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An Introduction to Bioactivity via Restorative Dental Materials
Published in Mary Anne S. Melo, Designing Bioactive Polymeric Materials for Restorative Dentistry, 2020
Mary Anne S. Melo, Ashley Reid, Abdulrahman A. Balhaddad
The use of bioactive materials in vital dental pulp therapy and root canal treatment is an essential area in dental research (Walsh et al. 2018). In clinical scenarios where pulp exposure occurs during an operative procedure for caries removal, it is the standard of care procedure that a dental material is placed directly over the exposed dental pulp to preserve its vitality. These materials are known as pulp-capping materials (Zhang and Yelick 2010). Pulp-capping materials can trigger the dental pulp to recruit odontoblasts and undifferentiated mesenchymal cells to form the reparative dentin. The main goal of this process is to preserve the pulp vitality and reduce the risk of irreversible pulpitis (Goldberg and Smith 2004).
Gene Therapy in Oral Tissue Regeneration
Published in Vincenzo Guarino, Marco Antonio Alvarez-Pérez, Current Advances in Oral and Craniofacial Tissue Engineering, 2020
Fernando Suaste, Patricia González-Alva, Alejandro Luis, Osmar Alejandro
The dental pulp is a soft connective tissue located at the center cavity of the tooth; this is composed of nervous and vascular cells. The principal factor from tissue damage occurs as a result of caries. The primary treatment to protect the tissue from damage is the pulp capping procedure; through this treatment, the dental pulp is protected from necrosis through the deposition of calcium hydroxide. Other methods have employed the use of growth factors that have been installed directly at the site of the injury (OP-1, TGF-13, BMP-4, and BMP-2). Through the use of Gene Therapy Dental Pulp Stem Cells DSPCs transfected with Vascular Endothelial Growth Factor (VEGF) and Stromal cell-Derived Factor-1α (SDF-1α), have proven to be an effective treatment that allows an increase in pulp regeneration in vivo (Goldberg et al. 2001; Zhu et al. 2018).
Which procedures and materials could be applied for full pulpotomy in permanent mature teeth? A systematic review
Published in Acta Odontologica Scandinavica, 2019
M. Zanini, M. Hennequin, PY. Cousson
Overall, the clinical and biological effects of pulp capping materials are not related, except for calcium silicate cements that can result in both pulp healing and clinical success. Positive clinical results were also reported with CH or CH covered with ZOE or IRM®, despite the lack of regular tertiary dentinogenesis induction [36,62,63,65,66]. The setting time of the pulp capping material may be considered before using it in clinical routine. For example, the setting time of MTA is rather long, more than two hours, leading to a delay in the permanent restoration and increasing the risk of immediate post-operative contamination [92]. Recent commercial forms of MTA, such as MTA Angelus® or MM-MTA®, CEM and Biodentine® (Septodont, St Maur des Fossés) have a faster setting time [97]. Calcium silicate-based cements are expensive and economic considerations could limit the routine use of MTA or Biodentine®. In such situations, the use of CH or CH covered with zinc oxide eugenol materials (ZOE or IRM®) could be a valuable alternative in combination with an immediate and long-term seal of the coronal restoration.
Cost-effectiveness of pulp capping and root canal treatment of young permanent teeth
Published in Acta Odontologica Scandinavica, 2019
Joséphine Brodén, Thomas Davidson, Helena Fransson
Despite the accepted approach of minimally invasive restorative dentistry, excavation of deep caries can lead to a pulp exposure, even with stepwise excavation [1]. In a Scandinavian randomized clinical trial comparing stepwise and immediate complete caries excavation, pulpal exposure was recorded in 17.5% of the 156 teeth randomized to stepwise excavation [2]. The aim of treatment of carious exposures in the permanent teeth of children should ideally be to retain the tooth in a healthy state throughout life. In clinical practice, there are two main approaches to the treatment of an exposed vital pulp: pulp capping (direct pulp capping and partial pulpotomy) and root canal treatment (also referred to as a pulpectomy). Pulp capping is the less invasive approach: the aim is to maintain the vitality of the tooth by application of a capping material to the exposed pulp. Pulpectomy is more invasive: the vital pulp tissue is extirpated, the walls are mechanically debrided and the root canal space is obturated. At present, little is known about the relative cost-effectiveness of these two treatment options in cariously exposed young permanent teeth in Scandinavian conditions.
Survival of primary molars with pulpotomy interventions: public oral health practice-based study in Helsinki
Published in Acta Odontologica Scandinavica, 2021
Battsetseg Tseveenjav, Jussi Furuholm, Aida Mulic, Håkon Valen, Tuomo Maisala, Seppo Turunen, Sinikka Varsio, Merja Auero, Leo Tjäderhane
Vital pulp therapy is often indicated for primary teeth with extensive or deep caries lesion (or both) at most with reversible pulpitis [1]. There are three viable options of vital pulp therapy, namely indirect pulp capping, direct pulp capping, and pulpotomy [1–3]. The superiority of any of these therapies has not been established due to lack of case-control studies [1] and the low quality of existing evidence [2].