Several in vitro studies have demonstrated that these show considerable anti-bacterial activity [42–44]. Prior to reclamation the runoff from the site caused flooding along roadways and waterways in the general area of the coal refuse material. Dental materials have an important role within endodontics. It was then separated by layering atop the 11 + 62% CsCl gradient with centrifugation for 20 min. Commonly used irrigants and intracanal medicaments include 0.5% sodium hypochlorite solution (as a disinfectant or antimicrobial), EDTA (as a chelating agent and lubricant), chlorhexidine (antimicrobial), non-setting calcium hydroxide (as an antibacterial agent), and some antibiotics and anti-inflammation drugs (non-setting Ledermix paste). While many dentists are hesitant to perform direct pulp capping procedures due to previously unpredictable results with conventional materials, MTA is a more predictable and reliable material for direct pulp capping teeth, with reversible pulpitis, as borne out by numerous clinical and histological studies. The material has been evaluated as unbound, hydraulically bound and bituminous bound forms. Table 6.1. The pulp is not exposed - a layer of infected dentine is … The calcium hydroxide sealer Apexit, for example, was found to have a high solubility when set compared with other types of endodontic sealer [39] and, in some studies, sealer particles have been found to occur with the tissues at a considerable distance from the sample [40,41]. Life is a hard-set calcium-hydroxide base indicated for use as a direct and indirect pulp-capping material and as a cement base for all restorative filling materials. Tronstad L, Mjör IA. Harold R. Stanley, LIDS, MS,” Gainesville, Fla. Water percolating through the piles produces the same type of acidic leachate present in the unreclaimed mines discussed in the last section, but low-permeability stabilized FGD has been shown to be an effective capping material, providing a barrier to the salt and acid migration from the toxic coal refuse to the surface and to limit the surface water infiltration into the pile. Consequently, the exposed pulp does not become infected or inflamed. Direct pulp coverage is a minimally invasive procedure, to perform this type of treatment we must first evaluate the case based on clinical and radiographic data, whether a direct pulp coverage or a root canal treatment is needed. In the past decade, there has been a debate on the best available material to be used in direct pulp capping. However, because of the association of some cases of contact allergy, onychodystrophy, and eczema with ethyl-2-cyanoacrylatenone, these compounds have been accepted as a practicable technique [62]. Practice Implications.Vital pulp therapy using MTA is a treatment option for teeth diagnosed with a condition no more severe than reversible pulpitis. Is it worth it? direct contact with) pulp, their use as direct pulp capping agents is generally contraindicated in the literature.1,29,37,38 Clearly, the remaining dentin thickness, which is very difficult to access clinically, has an effect on the pulpal response to any indirect pulp capping material.38 The … Established brands continue to be made available for practitioners, and clearly find favour with certain members of the profession. The physical properties of calcium hydroxide materials are acceptable for their use as endodontic sealers. Practice Implications.Vital pulp therapy using MTA is a treatment option for teeth diagnosed with a condition no more severe than reversible pulpitis. 10. Indirect Pulp Cap. Direct pulp capping with an adhesive resin on an exposed pulp has been suggested, provided that marginal microleakage can be prevented together with a composite resin to restore the tooth (Olmez et al., 1998, Paineijer and Stanley, 1998; Liebenberg, 1997). Consequently, it shares with MTA the features of being both bactericidal and bioactive. The most surprising piece of information regarded the removal of all the affected dentin prior to pulp capping. This was first introduced to dentistry in 1921 [ 11 ], and it is probably the most highly regarded of the available materials. Aim of the study was to evaluate and compare clinical and radiographic success with MTA and calcium hydroxide as direct pulp capping materials in cariously exposed mandibular molars. (B) Reclaimed site with FGD pond liner. Due to space limitations, details of these materials will