A Comparative Study of Dental Pulp Response to Several Pulpotomy Agents

Aim: To examine the in vivo response of dental pulps in dogs to three pulp-capping agents: calcium hydroxide (CH), mineral trioxide aggregate (MTA) and a new endodontic calcium enriched mixture (CEM) cement.

Methodology: Thirty-six second and third premolar teeth in six beagle dogs were randomly assigned to three experimental groups; CH, MTA or CEM cement. Following isolation and exposure, pulp tissues were removed with a fissure bur and haemostasis achieved. The pulps were dressed with appropriate materials, and the access cavity restored with amalgam. Histological analysis was performed 8 weeks after treatment; the samples were assessed by an independent observer for calcified bridge formation, pulp vitality and pulp inflammation. The data were analysed by Kruskal-Wallis, Mann-Whitney and one-way anova tests.

Results: The number of root canals that showed calcified bridge formation, pulp vitality and lack of inflammation was significantly higher for teeth capped with either MTA or CEM cement in comparison with CH (P < 0.05). No significant difference was found between the CEM cement and MTA in terms of calcified bridge formation, pulp vitality and lack of inflammation (P > 0.05).

Conclusions: Mineral trioxide aggregate and CEM cement were associated with a similar favourable biological response to pulpotomy treatment and demonstrated a more effective induction of dentinal bridge formation compared to CH.