title: Adverse effects of human pulps after direct pulp capping with the different components from a total-etch, three-step adhesive system. Clinical and histological evaluation of white ProRoot MTA in direct pulp capping. Dentine sialoprotein and collagen I expression after experimental pulp capping in humans using emdogain gel. Clinical and Histological Evaluation of Direct Pulp Capping on Human Pulp Tissue Using a Dentin Adhesive System Comparison of CaOH with MTA for Direct Pulp Capping Direct Pulp Capping with Calcium Hydroxide, Mineral Trioxide Aggregate, and Biodentine in Permanent Young Teeth with Caries: A Randomized Clinical Trial Effects of diode laser on direct pulp capping treatment Pulp capping: advantages of using laser technology. Clinical assessment of mineral trioxide aggregate (MTA) as direct pulp capping in young permanent teeth. Calcium Hydroxide vs. Mineral Trioxide Aggregates for Partial Pulpotomy of Permanent Molars with Deep Caries Direct capping of human pulps with a dentin bonding system or with calcium hydroxide cement. Response of human dental pulp capped with biodentine and mineral trioxide aggregate. Pulpal Responses to Direct Capping with Betamethasone/Gentamicin Cream and Mineral Trioxide Aggregate: Histologic and Micro-Computed Tomography Assessments. Histological evaluation of mineral trioxide aggregate and calcium hydroxide in direct pulp capping of human immature permanent teeth. Dental pulp capping: effect of Emdogain Gel on experimentally exposed human pulps. 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. Influence of rubber dam isolation on human pulp responses after capping with calcium hydroxide and an adhesive system. Evaluation of two mineral trioxide aggregate compounds as pulp-capping agents in human teeth. Partial pulpotomy on caries-free teeth using enamel matrix derivative or calcium hydroxide: a randomized controlled trial. A randomized controlled study of the use of ProRoot mineral trioxide aggregate and Endocem as direct pulp capping materials.
abstract: OBJECTIVES The objective was to evaluate the response of human pulps capped with different components from a total-etch three-step adhesive system . METHODS Direct pulp capping was performed in 25 caries-free human premolars scheduled for extraction due to orthodontic treatment . The teeth were r and omly divided in five groups , and capped with the following material s : Group 1-acid+primer+adhesive were used as recommended ; Group 2-only primer was applied ; Group 3-only bonding resin ( light-cured for 10s ) ; Group 4-only composite resin ( light-cured for 40s ) ; Group 5-calcium hydroxide . After capping , all teeth were restored with ScotchBond Multi Purpose Plus and Z-100 was placed incrementally . After 60 days , the teeth were extracted and processed for light microscopic examination ( H/E ) according to a histological score system . These were subjected to non-parametric tests ( alpha<0.05 ) . RESULTS Overall , the histological features showed that groups 1 - 4 were quite similar and inferior to group 5 . In groups 1 - 4 the pulp response varied from acute inflammatory cell infiltrate with varying degrees to necrosis . The groups 3 and 4 showed a trend towards better pulp response , since a normal connective tissue could be observed in more than half of the sample . All teeth from group 5 showed normal connective tissue below an amorphous dentin bridge . SIGNIFICANCE Adhesive components ( primer or adhesive ) as well as a composite should be avoided for pulp capping . Ca(OH)(2 ) should be the first choice for pulp capping PURPOSE To evaluate the clinical , radiographical and histological findings in human third molars in which mechanical pulp exposures were capped with white ProRoot mineral trioxide aggregate ( WMTA ) . METHODS Forty-eight human third molars , caries-free or with incipient caries , scheduled to be extracted , were used and r and omly divided into two groups : Group A : ( n= 24 ) received WMTA and control Group B : ( n= 24 ) received chemical set calcium hydroxide ( Dycal ) . The teeth were isolated with rubber dam and Class I cavities prepared . Pulp exposure was performed using a sterile diamond bur and confirmed by frank bleeding . A sterile cotton pellet dipped in saline solution was placed over the exposure for 60 seconds . The preparation was then lightly rinsed with water and gently air-dried . WMTA or CH was placed over the exposure site followed by a small amount of a light-cured compomer . After etching