not be discussed here. By and large, dentists use what they know, are comfortable with, and … It is composed of resin and calcium silicate. These cements include zinc oxide-eugenol cements, calcium hydroxide-containing sealers, glass-ionomer cements, polymers, and mineral trioxide aggregate, etc. Chicago/Turabian Style It can be used as a replacement for calcium It is evident that the bottom ash exhibits low susceptibility to sulphate attack, with soundness loss values ranging from 1.1% to 5.4%, which fall well below the 10% and 12% limits in Chinese and American standards, respectively. In an investigation, specific clustering of two or three NPs has been done by encapsulating the assembled AuNP clusters with polystyrene-block-poly(acrylic acid), which is still imperfect until the high purity products are isolated. Scheme of the technique of direct pulp cap-ping “step by step” As a pulp capping material we used mineral triox-ide aggregate (MTA) which is recommended and applied in many newly published scientific studies. This exposure may be due to a mechanical trauma after an accident or tooth fracture; or the pulp may be exposed during a cavity cutting procedure in the dental office. Using triblock copolymer coating, QDs modified with prostate tumor targeting ligands were used to tag injected cancer cells as well as to locate tumors and in mice using a whole-body illumination system with spectral QD imaging.59 Polyethylene glycol–phosphatidylethanolamine (PEG–PE) and PEG-phosphatidylcholine modified CdSe/ZnS-QDs were used to image Xenopus embryo development. Trial projects have been undertaken with SSA in bituminous bound road pavement layers in Japan and quite extensively in the United States in the 1980s and 1990s, though it appears that this has been discontinued. Portland cement has been used as an apical plug material, for perforation repair, as root end filling material, for pulp capping and pulpotomy in several studies. Modification of nonmagnetic molecules and ions using chelators such as glutathione and dopamine to superparamagnetic particles has been demonstrated to immobilize and preconcentrate with chemical extraction plus magnetic recovery. Next, the chamber is evacuated (10−5 mbar) and the Q factor of the sealed resonator is monitored over time. For this, 15 nm AuNP (14.6 ± 1.6) were prepared by citrate reduction with narrow size distribution. In 1970, Langer et al. Though these are not target limits, this suggests that the use of SSA in this form may need some restrictions. 30. SSA is not best suited to use on its own in these applications, though it could possibly be useful in combination with a coarser subbase or capping material, as a filler to improve the grading. Finally a 0.2 m growing medium consisting of composted yard waste, spoil, and FGD covered the site. Indeed, it is claimed that Biodentine itself can be used in its own right as a liner, for example, in the open-sandwich technique [21]. I. It is by far the oldest type of calcium hydroxide and has a long history of clinical success. Mineral trioxide aggregate, MTA, has also been used as a direct pulp capping material, though its primary use in dentistry as an endodontic sealer [18]. 2019; 12(20):3382. Hawes, Continued evaluation of direct and indirect pulp capping J Dent Res 43: (1964) 808- 11. The cement is used to act as a liner to provide a reliable seal against the ingress of bacteria, and is needed because calcium hydroxide alone is unable to provide an adequate seal [1]. As a fine aggregate in concrete slabs, SSA had no significant effect on the tested properties of skid resistance, freeze–thaw resistance and run-off and infiltration behaviour, achieving performances comparable to that of the control. Most likely, another reason for the widespread use of calcium hydroxide as a direct pulp capping agent on vital exposures is because this is the technique most dentists were taught in dental school. Materials Used for Direct Pulp Capping: MTA – Mineral Trioxide Aggregate Calcium hydroxide – Calcium Enriched Mixture Pulp-capping Material Life is a hard-set calcium-hydroxide base indicated for use as a direct and indirect pulp-capping material and as a cement base for all restorative filling materials. Calcium hydroxide materials have variable setting times. biocompatibility, radiopacity, sealing ability, low solubility, A direct pulp cap is done on permanent teeth when the removal of deep decay results