光敏黏接剂盖髓后牙髓的组织病理反应

目的观察应用3种光敏黏接剂直接盖髓后,兔牙髓的反应。方法兔前臼齿及臼齿72颗,分为4组,制备Ⅰ类洞机械穿髓,实验组3组(Excite,Prime & Bond NT,XenoⅢ),Dycal为对照,光敏树脂(SureFil)充填。于第7、14、21天每组拔除6颗牙齿,常规脱钙切片,镜下观察充血反应、炎细胞浸润、纤维化程度、牙本质桥形成、修复性牙本质形成、细菌污染等情况。结果所有实验牙齿都有牙本质桥形成,修复性牙本质封闭穿髓孔。同一时期内,兔牙髓对不同盖髓剂的反应无显著性差异。除对照组外,同种黏接剂在不同时期内对牙髓的影响无显著性差异。结论此3种黏接剂对兔牙髓具有良好的生物相容性,并能促进修复性牙本质生成。     

The dentinogenic effect of mineral trioxide aggregate (MTA) in short-term capping experiments

AIM: The objective of the present experiment was to study the early pulpal cell response and the onset of reparative dentine formation after capping application of MTA in mechanically exposed pulps. METHODOLOGY: Thirty-three teeth from three dogs, 12-18 months of age were mechanically exposed via class V cavities. Light pressure was applied to control haemorrhage. ProRoot MTA (Dentsply Simfra, Paris) was placed at the exposure site and light pressure was applied with a wet cotton pellet. The cavities were restored with amalgam and the pulpal tissue reactions were assessed by light and electron microscopy (transmission and scanning) after healing intervals of 1, 2 or 3 weeks. RESULTS: A homogenous zone of crystalline structures was initially found along the pulp-MTA interface, whilst pulpal cells showing changes in their cytological and functional state were arranged in close proximity to the crystals. Deposition of hard tissue of osteotypic form was found in all teeth in direct contact with the capping material and the associated crystalline structures. Formation of reparative dentine (tubular matrix formation in a polar predentine-like pattern by elongated polarized cells) was consistently related to a firm osteodentinal zone. CONCLUSIONS: The present experiments indicate that MTA is an effective pulp-capping material, able to stimulate reparative dentine formation by the stereotypic defensive mechanism of early pulpal wound healing.     

The induction of reparative dentine by enamel proteins

AIM: This study was designed to examine whether enamel matrix derivative (EMD) could induce reparative dentine formation without eliciting adverse side-effects in pulpotomized teeth in the miniature swine. METHODOLOGY: Pulpotomy was performed in 36 mandibular incisor teeth from 11 adult miniature swine. Following the surgical procedure, the exposed pulp tissue was treated with EMD or covered with a calcium hydroxide preparation (Dycal). Following an observation period of 3, 4 and 8 weeks, the experimental teeth were extracted and examined using light microscopy and histometric analysis. The total amount of reparative dentine formed in the EMD-treated teeth was calculated as total area using digital histomorphometry analysis of the five central-most sections from each experimental tooth. RESULTS: In the EMD-treated teeth, substantial amounts of dentine-like tissue formation consistently led to a complete hard-tissue bridging of the defects. The onset of hard tissue formation could be observed after 2 weeks and was located only on the pulpal wound. More limited dentine formation was also observed in Dycal-treated teeth. However, in these teeth the new hard tissue formed at the expense of pulp chamber width, causing narrowing of root canals. The total amount of reparative dentine formed in the EMD-treated teeth was significantly higher (P<0.005) than in the Dycal-treated specimens. CONCLUSION: These results demonstrate the potential of EMD as a biologically active pulp-dressing agent that specifically induces pulpal wound healing and dentine formation in the pulpotomized teeth without affecting the normal function of the remaining pulp.     

An in vivo evaluation of hemorrhage control using sodium hypochlorite and direct capping with a one- or two-component adhesive system in exposed nonhuman primate pulps.

