

28.Sazak H, Günday M, Alatli C. Effect of calcium hydroxide and combinations of Ledermix and calcium hydroxide on inflamed pulp in dog teeth. J Endod. 1996; 22: 447-9.         [ Links ]

29.Cox CF, Bergenholtz G, Heys DR, Syed SA, Fitzgerald M, Heys RJ. Pulp capping of dental pulp mechanically exposed to oral microflora: a 1-2 year observation of wound healing in the monkey. J Oral Pathol. 1985; 14: 156-68.         [ Links ]

 

 

Correspondence to:
Elisa Maria Aparecida Giro
Departamento de Clínica Infantil, Faculdade de Odontologia de Araraquara UNESP
Rua Humaitá, 1680 Centro. CEP:14801-903 CP: 331, Araraquara, São Paulo, Brasil
Phone:+ 55 16 33016336; fax:+55 16 33016329
E-mail: egiro@foar.unesp.br

Received for publication: June 18, 2009
Accepted: June 21, 2010