Clinical, radiographic and histologic analysis of the effects of pulp capping materials used in pulpotomies of human pri

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ORIGINAL SCIENTIFIC ARTICLE

Clinical, radiographic and histologic analysis of the effects of pulp capping materials used in pulpotomies of human primary teeth T. M. Oliveira • A. B. S. Moretti • V. T. Sakai • N. Lourenc¸o Neto • C. F. Santos • M. A. A. M. Machado R. C. C. Abdo



Received: 22 February 2012 / Accepted: 12 July 2012 / Published online: 3 April 2013 Ó European Academy of Paediatric Dentistry 2013

Abstract Aim To compare the clinical, radiographic and histological responses of the pulp to mineral trioxide aggregate (MTA), calcium hydroxide (CH) and Portland cement (PC) when used as a pulpotomy agent in human primary teeth. Study design Forty-five mandibular primary molar teeth were randomly assigned to CH, MTA or PC groups and treated by pulpotomy technique. Methods The teeth were treated by conventional pulpotomy technique, differing only in the capping material for each group. Clinical and radiographic evaluations were recorded at 6-, 12- and 24-month follow-up. Teeth in the regular exfoliation period were further processed for histologic analysis. Statistics Data were tested using parametric tests at a significance level of 5 %. The histological results were expressed descriptively. Results Clinically and radiographically, the MTA and PC groups showed 100 % success rates at 6, 12 and 24 months. In CH group, several teeth presented clinical and radiographic failures detected throughout the followup period, and internal resorption was a frequent T. M. Oliveira (&)  M. A. A. M. Machado  R. C. C. Abdo Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of Sa˜o Paulo, Alameda Dr. Octa´vio Pinheiro Brisolla, 9-75, Bauru, Sa˜o Paulo 17012-901, Brazil e-mail: [email protected] A. B. S. Moretti  V. T. Sakai  N. Lourenc¸o Neto Department of Pediatric Dentistry, Federal University of Alfenas, Alfenas, Brazil C. F. Santos Department of Biological Sciences, Bauru School of Dentistry, University of Sa˜o Paulo, Sa˜o Paulo, Brazil

radiographic finding. Histologic analysis revealed the presence of dentine-like mineralised material deposition obliterating the root canal in the PC and MTA groups. CH group presented, in most of the sections, necrotic areas in the root canals. Conclusions MTA and PC may serve as effective materials for pulpotomies of primary teeth as compared to CH. Although our results are very encouraging, further studies and longer follow-up assessments are needed in order to determine the safe clinical indication of Portland cement. Keywords Mineral trioxide aggregate  Calcium hydroxide  Portland cement  Primary teeth  Pulpotomy

Introduction Pulpotomy of primary teeth has been the treatment of choice in cases of inflammation of the coronal pulp caused by caries or trauma with no involvement of the radicular pulp, thus avoiding the premature loss of the teeth (Fuks 2006; Fuks and Papagiannoulis 2006; Seale and Coll 2010). Not only is the diagnosis of the inflamed dental pulp required for this therapy to succeed, but also the selection of a