OBJECTIVE: This study evaluated the biologic ability of sodium hypochlorite to control hemorrhage via chemical amputation of the coagulum, to remove dentin chips, to assist healing, and to facilitate formation of a dentinal bridge under two adhesive systems. METHOD AND MATERIALS: Ninety Class V cavities with mechanical pulpal exposures were placed in the teeth of five adult monkeys and histologically observed. All exposures were prepared with a No. 330 bur, and hemorrhage was controlled with 3% sodium hypochlorite. Twenty-two exposures were capped with All-Bond 2 and AElitefil, and 26 exposures were capped with One-Step (OS) and Resinomer (RS). Two pulps were excluded from the final data. Forty-two exposures were capped with calcium hydroxide and amalgam as controls. At 7, 27, and 90 days, tissues were obtained by perfusion fixation, demineralized, sectioned, stained, and histologically graded according to published qualitative criteria. RESULTS: For both adhesives, at 7 days, 12 of 16 pulps showed no coagulum remnants or dentin chips at the material interface. No necrotic pulps were observed. At 27 and 97 days, 26 of 30 capped pulps had dentinal bridges at the adhesive interface. Reparative dentin was present in 28 pulps. Four 97-day pulps exhibited necrosis associated with stained bacteria. One 97-day pulp contained dentin chips throughout the pulp and demonstrated no healing, no reparative dentin, and no stained bacterial profiles. CONCLUSION: Normal soft tissue reorganization and dentinal bridge formation were observed in 86% of pulps treated with sodium hypochlorite and either adhesive system.     

Pulpal responses following direct pulp capping of healthy dog teeth with dentine adhesive systems

OBJECTIVE: The aim of the present study was to evaluate the pulpal responses following direct pulp capping of mechanically exposed teeth with new dentine adhesive systems, in the preclinical model of dog teeth. METHODS: Class V cavities (approximately 2.50 mm wide, 3.00 mm long, 1.5-2.0 mm deep) were prepared on the buccal surface of permanent maxillary and mandibulary molars, two rooted premolars, canines and third incisors. The cavities were assigned to five experimental groups, representing one control group treated with a Ca(OH)2-based material and four experimental groups where the adhesive systems Clearfil SE Bond, Prompt-L-Pop, Etch & Prime 3.0 and Single Bond were tested. The pulpal tissue responses to dentine adhesives were assessed at post-operative periods of 7, 21, 65 days. RESULTS: Variable responses were recorded, which were characterized by moderate to severe inflammatory reactions, progressive extension of tissue necrosis with time and total absence of continuous hard tissue bridge formation after pulp capping with each of the four adhesive systems. Application of a Ca(OH)2-based material was characterized by inflammatory cell infiltration, limited tissue necrosis as well as partial to complete hard tissue bridging. CONCLUSIONS: It seems evident that application of dentine adhesive systems in direct contact with the mechanically exposed pulp of healthy dog teeth cannot lead to acceptable repair of the dentine-pulp complex e.g. wound healing with tertiary dentine bridge formation.     

Is hard tissue formation in the dental pulp after the death of the primary odontoblasts a regenerative or a reparative process?

Objectives

Conceptually, two types of tertiary dentine may be produced in response to caries and environmental irritations: “reactionary dentine” that is secreted by existing primary odontoblasts and “reparative dentine”, formed after the death of the odontoblasts by proliferation and differentiation of progenitor cells into odontoblast-like cells. Because histologic evidence for tubular dentine generated by newly differentiated odontoblast-like cells is lacking in human teeth, the present study examined pulpal cellular changes associated with caries/restorations, in the presence or absence of pulpal exposures.

Methods

Ninety-six extracted human teeth were histologically processed and serial sectioned for light microscopy: 65 contained untreated enamel/dentine caries; 20 were heavily restored and 11 had carious exposures managed by direct pulp-capping.

Results

Sparsely distributed, irregularly arranged dentinal tubules were identified from the tertiary dentine formed in teeth with unexposed medium/deep caries and in restored teeth; those tubules were continuous with the tubules of secondary dentine; in some cases, tubules were absent. The palisade odontoblast layer was reduced to a single layer of flattened cells. In direct pulp-capping of pulp exposures, the defects were repaired by the deposition of an amorphous dystrophic calcified tissue that resembled pulp stones more than dentine, sometimes entrapping pulpal remnants. This atubular hard tissue was lined by fibroblasts and collagen fibrils.