with 35 % phosphoric acid gel for 15 seconds , rinsing and blot drying , Prime and Bond NT adhesive was applied and light-cured . The cavity was then restored with a resin composite and light-cured . Evaluations were performed by phone after 7 days and clinical ly at 30 + /- 5 and 136 + /- 24 days , using st and ardized tests and radiographs . The teeth were extracted after 136 + /- 24 days ; the roots were cut + /- 4 - 5 mm from the apex to allow for rapid fixation in 10 % neutral buffered formalin . They were then processed for routine histological evaluation , embedded in paraffin , sectioned and stained with hematoxylin and eosin and Brown and Brenn for recognition of bacteria . Statistical analyses were performed using a Mann-Whitney U-test , a Chi-square test , a Fisher 's exact test and an ANOVA . RESULTS No significant differences in post-operative sensitivity were reported after 7 days between the two material s ( P > 0.05 ) . Clinical examination demonstrated no significant differences at 30 + /- 5 days ( P > 0.05 ) and at 136 + /- 24 days ( P > 0.05 ) . Histological findings : 45 of 48 teeth were suitable for microscopic evaluation ( 22 with WMTA and 23 with CH ) . Twenty from the WMTA and 18 from the CH group had developed a bridge . No statistically significant differences were found for superficial and deep inflammatory cell response ( P > 0.05 ) , presence of a dentin bridge ( P > 0.01 ) , and pulp vitality ( P > 0.01 ) , between WMTA and calcium hydroxide . A statistically significant difference was found for the diameter of exposure ( P < or = 0.05 ) between WMTA ( x= 0.35 + /- 0.19 mm ) and CH ( x= 0.25 + /- 0.09 mm ) . Only a minimal association between clinical and histological findings could be established for either material AIM To characterize the hard tissue formed in human teeth experimentally pulp capped either with calcium hydroxide or with Emdogain Gel  ( Biora AB , Malmö , Sweden ) - a derivative of enamel matrix ( EMD ) , using two markers for dentine ; dentine sialoprotein ( DSP ) and type 1 collagen ( Col I ) . METHODOLOGY Affinity-purified rabbit anti-Col I and anti-DSP polyclonal antibodies were used to stain histological sections from nine pairs of contra-lateral premolars that had been experimentally pulp amputated and r and omly capped with EMDgel or calcium hydroxide .  Twelve weeks after the teeth had been pulp capped , they were extracted , fixed , demineralized and serially sectioned prior to immunohistochemical staining . RESULTS In the calcium hydroxide treated teeth DSP was seen in the new hard tissue which formed a bridge . DSP was also seen in the newly formed hard tissue in the EMDgel-treated teeth . Proliferated pulp tissue partly filled the space initially occupied by EMDgel and DSP-stained hard tissue was observed alongside exposed dentine surfaces as well as in isolated masses within the proliferated pulp tissue , although the new hard tissue did not cover the pulp exposure . DSP staining was also seen in the cells lining the hard tissue in both groups . Col I staining was seen in the newly formed hard tissue in both groups . CONCLUSIONS The new hard tissue formed after pulp capping with EMDgel or calcium hydroxide contained DSP and Col I , considered to be markers for dentine . Thus , the newly formed hard tissue can be characterized as dentine rather than unspecific hard tissue 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 This practice -based , r and omized clinical trial evaluated and compared the success of direct pulp capping in permanent teeth with MTA ( mineral trioxide aggregate ) or CaOH ( calcium hydroxide ) .  Thirty-five practice s in Northwest PRECEDENT were r and omized to perform direct pulp caps with either CaOH ( 16 practice s ) or MTA ( 19 practice s ) . Three hundred seventy-six individuals received a direct pulp cap with CaOH ( n = 181 ) or MTA ( n = 195 ) . They were followed for up to 2 yrs at regular recall appointments , or as dictated by tooth symptoms . The primary outcomes were the need for extraction or root canal therapy . Teeth were also evaluated for pulp vitality , and radiographs were taken at the dentist ’s discretion . The probability of failure at 24 mos was 31.5 % for CaOH vs. 19.7 % for MTA ( permutation log-rank test , p = .046 ) . This large r and omized clinical trial provided confirmatory evidence for a superior performance with MTA as a direct pulp-capping agent as compared with CaOH when evaluated in a practice -based research network for up