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  • Title: Adverse effects of human pulps after direct pulp capping with the different components from a total-etch, three-step adhesive system.
    Author: Accorinte Mde L, Loguercio AD, Reis A, Muench A, de Araújo VC.
    Journal: Dent Mater; 2005 Jul; 21(7):599-607. PubMed ID: 15978268.
    Abstract:
    OBJECTIVES: The objective was to evaluate the response of human pulps capped with different components from a total-etch three-step adhesive system. METHODS: Direct pulp capping was performed in 25 caries-free human premolars scheduled for extraction due to orthodontic treatment. The teeth were randomly divided in five groups, and capped with the following materials: Group 1-acid+primer+adhesive were used as recommended; Group 2-only primer was applied; Group 3-only bonding resin (light-cured for 10s); Group 4-only composite resin (light-cured for 40s); Group 5-calcium hydroxide. After capping, all teeth were restored with ScotchBond Multi Purpose Plus and Z-100 was placed incrementally. After 60 days, the teeth were extracted and processed for light microscopic examination (H/E) according to a histological score system. These were subjected to non-parametric tests (alpha<0.05). RESULTS: Overall, the histological features showed that groups 1-4 were quite similar and inferior to group 5. In groups 1-4 the pulp response varied from acute inflammatory cell infiltrate with varying degrees to necrosis. The groups 3 and 4 showed a trend towards better pulp response, since a normal connective tissue could be observed in more than half of the sample. All teeth from group 5 showed normal connective tissue below an amorphous dentin bridge. SIGNIFICANCE: Adhesive components (primer or adhesive) as well as a composite should be avoided for pulp capping. Ca(OH)(2) should be the first choice for pulp capping.
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