Conclusions

Histological evidence from the present study indicates that reparative dentinogenesis cannot be considered as a regenerative process since the so-formed hard tissue lacks tubular features characteristic of genuine dentine. Rather, this process represents a repair response that produces calcified scar tissues by pulpal fibroblasts.

Clinical significance

Formation of hard tissue in the dental pulp after the death of the primary odontoblasts has often been regarded by clinicians as regeneration of dentine. If the objective of the clinical procedures involved is to induce healing, reduce dentine hypersensitivity, or minimise future bacteria exposure, such procedures may be regarded as clinical success. However, current clinical treatment procedures are not adept at regenerating physiological dentne because the tissues formed in the dental pulp are more likely the result of repair responses via the formation of calcified scar tissues.     

Effect of remaining dentine thickness beneath deep cavities on the rate of reparative dentine formation--experimental study

The aim of this study was to investigate the effect of remaining dentine thickness beneath deep cavities on the rate of reparative dentine formation throughout 119 days and to establish the limit value of the remaining dentine thickness that enables greatest amount of tertiary dentine in dogs' teeth. Deep buccal cavities were prepared in all canines and molars of three dogs, lined with four different lining materials for indirect pulp capping and filled with silver amalgam. Tetracycline labelling technique was used to demark the layers of reparative dentine produced during the experimental period of 17 weeks. After sacrificing and isolation the teeth from the jaws slices (1 mm thick) were cut off through the middle of the cavity, perpendicular to the cavity floor and mesio-distal tooth axis. Sections were ground to 100 microns thick; the measuring of the remaining and reparative dentine thickness was carried out with Fluoval, Carl-Zeiss, Jena, DDR fluorescent microscope. The results showed: 1. Cavity depth had a strong effect on the quantity of newly formed tertiary dentine; 2. The greatest rate of reparative dentine (348 microns) was produced beneath the cavities with remaining dentine thickness ranging 501-700 microns; 3. The least quantities of tertiary dentine (219 and 227 microns) were produced beneath the deepest cavities, with remaining dentine thickness less than 500 microns, as well as beneath shallower cavities with remaining dentine thickness of over 900 microns.     

Biocompatibility of resin-based materials used as pulp-capping agents

AIM: To evaluate and compare the response of pulps of rats capped with resin-modified glass-ionomer cement (RMGIC) or self-etching adhesive system. METHODOLOGY: Class I cavities were prepared on the occlusal surface of 54 maxillary first molars of 27 rats. Pulp exposure was performed on the cavity floor. The following resin-based materials were applied as pulp-capping agents: G1, Clearfil Liner Bond 2V (CLB 2V; Kuraray Co., Japan); G2, Vitrebond (VIT; 3M/ESPE, USA). In group 3 (control group), a calcium hydroxide/saline paste (CH; Labsynth, Brazil) was used. The cavities were restored with amalgam. After 7, 30 and 60 days, the animals were sacrificed and the jaws were processed for microscopic evaluation. RESULTS: Despite the inflammatory response caused by the experimental and the control materials at 7 days, pulpal healing associated with calcified barrier formation was observed at 60 days following the pulp therapy. Both resin-based materials promoted a large zone of cell-rich fibrodentine matrix deposition on the pulp horn related to the pulp exposure site, which was larger to VIT than to CLB 2V specimens. Tertiary dentine underneath the fibrodentine matrix was deposited by a layer of elongated pulpal cells. The remaining pulpal tissue exhibited normal histological characteristics. In the control group, healing and dentine-bridge formation was observed at 30 days. Pulpal breakdown occurred only when bacterial infection occurred. CONCLUSION: Both experimental pulp-capping agents allowed pulpal healing characterized by cell-rich fibrodentine and tertiary dentine deposition as well as calcified barrier formation.     

