• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.2
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• pp.475-483
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• 1997

Fracture of the crown in a permanent incisor is relatively common. When it occurs with pulp exposure, it presents both restorative and endodontic problems. In the restoration of a fractured incisor, reattachment of the original fragment or restoration with a composite resin is preferred over a temporary crown. If fractured fragment is intact, the tooth can be restored with reattachment of the fragment. An exposed pulp in a young crown-fractured incisor is usually treated with either pulp capping or pulpotomy depending on the size of an exposure and time elapsed since injury. However, in teeth showing vital and/or hyperplastic pulp tissue at the exposure, only superficial layers of the pulp and surrounding dentin should be removed : i.e. partial pulpotomy can be performed in immature as well as mature teeth. This paper reports 2 cases of crown-fractured permanent incisors with pulp exposure that had been treated by reattachment of original fragment followed by partial pulpotomy or partial pulpectomy. The following results are obtained. ; 1. Fragment reattachment is an acceptable semi-permanent restoration of crown fractured young permanent incisor. 2. Partial pulpotomy is recommended as the treatment of choice in crown-fractured permanent teeth with pulp exposure.

• Restorative Dentistry and Endodontics
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• v.45 no.1
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• pp.10.1-10.8
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• 2020

Objectives: This study aimed to compare the shear bond strength (SBS) of a self-adhering flowable composite (Dyad Flow) and a bulk-fill flowable composite (Smart Dentin Replacement [SDR]) to several pulp-capping materials, including MTA Plus, Dycal, Biodentine, and TheraCal. Materials and Methods: Eighty acrylic blocks with 2-mm-deep central holes that were 4 mm in diameter were prepared and divided into 2 groups (n = 40 each) according to the composite used (Dyad Flow or SDR). They were further divided into 4 sub-groups (n = 10 each) according to the pulp-capping agent used. SBS was tested using a universal testing machine at a crosshead speed of 1 mm/min. Data were analyzed using 2-way analysis of variance. A p value of < 0.05 was considered to indicate statistical significance. Results: A statistically significant difference (p = 0.040) was found between Dyad Flow and SDR in terms of bond strength to MTA Plus, Dycal, Biodentine, and TheraCal. Conclusions: Among the 8 sub-groups, the combination of TheraCal and SDR exhibited the highest SBS.

• Restorative Dentistry and Endodontics
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• v.7 no.1
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• pp.107-115
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• 1981

The purpose of this investigation was to study histopathological chronology and differences of the proprietary pulpcapping agents. One hundred eighty molars from thrity rats (Srague-Dawley species), weighing about 130gm, were divided into six groups. Cavities were prepared in their maxillary molars under intraperitoneal anesthesia with Secobarbital. The cavities in the right first and second molars were filled with Dycal$^{(R)}$ and the left ones were with Cavitec$^{(R)}$. Each group of rats were sacrificed at the intervals of 1, 3, 5, 7, 14 and 21 days following operation. The rats were decapituated, and the jaws were fixed in 10% neutral buffered formalin. Then the specimens were decalcified, embedded in paraffin or celloid, and sectioned at 6-8 ${\mu}$ in thickness through the cavities included and pulp mesiodistally. They were stained with Hematoxylin-Eosin and examined by lightmicroscope. The results were as follow: 1. The pattern of pulp healing was dependent upon the presence and character of the pulpcapping agents above. 2. Dentin bridge formation as a sign of pulp healing occurred in the 14 days after operation. 3. Dycal$^{(R)}$ reparation appeared to favor pulp bealing rather than Cavitec$^{(R)}$ preparation. 4. In the odontoblastic layer and pulp tissue specific vaculoes were showed at the 3, 5 and 7 days of the Dycal filling.

• Journal of dental hygiene science
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• v.10 no.4
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• pp.227-231
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• 2010

The purpose of this study was to examine the MAPK signaling pathways involved in regulation of HO-1 and the odontoblast differentiation markers during the odontoblastic differentiation for HDPCs. We evaluated cell growth by MTT assay and differentiation marker mRNA expression by RT-PCR. When the cells were treated with p38 inhibitor (SB203580, $10{\mu}M$), JNK inhibitor (SP600125, $10{\mu}M$), and ERK inhibitor (PD98059, $20{\mu}M$) for 7 days, cell growth and expression of HO-1 and differentiation makers were significantly decreased in HDPCs. Our results suggest that odontoblastic differentiation is positively regulated by HO-1 induction in HDPCs via ERK, JNK, and p38 signaling pathways. Thus, pharmacological HO-1 induction might represent a potent therapeutic approach for pulp capping and the regeneration of HDPCs.