to 2 yrs ( Clinical Trials.gov NCT00812887 ) 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 At the present time , evidence -based , best practice s have yet to be established for maintaining the vitality of teeth by managing caries-associated pulp exposure in permanent teeth . In terms of biomechanical and esthetic considerations , pulp capping has proven to be more effective than root-canal therapy . Given the low success rate of conventional methods , new techniques , such as laser-assisted repairs , should be developed . The purpose of this study was to compare the effectiveness of conventional and diode laser-assisted methods  in direct pulp capping of carious teeth . Ten patients ranging in age from 12 to 40 were assigned r and omly to experimental and control groups in this clinical trial in which the participants ’ teeth were treated with different techniques , i.e. , conventional treatment and diode 808-nm , laser-assisted treatment . For each of these groups , five cases were chosen for treatment with the same method under rubber dam isolation . The data were analyzed by the runs test using SPSS software . The success rate was significantly different between conventional ( 60 % ) and diode 808-nm , laser-assisted ( 100 % ) groups after one year ( P > 0.05 ) . The laser-assisted procedure proved to be more effective than the  conventional technique in enhancing the outcomes of pulp-capping therapy in carious exposures AIM Pulp capping represents the boundary between conservative and endodontic therapy . The importance of this technique , which considerably improves the prognosis of the tooth , justifies the quest for new techniques and technologies : the most recent literature reports more predictable results ( approximately 90 % ) with cappings performed using laser of different wavelengths , compared to traditional procedures , which report a success rate of approximately 60 % . The purpose of this work is to assess the efficiency of laser technology combined with the use of a self-hardening calcium hydroxide base in pulp capping procedures performed on decayed permanent teeth . MATERIAL S AND METHODS This study was carried out on 34 patients , aged between 11 and 18 years ( average 14,5 ) who needed pulp cappings for deep caries affecting permanent teeth ( 8 front and 26 back ) . They were divided into three groups based on the operative protocol employed : traditional technique , laser-assisted technique using Er , Cr : YSGG lasers ( 2780 nm ) and laser assisted technique using Erbium : YAG lasers ( 2940 nm ) ; all patients were asked to return for follow-up visits ( anamnesis , vitality testing and intraoral x-ray ) scheduled at 1 , 3 , 6 , 12 months , 2 and 4 years ; other 30 cases on adult patients ( 19 to 40 years , average 27,1 ) , treated with the same methods , were used as control group . RESULTS Traditional technique group showed a success of 63 % ( adult control group 50 % ) ; Er , Cr : YSGG laser-assisted technique showed a success rate of 80 % ( adult control group 80 % ) ; Erbium : YAG lasers laser-assisted technique showed a success rate of 75 % ( adult control group 70 % ) . All age groups had good success rates with the pulp capping technique , regardless of the technique used . CONCLUSION Laser technology proved effective in improving the prognosis of pulp capping procedures on teeth affected by deep caries pathology 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 Aim : To prospect ively compare the clinical success rate of partial pulpotomy treatment in permanent molars using calcium hydroxide ( CH ) and mineral trioxide aggregates ( MTA ) as pulp dressing agents . Methods : Restorable permanent first molars ( 64 ) with carious pulp exposures were r and omly assigned to two groups ; CH and MTA . A st and ardized operative procedure was followed in both groups . Following isolation and caries removal , the exposed superficial pulp tissue layers were removed with a sterile flame shape diamond bur to a depth of 2–4 mm . Bleeding was controlled and pulp dressed with either a paste of non- setting Ca(OH)2 followed by a setting layer of Ca(OH)2 , or with grey MTA . The dressing material s in both groups were then covered with a layer of light cured glass ionomer cement . The teeth were either restored using amalgam , or where grossly carious with preformed metal crowns . Patients were scheduled for follow-up at 3 , 6 , 12 months and annually thereafter . Results : There were 34 patients ( 17 males and 17 