Dentine-pulp tissue engineering in miniature swine teeth by set calcium silicate containing bioactive molecules

Objective: The present study aims to investigate whether reparative dentinogenesis could be guided at central pulpal sites or at a distance from the amputated pulp of miniature pig teeth, by using set calcium silicate-based carriers containing human recombinant bioactive molecules.DesignPulp exposures were performed in 72 permanent teeth of 4 healthy miniature swine. The teeth were capped with pre-manufactured implants of set calcium silicate-based material containing BMP-7, TGFβ1 or WnT-1, for 3 weeks. Conical-shaped intrapulpal implants were exposed in the central pulp core, while disc-shaped extrapulpal implants were placed at a distance from the amputated pulp. Implants without bioactive molecules were used as controls. Thickness and forms of new matrix mineralized deposition were assessed histologically at post-operative periods of 3 weeks by light microscopy.ResultsIntrapulpal applications: Calcified structures composed of osteodentine were found in contact with the BMP-7 implants. An inhomogeneous calcified tissue matrix was found around the WnT-1 carriers. A two-zone calcified structure composed of osteodentine and a thicker tubular matrix zone was seen at the TGFβ1 carrier-pulp interface. Extrapulpal applications: The space between WnT-1 implants and pulp periphery had been invaded by soft tissue with traces of calcified foci. Thick calcified structures composed of osteodentine were found surrounding pulp exposure sites in response to application of BMP-7. Spindle-shaped cells associated with atubular calcified matrix or elongated polarized cells associated with tubular dentine-like matrix were found along the cut dentinal walls of the TGFβ1 group.ConclusionThe present experiments indicated that set calcium silicate could be used as carrier for biologically active molecules. TGFβ1 was shown to be an effective bioactive molecule in guiding tertiary dentine formation.     

In vivo antibacterial effects of dentin primer incorporating MDPB

This study examined the hypothesis that experimental primer containing the antibacterial monomer 12-methacryloyloxydodecylpyridinium bromide (MDPB), which was previously reported to show bactericidal effects in vitro, inhibits bacteria in cavities under in vivo conditions. The number of bacteria resulting from applying primer solution to cavities in dog teeth infected with Streptococcus mutans was determined. The infected cavities were also restored using primer and the pulp response was histopathologically examined after 7, 30 and 75 days. No bacteria were recovered after applying the experimental primer, although the bactericidal effects of the proprietary primer were insignificant. Restoration with the experimental primer resulted in little or no pulpal inflammation for all periods; whereas, mild to moderate inflammatory response was observed when using proprietary primer. These results indicate that the experimental primer containing MDPB could exhibit in vivo antibacterial effects, suggesting its possible clinical benefit.     

Effect of a fluoride-releasing one-step adhesive system on monkey pulp tissue

PURPOSE: The purpose of this study was to evaluate the pulpal response of a fluoride-releasing one-step adhesive in nonexposed monkey teeth. MATERIALS AND METHODS: Cervical Class V cavities were prepared in monkey teeth. The cavities were divided into three groups of different restorative materials. A one-step adhesive (SI-IB551, Shofu) was applied to the teeth, and the cavities were filled with a resin composite (Beautifil, Shofu). In the other two groups, a two-step adhesive (Imperva FluoroBond, Shofu) together with either a resin composite (Beautifil) or a glass-ionomer cement (Fuji II, GC) was placed in the cavities. The teeth were then extracted after 3, 30, and 90 days, fixed in 10% buffered formalin solution, and prepared according to routine histological techniques. Five-micrometer sections were stained with hematoxylin and eosin, or Brown & Brenn gram stain for bacterial observation. Four histological features, odontoblastic change, inflammatory cell infiltrate, reparative dentin formation, and the bacterial staining, were evaluated and compared. The results were compared statistically with significance defined as p < 0.05 (Kruskall-Wallis test). RESULTS: Disarrangement of the odontoblasts and slight inflammatory cell infiltrations were the main initial reactions, while deposition of reparative dentin was the major long-term reaction in all groups. No statistically significant differences in the four histological features were seen among the restorative materials placed in the cavities (p > 0.05). No serious pulpal inflammatory reactions, such as necrosis or abscess formation, were observed in any of the experimental groups. CONCLUSION: The one-step adhesive showed acceptable biological compatibility with the monkey pulp, whereas the pulpal response to the system was minimally different from that of the glass-ionomer cement or the two-step self-etching adhesive.     