in exposing the pulp. Direct pulp capping in an immature incisor using a new bioactive material Sham S. Bhat , Sundeep K. Hegde , Fardin Adhikari , and Vidya S. Bhat 1 Department of Paedodontics and Preventive Dentistry, Yenepoya Dental College, Mangalore, Karnataka, India Rehoboth reclamation site. 8); Cavit-G was then placed over this to serve as a provisional restorative material, and seven days after the procedure the patient was evaluated to 9. Gutta-percha point is one of the application of gutta-percha, warm lateral or vertical condensation can be applied to it to soften and compact it. Advantages of a successful direct pulp capping are numerous, including the avoidance of more extensive treatment, such as root canal treatment or extraction. When the pulp tissue is actually exposed, a direct pulp capping procedure can be performed. The resilient modulus was 10–25% lower with SSA as a complete filler compared to limestone. Alex G. Direct and indirect pulp capping: a brief history, material innovations, and clinical case report. • 2- Mineral Trioxide Aggregate MTA. Resin-Modified Calcium Silicate Pulp Protectant/Liner TheraCal LC is a light-cured, resin-modified calcium silicate filled liner designed for use in direct and indirect pulp capping and as a protective liner under composites, amalgams, cements, and other base materials. The direct pulp cap, in which a material is placed directly over the exposed pulp tissue, has been suggested as a way to promote pulp healing and generate reparative dentin. Zinc oxide-eugenol released eugenol at concentrations capable of damaging pulp cells [22,23], resin-modified glass-ionomer led to chronic inflammation of the pulp that persisted for at least 300 days following placement, and dental adhesives were also been shown to be cytotoxic [24,25]. (© 2011, IEEE. Copyright © 2021 Elsevier B.V. or its licensors or contributors. (a) Schematic cross-section of the test structure, (b) Measured Q as a function of time during evacuation of a He-filled cavity, for two different lengths of the diffusion path. Leakage appears to be related to both the solubility of the material and the questionable adhesion to both the dentine walls and the gutta percha points. 18 A successful pulp cap has a vital pulp and a dentin bridge within 75 to 90 days. Buy Now; Documentation; More Info. Materials and methods. If successful, this procedure precludes the need for more invasive, more extensive and more expensive treatment. Int J Clin Exp Med. All the steps of this procedure are important, but the most important, in ,y opinion, is the isolation of the operative field. One of the main disadvantage of calcium hydroxide is the formation of tunnel defects within the newly formed dentin bridge thereby creating a pathway for microbial invasion. However, the pulpal response appears as unpredictable dentin bridging, and diminished inflammation was documented in the literature. Control bleeding with water or saline. This systematic review is reported using the PRISMA guidelines (Moher et al. Materials Used in Direct and Indirect Pulp Capping Historically, calcium hydroxide (Ca(OH)2) has been considered the gold standard.Long term clinical observations of calcium hydroxide are incomparable to any other bioactive material, as the Capping of the inflamed pulp. However, there was one set of test samples, taken from a plant in the United States (Chandler et al., 1997), that exhibited exceptionally high soundness losses ranging from 10.38% to 14.32% and, as such, surpassed the acceptable limit. The setting versions of calcium hydroxide materials can be either self-cured or light-cured versions, though light-cured materials are not recommended for direct pulp capping. Study was conducted in Post Graduate Institute of Dental Sciences, Rohtak in … Before any endodontic treatment we must always consider the possibility of direct coverage of the pulp. If pulp tissue is exposed, bleeding will occur from the pulp. Direct Pulp capping is done mostly when there is accidental exposure of Pulp either by any Trauma or by accidental exposure by the dentist. Van Hassel HJ. The solution was linearly aggregated by NaCl and isolated by centrifugation. On the other hand, if there is a direct exposure to the pulp, treatment with direct pulp capping requires careful and specific selection of the pulp capping material. Compared with the traditional material of calcium hydroxide, it has superior