Pulp capping involves the application of a protective agent to an exposed pulp to maintain the vitality and function of the pulp. A variety of materials containing calcium hydroxide have been the traditional pulp- capping treatment, but certain physical limitations of these materials have led to the search for alternative direct pulp-capping materials. Dentin adhesives have been suggested as a possible alternative to calcium hydroxide for pulp capping. A study by Fernandes, et al analyzed the expression of fibronectin and type III collagen in human dental pulps that were directly pulp-capped with either calcium hydroxide or a dentin adhesive system. Fibronectin and type III collagen are extracellular matrix components identified in the pulp tissue that are involved with regeneration processes. The study involved 46 healthy premolar teeth indicated for extraction for orthodontic reasons. The teeth were randomly divided into 3 groups: control; pulps exposed and capped with the dentin adhesive system; and pulps exposed and capped with calcium hydroxide. In the experimental groups, teeth were extracted after 7 or 30 days and underwent immunohistochemical analysis. The study found that expression of type III collagen and fibronectin was similar in teeth treated with calcium hydroxide and the control group. No effective expression of type III collagen and fibronectin was observed in the dentin adhesive treatment group. The authors conclude that the presence of a persistent inflammatory process throughout the study period and the lack of expression of type III collagen and fibronectin in the dentin adhesive treatment group indicates that adhesive systems should not be indicated for direct capping of human pulps.
(Source: Oral Surg Oral Med Oral Pathol Oral Radiol Endod, March 2008, Volume 105, Number 3)