Dentinogenic Responses after Direct Pulp Capping of Miniature Swine Teeth with Biodentine

Introduction

The aim of this study was to evaluate pulpal responses after experimental direct pulp capping of mechanically exposed teeth with a new calcium silicate–based dentin replacement material.

Methods

Thirty-four anterior and posterior teeth of 3 miniature swine were used. Class V or I cavities were prepared on the buccal or occlusal surfaces, respectively. Pulpal exposures were further performed using a round carbide bur 0.8 mm in diameter. Exposures were treated with white MTA Angelus (Angelus, Londrina, PR, Brazil) or Biodentine (Septodont, Saint Maur des Fosses, France), and the cavities were further restored with Biodentine. The pulpal tissue responses were histologically assessed at postoperative periods of 3 and 8 weeks. Data were statistically analyzed using the Kruskal Wallis and the Mann-Whitney U tests.

Results

Inflammatory infiltration or pulp tissue necrosis was not found in any of the specimens. All teeth showed mineralized matrix formation in the form of a complete hard tissue bridge composed of osteodentin or osteodentin followed by a discontinuous or continuous reparative dentin zone. A significantly higher thickness of the hard tissue bridge was found in the group of teeth treated with Biodentine at both 3 and 8 weeks. A number of teeth, which were under root development at the onset of the experimental procedures, exhibited ectopic pulp calcification.

Conclusions

The application of both calcium silicate–based materials in direct contact with the mechanically exposed pulp of healthy miniature swine teeth led to pulp repair with complete hard tissue bridge formation. The thickness of hard tissue bridges was significantly higher after pulp capping with Biodentine.     

Pulpal response to prolonged dentinal exposure to sodium hypochlorite

AIM: The aim of this study was to examine the effect of undiluted NaOCl on vital pulp tissue when applied to freshly cut dentine. METHODOLOGY: Class V cavities were prepared to a depth of 2 mm in 20 teeth in four Beagle dogs. The cavities on one side of each dog were irrigated continuously for 5 min with 5.25% NaOCl, whilst the cavities on the opposite side in each dog were irrigated with saline for the same length of time. Prior to filling each cavity with Cavit, they were again rinsed with saline and gently dried with an air stream. The dogs were sacrificed to allow for investigation of pulpal conditions under the cavities after periods of 24 h, 1 week, and 4 weeks. Histological preparations were made and stained with H & E for evaluation of the pulp subjacent to each cavity. The tissues were examined for presence of inflammatory cells and categorized as (i) no inflammation, (ii) mild, (iii) moderate, and (iv) severe inflammation. RESULTS: The six teeth in the 24 h observation group all showed mild inflammation, both in the NaOCl and the saline groups. After 1 week and 4 weeks, the pulps from all the teeth were free of inflammatory cells. CONCLUSION: Under the conditions of this experiment, the use of NaOCl in a freshly cut cavity in an intact tooth of a dog, with exposed dentinal tubules, does not appear to cause additional pulpal damage to that caused by the physical contact in cutting tooth structure.     

The influence of haemostatic agents on healing of healthy human dental pulp tissue capped with calcium hydroxide