• Restorative Dentistry and Endodontics
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• v.32 no.2
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• pp.95-101
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• 2007

This study was performed to verify the possibility of MTA and calcium sulfate as a pulp capping agent through comparing the dental pulp response in dogs after capping with MTA, calcium sulfate, and calcium hydroxide. 24 teeth of 2 dogs, 8 month old, were used in this study. Under general anesthesia, cervical cavities were prepared and pulp was exposed with sterilized #2 round bur in a high speed handpiece. MTA calcium hydroxide, and calcium sulfate were applied on the exposed pulp. Then the coronal openin,fs were sealed with IRM and light-cured composite. Two months after treatment, the animals were sacrificed. The extracted teeth were fixed in 10% neutral-buffered formalin solution and were decalcified in formic acid-sodium citrate. They were prepared for histological examination in the usual manner. The sections were stained with haematoxylin and eosin. In MTA group, a hard tissue bridges formation and newly formed odontoblasts layer was observed. There was no sign of pulp inflammatory reaction in pulp tissue. In calcium hydroxide group, there was no odontoblast layer below the dentin bridge. In pulpal tissue, chronic inflammatory reaction with variable intensity and extension occurred in all samples. In calcium sulfate group, newly formed odontoblast layer was observed below the bridge. Mild chronic inflammation with a few neutrophil infiltrations was observed on pulp tissue. These results suggest that MTA is more biocompatible on pulp tissue than calcium hydroxide or calcium sulfate.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.2
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• pp.45-49
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• 2016

This study investigates the success rate of pulpotomy using electrosurgery operated on a primary molar in caries. The pulpotomy using electrosurgery was done on 253 primary molars of 111 young patients from 2 to 9 years old during the period of the first day of January 2011 to the last day of December 2015. After the amputation of pulp and hemostasis of primary molar were done using electrosurgery, MTA as pulp capping material was applied to the primary molar and the tooth was restored with the stainless steel crown. The follow up period after the treatment ranged from 4-46 months. The clinical and radiographic success rate ranged from 92.1 - 94.3%. Which is comparable to formocresol and ferric sulfate pulpotomy. Due to its non-pharmacological characteristic, electrosurgery can minimize harmful effect on the pulp tissue. Its fast bleeding control makes it easy and safe to use in pediatric and disabled patients in comparatively simple manner. Electrosurgery can be an alternative for pulp therapy considering the side effects of pharmacological ways.

• Journal of the korean academy of Pediatric Dentistry
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• v.8 no.1
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• pp.37-46
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• 1981

This study was undertaken to evaluate the pulpal responses to the pulp-capping materials such as glutaraldehyde and formocresol in pulpotomy technique, especially in the primary dentition. Mandibular primary canines and molars of 5 dogs (aged about 8-9 weeks)were selected for this study. The intervals of observation for histologic study of pulpotomized primary teeth with 2% glutaraldehyde, formocresol and calcium hydroxide in the usual manner ranged from 2 hours, 1 week, 2 weeks, 3 weeks and 5 weeks after experiments respectively. Each specimens were fixed with 10% formalin and decalcified in 5% nitric acid. All slides were stained with Hematorylin-Eosin and examined histopathologically. The results were as follows; 1. In calcium hydroxide groups, formation of dentin bridge was initiated in 1 week after experiments and completed in 5 weeks after experiments. 2. Formation of dentin bridge was not seen, whereas necrosis of pulp tissue was noted, in formocresol and glutaraldehyde groups. 3. Duration of tissue reactions and tissue changes were similar, in formocresol and glutaraldehyde groups. 4. In formocresol and glutaraldehyde groups, amputation surfaces of the pulp were covered with blood clots, beneath which coagulation necrois was noted, but inflammatory cells were not prominent, in 2 hours and 1 week after experiments. But coagulation necrosis was proceeded to the apical portion, accompanied by infiltration of inflammatory cells, since 2 weeks after experiments. And suppuration or gangrene of the pulp tissue were noted in 3 weeks and 5 weeks groups. 5. Suppuration or gangrene of pulp seemed to provoke the resorption of dentin wall, and inflammatory changes and resorption of roots were noted in the periodontal membrane near the periapical region. 6. As compared with calcium hydroxide groups, resorption of the root was pronounced in form or cresol and glutaraldehyde groups. Effects of medicaments to the succedaneous tooth germ were not seen.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.1
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• pp.27-40
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• 1997

