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In cases of deep caries or trauma of primary teeth, pulpotomy is the procedure of choice to preserve pulp vitality and the teeth. This study aimed to evaluate the histological analysis and CD31 immunolocalization after pulpotomy using Mineral Trioxide Aggregate or Portland cement in human primary teeth.
Twenty mandibular primary molars were divided into two study groups: G1 — Mineral Trioxide Aggregate and G2 — Portland cement. After conventional pulpotomy, clinical and radiographic follow-up, teeth at the regular exfoliation period were extracted for histological analysis and CD31 immunolocalization.
The statistical analyses were performed by Kruskal-Wallis followed by Dunn test (P < 0.05). No statistically difference regarding inflammation and blood vessels amount (P > 0.05) were found between groups. The immunohistochemistry analysis revealed positive CD31 expression in the blood vessels of both studied groups.
Group 1 showed mainly small blood vessels, while Group 2 exhibited larger blood vessels spread throughout the remaining pulp tissue not related to inflammatory infiltrate. Both materials behaved histologically similar regarding pulp inflammation and vascularization with intense CD31 positivity on the wall of blood vessels.
Thais Marchini Oliveira, DDS, MsC, PhD, Associate Professor, Brazil done research on Histological and CD31 Immunolocalization after Pulp Therapyusing Mta or Portland Cement. This research article published in International Journal of Dentistry and Oral Science (IJDOS).
The study protocol was approved by the Institutional Review Board regarding ethical aspects (protocol #121/2009). The clinical procedure, associated risks and benefits were fully explained to the parents or legal guardians of the children. Written informed consent was obtained from the parents or legal guardians of the participants prior to investigation. All the children were screened by taking a detailed history and performing a thorough clinical and radiographic examination.
A total of 20 primary molar teeth in 17 patients were assessed for the study following the inclusion criteria: primary mandibular first or second molars compromised by deep caries with the possibility of proper restoration, vital pulp with no fistula or abscess, absence of internal or external root resorption at radiographic examination, and intraoperatively, only when hemostasis was adequately achieved within 5 minutes after coronal pulp amputation. Exclusion criteria were related to the presence of systemic pathology and history of allergic reaction to local anesthetics or some of the constituents of the dressing materials.
All selected teeth were divided into the two study groups depending on the capping material used on the pulpotomy: MTA or PC. After local anesthesia and rubber dam isolation, caries removal was accomplished with hand piece with a round bur and the opening of the pulp chambers was conducted with high speed and round carbide bur. Coronal pulp tissue was amputated manually with an excavator, followed by irrigation with saline solution until bleeding ceased. These procedures were performed by two previously calibrated pediatric dentists, at one single session as described previously.
The amputated pulp stumps and chamber floor were covered with MTA (Angelus, Londrina, PR, Brazil) or PC (Votorantim-Cimentos, São Paulo, SP, Brazil), according to the respective groups. All teeth were restored with reinforced zinc oxide-eugenol (IRM, Dentsply, Petropolis, RJ, Brazil) followed by resin-modified glass ionomer cement (Vitremer, 3M ESPE, São Paulo, SP, Brazil). Then, the patients were dismissed and recalled at periodic followups at three-month intervals, until the treated teeth achieved the regular exfoliation period to be extracted for histological and immunohistochemistry analysis.
Histological Preparation
Following postoperative intervals, the teeth were extracted and immediately fixed in 10% neutral formalin solution for 24 hours, and decalcified in 4% EDTA solution for 45–60 days. Subsequently, each tooth was embedded in paraffin wax and 5 μm-thick serial sections were obtained and stained with hematoxylin and eosin. The histological evaluation was made under a light microscope (Carl Zeiss, Oberkachen, Germany) and based on the scores previously described for inflammation [14]: 0 (none); 1 (mild); 2 (moderate); 3 (intense); and 4 (necrosis); and vascularization: 0 (absent); 1 (regular amount of blood vessels); and 2 (great amount of blood vessels). The data obtained were subjected to statistical analysis by Kruskall-Wallis followed by Dunn test to determine statistically significant differences (P < 0.05).
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Journal Reference: International Journal of Dentistry and Oral Science (IJDOS).
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