Abstract
Objectives
To produce a novel injectable treated dentin matrix hydrogel (TDMH) to be used as a novel pulp-capping agent for dentin regeneration compared with Biodentine and MTA.
Materials and methods
Thirty intact fully erupted premolars scheduled to be extracted for orthodontic reasons were included. Pulps were mechanically exposed in the middle of the cavity floor. TDMH was composed of TDM powder (500-μm particle size) and sodium alginate as an injectable scaffold. The capped teeth were divided into three equal groups (n = 10): TDMH, Biodentine, and MTA respectively. Clinical examination and assessment of periapical response were performed. The teeth were extracted after 2-weeks and 2-month intervals, stained with hematoxylin-eosin, and categorized by using a histologic scoring system. Statistical analysis was performed using chi-square and Kruskal-Wallis test (p = 0.05).
Results
All teeth were vital during observation periods. Histological analysis after 2 months showed complete dentin bridge formation and absence of inflammatory pulp response with no significant differences between groups. However, the formed dentin was significantly thicker with the TDMH group with layers of well-arranged odontoblasts that were found to form a homogenous tubular structure with numerous dentinal tubule lines showing a positive trend to dentin regeneration.
Conclusions
TDMH could achieve dentin regeneration and conservation of pulp vitality and might serve as a feasible natural substitute for silicate-based cements in restoring in vivo dentin defect in direct pulp-capping procedure.
Trial registration
PACTR201901866476410
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All procedures performed were conducted strictly in full accordance with the ethical principles and standards of the institutional and national research committee and with the 1964 World Medical Association Declaration of Helsinki and its later amendments (version 2008). All experimental protocols were independently reviewed and approved by the Institutional Ethical Committee, Faculty of Dentistry, Alexandria University (IRB No. 00010556-IORG 0008839). This study was registered by the Pan African Clinical Trial Registry (PACTR) managed by Cochrane SA with identification number PACTR201901866476410.
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Clinical relevance
This is the first histological study using the treated dentin matrix as a pulp-capping agent on humans showing a positive trend to dentin regeneration.
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Holiel, A., Mahmoud, E., Abdel-Fattah, W. et al. Histological evaluation of the regenerative potential of a novel treated dentin matrix hydrogel in direct pulp capping. Clin Oral Invest 25, 2101–2112 (2021). https://doi.org/10.1007/s00784-020-03521-z
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DOI: https://doi.org/10.1007/s00784-020-03521-z