This study investigated the effects of laser irradiation on the exposed pulp and the possibility of direct pulp capping with the $CO_2$ laser. Results were obtained from the observation of the residual pulpal healing process. Class V cavities on 48 anterior teeth from 8 adult dogs were prepared and pulp chambers were intentionally opened with dental explorer. The control group consisted of 16 teeth. $Dycal^{(R)}$(Caulk Co., U.S.A.) was applied to exposed site once bleeding was stopped. Cavities were sealed with $I.R.M^{(R)}$. In the experimental group 1 (16 teeth), laser(LASERSAT $CO_2^{(R)}$, Satelec Co.) was irradiated on the exposed pulp. The laser procedure followed the manufacturers recommendations for the treatment of human pulp(1.5 Watts, 0.2 seconds, unfocused), and cavities were sealed with $I.R.M^{(R)}$. In the experimental group 2 (16 teeth), laser was irradiated on the exposed pulp in a more powerful dosage(5.0 Watts, 0.2 seconds, unfocused), and cavities were sealed with $I.R.M^{(R)}$. Two dogs were sacrificed immediately after experiment and the others were sacrificed at intervals of one, three, and eight weeks respectively. All teeth were routinely processed and the pulpal tissues and odontoblastic layers were observed by the light microscope. The results were as follows; 1. In the control group, the initial mild inflammation had improved to normal by week eight. An active formation of reparative dentin was observed at week three, and at week eight, a firm dentin bridge was present beneath the $Dycal^{(R)}$ with no inflammatory responses in the remaining pulp. 2. In the experimental group 1, immediately following irradiation, the superficial shape of the exposed pulp was crater-like. And it was lined with the coagulated layer, $60{\sim}70{\mu}m$ in width. Moderate inflammatory pulpal conditions existing at week one were improved to mild at week eight. And from the week three specimens, a reparative dentin formation was observed in the adjacent odontoblastic layer of the exposed site. A dentin bridge at the exposed site, however, did not form during the experimental period. 3. In the experimental group 2, the width of the coagulation layer lining the crater was $70{\sim}130{\mu}m$. Beneath the coagulated layer, severe inflammatory pulpal responses were observed at week one, and conditions did not improve during the experimental period.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.324-332
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• 2008

Traumatic crown fracture in mixed dentition or early permanent dentition is relatively common. Crown fracture is classified into simple or complicated crown fracture by the presence of pulp exposure. The condition of pulp must be considered in treatment of crown fractures with pulp exposure. Treatment of immature crown-fractured incisor with pulp exposure is more complex because of its incomplete root formation. Pulp capping, partial pulpotomy, cervical pulpotomy can be used for continuous root development in immature crown-fractured incisor with pulp exposure. The success rate of partial pulpotomy is very high and there are several advantages of partial pulpotomy because the cell-rich coronal pulp tissue is preserved. This paper reports 2 cases of crown-fractured permanent incisors with pulp exposure that had been treated by partial pulpotomy successfully.

• Restorative Dentistry and Endodontics
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• v.34 no.5
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• pp.415-423
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• 2009

The purpose of this study is to investigate the response of human pulp cell on Portland cement mixed with $\beta$-glycerophosphate. To investigate the effect of $\beta$-glycerophosphate and/or dexamethasone on human pulp cell, ALP activity on various concentration of $\beta$-glycerophosphate and dexamethasone was measured and mineral nodule of human pulp cell was stained with Alizarin red S. MTS assay and ALP activity of human pulp cell on Portland cement mixed with various concentration of $\beta$-glycerophosphate (10 mM, 100mM, 1M) was measured and the specimens were examined under SEM. Addition of $\beta$-glycerophosphate or dexamethasone alone had no effect however, the addition of 5 mM $\beta$-glycerophosphate and 100 nM dexamethasone had the largest increasement in ALP activity. There was no toxicity in all samples and the data showed that Portland cement mixed with 10 mM $\beta$-glycerophosphate had more increase in ALP activity compared with control. In conclusion, Portland cement mixed with $\beta$-glycerophosphate has no toxicity and promotes differentiation and mineralization of pulp cell compared with additive-free Portland cement. This implicated that application of Portland cement mixed with $\beta$-glycerophosphate might form more reparative dentin and in turn it would bring direct pulp capping to success.