females ) with 51 teeth available for evaluation . The age of patients at the time of restoration ranged between 6.8 to 13.3 years ( mean of 10.3 ±1.8 years ) . The follow-up period ranged from 25.4 to 45.6 months with an average of 34.8 ± 4.4 months . There was no statistically significant difference in the success rate of teeth treated with CH ( 91 % ) in comparison to teeth treated with MTA ( 93 % ) . Radiographically , a hard tissue barrier under CH was noticed in 12 ( 55 % ) teeth compared with 18 ( 64 % ) teeth under MTA ( p=0.4 ) . Conclusions : MTA has clinical success rate comparable to CH as a pulp dressing material for partial pulpotomy in permanent molars with carious OBJECTIVE To study human pulp reactions to direct cappings with a dentin adhesive compared with a calcium hydroxide cement , especially with respect to formation of hard tissue in the exposure site . STUDY DESIGN Direct pulp cappings were made in 34 caries-free premolars scheduled for extraction due to orthodontic treatment . Half of the teeth were capped with a dentin adhesive , the other half with a calcium hydroxide cement . After periods of from 7 to 70 days , the teeth were extracted and processed for light microscopical examination . RESULTS No postoperative sensitivity was experienced . A slight inflammatory reaction was seen in both groups in the short observation period . In the long observation period , significantly more " dentin bridging " was seen in the calcium hydroxide group than in the dentin adhesive group ( P < .05 ) . CONCLUSION The findings from the present limited material is in accordance with previous findings from human studies and contraindicate use of dentin adhesives for direct pulp capping 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 INTRODUCTION This clinical trial was conducted to evaluate the response of human dental pulp to direct capping with betamethasone/gentamicin ( BG ) cream and mineral trioxide aggregate ( MTA ) . We hypothesized that the results of direct pulp capping with a topical BG combination would be similar to or better than those with MTA . METHODS Thirty-six human first premolar teeth scheduled for orthodontic extraction were r and omly divided into 4 groups : BG1 group ( n = 9 ) , BG cream with 2-week follow-up ; BG2 group ( n = 10 ) , BG cream with 8-week follow-up ; MTA1 group ( n = 8) , MTA with 2-week follow-up ; and MTA2 group ( n = 9 ) , MTA with 8-week follow-up . Teeth were extracted and evaluated at respective time intervals . Micro-computed tomography scanning and histologic analyses were performed for all specimens . Pulp pathology ( inflammation , pulp abscesses , and pulp necrosis ) and reparative reaction ( formation of dentin bridges ) were recorded . RESULTS Both BG cream and MTA result ed in significantly better pulpal responses at 8 weeks than at 2 weeks . Dentin bridge formation was significantly thicker in the MTA group at 8 weeks than in any other group ( P < .05 ) . Inflammation was of the acute type in all groups ; no statistically significant differences in the distribution of inflammatory cells were found among the groups . Pulpal abscesses and /or necrosis were observed more often in teeth capped with BG than with MTA . CONCLUSIONS Direct pulp capping with both BG cream and MTA was associated with dentin bridge formation . MTA result ed in a significantly better pulpal response , with less inflammation and a thicker dentin bridge at 8 weeks 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 AIM To investigate the effect of Emdogain Gel ( Biora AB , Malmo , Sweden ) , consisting of a enamel matrix derivative ( EMD ) in a propylene glycol alginate ( PGA ) vehicle , on experimentally exposed human pulps and to register postoperative symptoms . METHODOLOGY Nine pairs of contralateral premolars scheduled for extraction on orthodontic indications were included . Following a superficial pulp amputation performed with a small ( 016 ) diamond bur , either EMDgel or a mix of calcium hydroxide and sterile saline was placed at r and om in contact with the pulp wound . The subjects made records of symptoms and were also interviewed about pain/discomfort by a blinded examiner . After 12 weeks the teeth were extracted , prepared and subjected to light microscopic examination in which the inflammation and newly formed hard tissue in the pulp were analysed . Immunohistochemistry was performed using affinity-purified rabbit anti-EMD polyclonal antibodies . RESULTS Postoperative symptoms were less frequent in the EMDgel-treated than in the calcium hydroxide-treated teeth , especially during the first six weeks . In the EMDgel-treated teeth , new tissue partly filled the space initially occupied by the gel and hard tissue was formed alongside the exposed dentine surfaces and in patches in the adjacent pulp tissue .  