long-term sealing ability and stimulates a higher Figure 2 Direct pulp-capping technique [9]. The treatment options for a pulp-exposed permanent tooth include direct pulp capping (DPC), pulpotomy, and pulpectomy. Direct pulp capping involves placing a pulp capping material directly over the exposed pulp with the aim of promoting pulp healing and the generation of reparative dentine [1]. Resin-Modified Calcium Silicate Pulp Protectant/Liner TheraCal LC is a light-cured, resin-modified calcium silicate liner designed for use in direct and indirect pulp capping, as a protective liner under composites, amalgams, cements, and other base materials. Another example of the application of SEC as an efficient nanoseparation technique is the purification of monomer AuNPs from NPs dimers, trimers, and tetramers, which are covalently bonded to phenylethynyl di-, tri-, and tetrathiols. Pulp capping: Conserving the dental pulp-Can it be done? An example of stabilized FGD as a cap material is the Rehoboth refuse pile, which was a 24 ha coal waste site located in Perry County, Ohio. Direct pulp capping is generally performed using calcium hydroxide as the main material. However, this approach is controversial, because the alkalinity is potentially damaging to the gingiva, and the material would be expected to erode quickly. The overall conclusion is that no material approaches the performance of either calcium hydroxide or calcium silicate materials in this application and that, of the two, non-setting calcium hydroxide remains the best understood and successful material for direct pulp capping. Our aim is to evaluate the effects of an injectable silver-doped bioactive glass/chitosan hydrogel (Ag-BG/CS), as a pulp-capping material, and explore the molecular … Direct Pulp Caps. In the present study, 3 capping materials were used and compared in terms of promoting pulp … The most widely used canal-filling material is gutta-percha. Coal refuse piles are comprised mainly of the coal shales that encased the coal seam prior to the coal extraction. In addition to gutta-percha, sealer cements are also needed in root canal filling procedures. There is evidence that the pulp is more likely to survive if exposure occurs by accident during tooth preparation rather than due to the progression of caries [11,12]. For trimer isolation, most of the monomers and dimers were removed along excess CsCl. Physiology of the human dental pulp. Experimental disks (diameter, 7 mm; height, 4 mm) were stored in a humified incubator at 37 °C for 48 h. These materials can be generally classified into two groups: materials used to maintain the vitality of the pulp (pulp capping materials), and materials used to disinfect (irrigants and intracanal medicaments) and fill the pulp in root canal therapy. Although it is known that He diffuses through SiO2, which is present in this MEMS package, exactly this property is used for the test. Takashi Matsuo, DDS, PhD, Tadashi Nakanishi, DDS, Hirotoshi Shimizu, DDS, and Shigeyuki Ebisu, DDS, PhD A Clinical Study of Direct Pulp Capping Applied to Carious-Exposed Pulps. Calcium hydroxide (CaOH) has been considered the “gold standard” of direct pulp-capping materials for several decades (Baume and Holz, 1981; Camp and Fuks, 2006; Hilton, 2009). • 3- Tri-calcium phosphate. Ravindra K. Dhir OBE, ... Ciarán J. Lynn, in Sustainable Construction Materials, 2017. Increased bleeding is generally associated with inflammation, so that substantial bleeding may indicate extensive infection, which itself is a sign that there is reduced capacity for induced repair of the exposure [1]. In direct capping with this paste showed no pulp . It was concluded that one advantage of SEC is the possibility of direct/immediate postcolumn optical and electrochemical analysis of collected fractions using an automated setup (e.g., with UV–vis coupled directly to chromatography) [5]. For example, Apexit sets in about 2 h at 100% relative humidity [39], whereas Sealapex takes 2–3 weeks to set under the same conditions [45,46]. 9.2 Direct pulp capping. John Nicholson, Beata Czarnecka, in Materials for the Direct Restoration of Teeth, 2016. However, calcium hydroxide and mineral trioxide aggregate (MTA) are the preferred material of choice in clinical practice due to their favourable outcome. For the latter materials, their cytotoxicity was attributed to the synergistic effects of the various monomers released by these substances.