Direct Pulp Capping Clinical Trial
Official title:
Histologic and Immunohistochemical Study of Fibronectin and Tenascin in Human Teeth Pulp Capped With MTA and NEC
The purpose of this study is to evaluate the response of human dental pulp to capping with MTA and NEC by histology and immunohistochemistry, using fibronectin and tenascin as markers, following 2 weeks and 8 weeks.
Capping of the exposed pulp is indicated for reversible pulp tissue injury after physical or
mechanical trauma in developing or mature teeth.The response to direct pulp capping with
materials such as MTA or NEC is the formation of dentin barrier, resulting from the
recruitment and proliferation of undifferentiated cells.
Different materials can be used to induce dentinal bridge formation.MTA has been introduced
as a proper material to induce dentinal bridge formation,with greater mean thickness of
dentinal bridge and less inflammation compared to traditional materials like calcium
hydroxide. Although biocompatible, MTA has a poor handling characteristic, delay setting
time, off-white color, and it is almost expensive.The Novel Endodontic Cement (NEC) has been
introduced to combine reasonable characteristics of MTA with appropriate chemical
properties, setting time, color, and handling characteristics.
The extracellular matrix (ECM) of pulp comprises a variety of proteins and polysaccharides,
forming a neat network. The ECM components can induce either reactionary or reparative
dentin formation. Fibronectin (FN) and tenascin (TNC) are the two major glycoproteins
involved in wound healing and odontogenesis.
Fibronectins (FNs) are a class of high molecular weight adhesive proteins composed of two
very large subunits. It has a variety of cell functions, such as adhesion, migration,
growth, and differentiation. Furthermore FN may be involved in the polarization and
migration of odontoblasts.
Tenascin is a large oligomeric glycoprotein of the ECM secreted by fibroblasts and glial
cells in tissue cultures. It has also been identified in pulp and more prominent in
dentinogenesis. TN has been shown to be important in the differentiation of odontoblasts.
Therefore, it may be associated with secondary dentin formation, when pulp cells
differentiate into odontoblasts in response to physiologic stimuli.
Although dentin bridge formation has been reported,using different materials such as MTA and
NEC in direct pulp cap, but the exact mechanism is not well understood.
Immunohistochemistry, using different markers, may be useful in developing the molecules
involved in this process.
Moreover,response of dental pulp to different pulp capping materials can be
studied,including mean thickness of dentinal bridge, morphology of dentinal bridge, and
intensity of pulp inflammation and presence of odontoblast cells.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Caregiver, Outcomes Assessor), Primary Purpose: Treatment
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