Human pulpal response to Mineral Trioxide Aggregate (MTA): A histologic study

The purpose of this study was to study the histologic changes in the dental pulp following pulpotomy with Mineral Trioxide Aggregate (MTA) and Calcium hydroxide. Pulpotomies were performed on premolar teeth that were to be extracted for orthodontic reasons. The radicular pulp was capped with either MTA or Calcium hydroxide and restored with IRM. The teeth were extracted at 4 and 8 week intervals, fixed in 10% formalin and then kept in 5% nitric acid for 28 days for demineralization. Lon-gitudinal sections were then prepared and viewed under light microscope.The pulps capped with MTA (at the end of 4 weeks and 8 weeks) showed dentin bridge formation which was more homogenous and continuous with the original dentin when compared to the pulps capped with calcium hydroxide. The pulpal inflammation was also less in the MTA group as compared to the calcium hydroxide group at the end of 4 and 8 weeks.

1. Cox CF, Subay RK, Ostro E, Suzuki S, Suzuki SH.Tunnel Defects in Dentin Bridges: Their formation following Direct Pulp Capping. J. Oper. Dent; 21:4–11. 1996

2. Torabinejad M, Hong CU, Mc Donald F, Pittford TR. Physical and Chemical properties of a new root end filling material. J. Endod.21:349–53. 1995

3: Abedi H,Torabinejad M, Pittford TR, Backland CK. Using MTA as a pulp capping material. JADA 127:1491–4. 1996

4. Torabinejad M, Chivian N. Clinical Application of Mineral Trioxide Aggregate. J. Endod 25:197–205,1999.

5. Koh ET, Pitt Ford TR,Torabinejad M, Mc Donald F. Mineral trioxide aggregate stimulates cytokine production in human osteoblasts. J. Bone Min Res. 105:5406,1995.

6. Schwartz,RS, Mauger M, Clement DJ, Walker WA. Mineral Trioxide Aggregate: A new material for endodontics. JADA 130, 325–331 July 1999.

7. Schmitt DJ, Bogen G. Multifaceted use of Pro Root MTA root canal repair material. J. Ped Dent-23:4,115–118 2001.

8. Koh ET, Ford TR,Torabinejad M, Mc Donald F. Mineral trioxide aggregate stimulates cytokine production in human osteoblasts. J. Bone Min Res. 105:5406, 1995.

9. Schroder U. Evaluation of healing following experimental pulpotomy of intact human teeth and capping with calcium hydroxide odontol revy; 23:329–40. 1972

10. Siqueira JR and Lopez HP. Mechanism of antimicrobial activity of calcium hydroxide; a critical review. Int. Endod. J 32, 361–369, 1999.

11. Carlile MJ, Sturrock MG, Chisholm DM, Ogden GR, Schor AM. The presence of pericyte and transitional cells in the vasculature of the human dental pulp. An ultrastructural study.. Histochem J. 32:239–245. 2000

12. Mjor JA: Pulp-dentin biology in restorative dentistry. Part 7:The exposed pulp. Quintessence International 33, No2, 2002.

13. Alliot Licht B, Hurtrel D, Gregoire M. Characterization of asmooth muscle actin positive cells in mineralized human dental pulp cultures. Arch. Oral Biol; 46:221–228. 2001

14. Fitzgerald M, Heys RJ. A clinical and histological evaluation of conservative pulp therapy in human teeth. Operative dentistry.; 16(3); 101–112. 1991

15. Massauge J. TGF-b signal transduction. Annu. Rev. Biochem; 67:753–791. 1998

16. Anthony J. Smith, Peter E, Murray and Philip J. Lumley. Preserving the vital pulp in Operative Dentistry: 1, A biologic Approach. Dent Update.29:64–69. 2002

17. Smith AJ, Lesot H. Induction and regulation of crown dentinogenesis embryonic events as a template for dental tissue repair. Crit Rev. Oral Biol. Med. 12:425–437. 2001

18. Mc Comb P. Comparison of physical properties of commercial calcium hydroxide lining cements. JADA.107: 610-613. 1983

19. Hwas M and Sandrik JL. Add and water solubility and strength of calcium hydroxide bases. JADA 108. 46–48. 1984

21. Cox CF, Bergenholtz. Capping of dental pulp mechanically exposed to oral microflora – a five week observation of wound healing in monkey. J. Oral Pathol. 11; 327–339. 1982

22. Dominguez MS,Witherspoon DE, Gutmann JC, Opperman LA. Histological and SEM assessment of various vital pulp therapy materials. J. Endod. 29(5):329–33. 2003

23. Balto HA. Attachment and morphological behavior of human periodontal ligament fibroblasts to mineral trioxide aggregate: a SEM study. J Endod. 30(1):25–9. 2004

24. Aeinehchi M, Eslami B, Ghanbariha M, Saffar AS. Mineral trioxide aggregate (MTA) and calcium hydroxide as pulp capping agents in human teeth: a preliminary report. Int. Endod J. 36(3):225–31. 2003

25. E. Joffe. Preserving tooth vitality. Operative Dentistry, 28(4): 465–468. 2003

26. Ford TR, Torabinejad M, Abedi HR, Bakland LK, Kariyawasam SP. Using Mineral Trioxide Aggregate as a pulp-capping material JADA. 127(10):1491–4. 1996

27. Heithersay GS. Calcium hydroxide in the treatment of pulpless teeth with associated pathology. J. Br. Endod Soc. 8:74–93. 1975

28. Holland R, De Souza V, Nevy NJ, Otobone Filho JA, Bernabe DF, Dezan JunorE: Reaction of rat connective tissue to implanted dentin tubes filled with mineral trioxide aggregate or calcium hydroxide. J. Endod 25:161–6. 1999;

29. Schroeder U. Effects of calcium hydroxide containing pulp capping agents on pulp cell migration, proliferation and differentiation. J. Dent Res.; 11:6–10. 1985

30. Mjor JA Pulp reaction to calcium hydroxide containing materials. Oral surgery, Oral medicine, Oral Pathology 33: 961–965. 1972

31. Woehrlen AE Jr. Evaluation of techniques and materials used in pulp therapy based on a review of the literature. Part 1. JADA. 95:1154–1158. 1977