AIM: To investigate the hypothesis that different haemostatic agents could impair the histological response of human pulps capped with calcium hydroxide. METHODOLOGY: Forty-five third molars scheduled for extraction were selected. Class I cavities with pulp exposures were prepared. Three agents were used to control bleeding: 0.9% saline solution (control, n = 14), 5.25% sodium hypochlorite (n = 16) and 2% chlorhexidine digluconate (n = 15). The pulps were dressed with hard-setting calcium hydroxide cement. After 7, 30 or 90 days, teeth were extracted, formalin-fixed and prepared for histochemical techniques. The biological response was categorized using the following criteria: inflammatory response, soft tissue organization, reactionary dentine and reparative dentine. Data were submitted to statistical analysis, using nonparametric Kruskal-Wallis one-way analysis of variance on ranks. Differences amongst groups were detected using Dunn's method. RESULTS: The statistical analysis disclosed that whilst inflammatory response decreased over time, reactionary dentine deposition and reparative dentine formation increased in the latter periods of evaluation (P < 0.05). The three agents had similar performances for all criteria evaluated. The conventional pulp response to calcium hydroxide was observed over time, and complete pulp healing was observed in 88% of the specimens after 90 days. CONCLUSION: The three haemostatic agents did not impair the healing process following pulp exposure and capping with calcium hydroxide at different time intervals investigated.     

The pulpal response to citric acid in cats

Abstract Citric acid conditioning of dentine has been proposed as an efficacious treatment for promoting re-attachment after periodontal surgery. This study investigated the pulpal reactions to periodontal surgery combined with citric acid (pH 1) demineralization of exposed dentine for 3 min. 9 cats were used as the experimental animals, with each cat providing 1 negative and 1 positive control and 2 experimental canine teeth. Evaluation was over 3 observation periods, with 3 cats in each period being sacrificed at 4, 21 and 83 days. Positive control teeth, which underwent periodontal surgery combining the removal of approximately 3 mm² of labial bone and vigorous root planning of the exposed root surfaces, displayed mild to moderate pulpal reactions during the short- and intermediate-term periods and only mild to no reactions in the long-term period. The addition of citric acid demineralization, however, resulted in 5 experimental teeth (28%) becoming abscessed or totally necrotic in the intermediate- and long-term periods. At 21 days, the frequency of adverse pulpal responses to surgery and citric acid conditioning was significantly (p<0.05) greater than to surgery alone. Although 4 experimental teeth were relatively uninflamed at the long-term period of observation, all showed irritational dentine formation. Penetration of exposed dentinal tubules by plaque bacteria was observed only in the citric acid treated teeth.     

Effect of calcium hydroxide treated dentine on pulpal responses

Summary. The purpose of the present study was to test the hypotheses that calcium hydroxide enhances pulpal protection against irritating substances in and around dental restorations when topically applied to cut dentine, and to acquire further information regarding the possible mechanisms involved. Cavities in dentine were treated for 30 days with either a water slurry of calcium hydroxide or a hard-setting calcium hydroxide containing base. Control cavities were treated with saline. The additional effect of dry cutting prior to the restoration was also included as a control. Pulpal responses after placement of a silicate cement restoration were evaluated after an additional period of 30 or 150 days. From histological sections the volumes of inflamed pulp and the volumes of irregular secondary dentine were calculated with a morphometric method of evaluation. Changes in dentine to the calcium hydroxide treatment were observed with scanning electron microscopy. Most pulps in teeth with cavities treated with saline and restored for 30 days with silicate cement exhibited inflammatory alterations. Calcium hydroxide treated teeth had a significantly lower volume of inflamed pulp compared with the saline controls. Dry preparation was also associated with reduced inflammatory reaction. Pulps in teeth with dentine treated by the calcium hydroxide containing hard- setting base displayed the same magnitude of pulpal inflammation as the saline treated controls. After restoration for 150 days the volumes of inflamed pulp tissue were reduced in all treatment groups, however the least pulpal responses were found in teeth treated with calcium hydroxide slurry. Data also showed that the calcium hydroxide treatment was associated with only small volumes of irregular secondary dentine, while in contrast dry cut teeth showed large volumes of irregular secondary dentine. Scanning electron microscopic evaluation of dentine treated with calcium hydroxide revealed reticular structures inside the dentinal tubules     