EMD  was detected in the areas where new hard tissue had been formed . The wound area of the EMDgel-treated teeth exhibited inflammation in the majority of the teeth whereas less inflammation was seen in the calcium hydroxide-treated teeth where the hard tissue was formed as a bridge . CONCLUSIONS In the EMDgel-treated teeth , postoperative symptoms were less frequent and the amount and pattern of hard tissue formation were markedly different than in the teeth treated with calcium hydroxide . However , the operative procedure and the formulation with EMD in a PGA vehicle do not seem to be effective for the formation of a hard tissue barrier 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 OBJECTIVE The objective was to evaluate the influence of rubber dam isolation on the response of human pulps capped with calcium hydroxide and an adhesive system . METHODS AND MATERIAL S Direct pulp capping was performed in 40 caries-free human premolars scheduled for extraction as part of orthodontic treatment . The teeth were r and omly divided into 8 groups ( n = 5 ) according to the combination of treatment factors : capping agent ( adhesive resin or calcium hydroxide ) , isolation ( rubber dam or cotton pellets only ) , and period of evaluation ( 30 or 60 days ) . Class 2 cavities were prepared , and pulp exposures were created on the occlusal floor . After capping , all teeth were restored with Z-100 placed incrementally . After 30 or 60 days , patients were asked about their symptoms , teeth were extracted , and serial sections were evaluated . The data were subjected to a nonparametric test . RESULTS Overall , the histologic features showed that the pulp response was worse for groups capped with adhesive . For adhesive-capped groups , the pulp response varied from pulp necrosis to acute inflammatory cell infiltrate , and most of the pulps capped without rubber dam isolation showed severe inflammatory cell infiltrate involving the coronal pulp with chronic abscesses . For the calcium hydroxide groups , all specimens showed dentin bridge formation , regardless of the type of isolation used . CONCLUSION Calcium hydroxide should be used as the material of choice for pulp capping with or without rubber dam isolation . The use of adhesive systems in vital pulp capping is contraindicated , especially if rubber dam isolation is not implemented 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 effect of enamel matrix derivative ( EMD ) and calcium hydroxide [ Ca(OH)(2 ) ] on exposed human pulp . METHODOLOGY Fifteen pairs of human contralateral premolars were intentionally and partially pulpotomized . The exposed pulps were r and omly capped with either EMDgel ( Emdogain ) or a mix of Ca(OH)(2 ) and sterile water . The subjects recorded pain or discomfort during the first 10 days and were also interviewed and examined by a blinded examiner at 1 day , 2 weeks , 3 and 6 months post-operation . Periapical radiographs were taken prior to the operation , and 3 and 6 months post-operation . After 6 months , the teeth were extracted and processed for histological evaluation . The data were described and analysed using McNemar test and Kaplan-Meier survival analysis . RESULTS The EMDgel-treated teeth had significantly less tooth hypersensitivity than the Ca(OH)(2)-treated teeth during the first 2 weeks ( P = 0.031 ) but were not significantly different after 2 weeks ( P = 0.125 ) . No detectable periapical radiographic changes were observed in any teeth and radiographic evidence of dentine bridge formation from both groups were not significantly different during the follow-up periods ( P > 0.05 ) . Histological evaluation demonstrated that the Ca(OH)(2)-treated teeth had less inflammation and more dentine bridge formation than those in the EMDgel-treated teeth . CONCLUSIONS After 6 months , healthy pulps capped with Ca(OH)(2 ) had more favourable results than counterparts capped with EMDgel . However , similar clinical and radiographic results were seen in both groups 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
target: 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
background: 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 .