Marginal seal and biocompatibility of a fourth-generation bonding agent

The pulpal reaction and the marginal sealing of in vivo restored samples using resin composite and Scotchbond Multi-Purpose adhesive system (3M Dental Products) were analyzed in this study.Twelve Class I non-exposed cavity preparations were placed on premolars to be removed for orthodontic reasons. They were restored and observed at 7 d and 28 d.The examination of the resin-dentin interface under the scanning electron microscope (SEM) revealed: 1) a gap-free attachment between adhesive resin and dentinal surface in 80% of the areas studied, 2) penetration of resin tags into the dentinal tubules, and 3) formation of a 3–5 μm thick acid-resistant hybrid layer. Microfissures measuring about 10 μm were observed in only 20% of the areas studied; these were located along the walls of the cavities, especially near the enamel in zones where there was a lower concentration of dentinal tubules. The histological analysis, carried out 7 d after preparation of the restoration, did not show any alteration of the pulp. After 4 wk, reparative dentin was produced in the pulpal areas corresponding to the restored cavities.The quantity of newly formed dentin is correlated with the distance from the cavity to the pulp. The results indicate that acid-etching of vital dentin using 10% maleic acid does not impair pulpal healing in deep Class I cavities and that the Scotchbond Multi-Purpose adhesive system is able to preserve the morphological and biological integrity of the pulpo-dentinal complex.     

The effects on the dental pulp of a composite resin and two dentine bonding agents and associated bacterial microleakage

The pulpal reaction associated with a composite resin alone and composite resin used in conjunction with two dentine bonding agents was studied. Class V cavities were prepared on the labial surfaces of the canine teeth of 18 male ferrets. After acid etching of the enamel margins, the cavities were restored with either a composite resin alone or in combination with one of two dentine bonding agents, Scotchbond and Gluma. One cavity in each animal was filled with Kalzinol as a control. The animals were killed after 7, 14 and 28 days. After histological processing, the pulpal changes were assessed qualitatively and quantitatively according to standard criteria. There were variations in the pulpal response at all time intervals. The responses to the two dentine bonding agents were similar to those found with composite resin alone. No pulpal inflammation was observed in the control teeth. Gram-positive micro-organisms were identified at the interface of restoration and cavity wall, or within the dentinal tubules in virtually all cases in which pulpal inflammation was observed.     

生物陶瓷材料iRoot BP Plus对小型猪修复性牙本质形成影响的实验研究

目的 应用小型猪实验动物模型评价iRoot BP Plus直接盖髓后修复性牙本质桥形成的情况以及牙髓的生物学反应.方法 选取4只18月龄小型猪前磨牙26颗,制备直径为2 mm穿髓孔,随机分3组:氢氧化钙组、MTA组和iRoot BP Plus组,进行直接盖髓.术后8周,组织病理学观察.结果 MTA组和iRoot BP Plus组均可以形成具有天然牙本质小管样结构及极性的成牙本质细胞层的钙桥.与MTA组相比,iRoot BP Plus组形成的钙桥质地较为均匀连续,牙髓组织炎症反应较轻,髓腔未见不规则钙化.氢氧化钙组表现钙桥较为疏松,冠部牙髓组织坏死,根髓可见不同程度的炎症反应,根管壁出现不规则钙化.结论 iRoot BP Plus和MTA盖髓明显优于传统的氢氧化钙.iRoot BP Plus在盖髓术中表现了良好的生物学特性.     

Caries-induced changes in the expression of pulpal neuropeptide Y

Recent evidence suggests that the sympathetic nervous system may have a role in modulating neurogenic inflammation and bone remodelling. Neuropeptide Y (NPY) is a well-characterized neuropeptide transmitter in the peripheral sympathetic nervous system. NPY is known to be present in human dental pulp; however, quantitative data on NPY levels in pulpal health and disease in an adult population remain to be determined. The aims of the current study were to assess, quantitatively, NPY levels by radioimmunoassay and confirm the distribution of NPY fibres by immunocytochemistry in carious and non-carious adult human pulp tissue. Our results suggest changes in the levels and distribution of NPY in human dental pulp during the caries process, with significantly higher levels of NPY in carious compared with non-carious adult human teeth. Within the carious samples studied, our finding, that NPY levels were significantly elevated in mild/moderate caries, concurs with the hypothesis that NPY could have a modulatory role in pulpal inflammation and in reparative dentine formation.