Histological evaluation of direct pulp capping with DSP-derived synthetic peptide in beagle dog

Article information

Restor Dent Endod. 2009;34(2):120-129

Publication date (electronic) : 2009 January 14

doi : https://doi.org/10.5395/JKACD.2009.34.2.120

Jae-Hoon Kim ¹, Jun-Bae Hong ¹, Bum-Soon Lim ², Byeong-Hoon Cho ¹^,

¹Department of Conservative Dentistry, School of Dentistry, Seoul National University

²Department of Dental Biomaterials Science, School of Dentistry, Seoul National University

^*Corresponding Author: Byeong-Hoon Cho, Department of Conservative Dentistry, School of Dentistry, Seoul National University, 28 Yeongeon-dong, Jongro-gu, Seoul, 110-749, Korea Tel: +82-2-2072-3514 Fax: +82-2-2072-3859, E-mail: chobh@snu.ac.kr

Received 2008 November 28; Revised 2008 December 15; Accepted 2009 March 03.

Abstract

The purpose of this study was to investigate the pulpal response to direct pulp capping with dentin sialo-protein (DSP) -derived synthetic peptide in teeth of dogs, and to compare its efficacy to capping substances Ca(OH)₂ and white mineral trioxide aggregate (WMTA). A total of 72 teeth of 6 healthy male beagle dogs were used. The mechanically exposed pulps were capped with one of the following: (1) DSP-derived synthetic peptide (PEP group); (2) Ca(OH)₂ (CH group); (3) a mixture paste of peptide and Ca(OH)₂ (PEP+CH group); or (4) white MTA (WMTA group). The access cavity was restored with a reinforced glass ionomer cement. Two dogs were sacrificed at each pre-determined intervals (2 weeks, 1 month, and 3 months). After the specimens were prepared for standard histological processing, sections were stained with hematoxylin and eosin. Under a light microscope, inflammatory response and hard tissue formation were evaluated in a blind manner by 2 observers. In the PEP group, only 3 of 17 specimens showed hard tissue formation, indication that the DSP-derived synthetic peptide did not induce proper healing of the pulp. Compared with the CH group, the PEP group demonstrated an increased inflammatory response and poor hard tissue formation. The CH and WMTA groups showed similar results for direct pulp capping in mechanically exposed teeth of dogs.

Keywords: Pulp capping; Dentin sialoprotein; Reparative dentin; Histological evaluation; Calcium hydroxide; Beagle dog

Figure 1.

Pulp capping with PEP at 2 weeks. Although the pulp capping material was impacted into the pulp, newly formed hard tissue barrier was observed. Incisal portion of the pulp from the impacted site (left portion in the figure) showed degeneration of the pulp.

Figure 2.

Pulp capping with CH at 2 weeks. Newly formed hard tissue barrier was observed and odontoblast-like cells arranged beneath it. Although hemorrhage was seen, a few inflammatory cells were found.

Figure 3.

Pulp capping with PEP+CH at 2 weeks. Hard tissue formation was rare. Inflammatory cells infiltrated around the impacted capping material.

Figure 4.

Pulp capping with WMTA at 2 weeks. Among the dentin debris, scattered hard tissue was formed. Infiltration of inflammatory cells under odontoblast cell layer and dilatation of blood vessels were observed.

Figure 5.

Pulp capping with PEP at 1 month. Many inflammatory cells infiltrated around the exposed site. There was no hard tissue formation even around the dentin debris.

Figure 6.

Pulp capping with CH at 1 month. The thickness of hard tissue increased, compared with that of 2 weeks. In newly formed hard tissue, dentinal tubule-like structures were observed.

Figure 7.

Pulp capping with PEP+CH at 1 month. Newly formed hard tissue grew mainly around the fragments of dentin. Dilatation of blood vessels was observed.

Figure 8.

Pulp capping with WMTA at 1 month. Newly formed hard tissue grew into a complete bridge. They include the fragments of dentin that were pushed into the pulp during cavity preparation.

Figure 9.

Pulp capping with PEP at 3 months. Inflammatory response persisted at the exposed site. The newly formed hard tissue were related to the dentin debris.

Figure 10.

Pulp capping with CH at 3 months. There was a complete dentin bridge and normal pulp tissue organization beneath the exposed site. There were vacuole-like structure, cells and dentin chips inside a dentin bridge.

Figure 11.

Pulp capping with PEP+CH at 3 months. No hard tissue formation was observed. Inflammatory response of the pulp persisted.

Figure 12.

Pulp capping with WMTA at 3 months. There was a thick hard tissue barrier, that did not include a cell body and had no tubular structure, across the exposed site.

Table 1.

Number of teeth and the experimental periods

Table 2.

Criteria for grading inflammatory cell response

Table 3.

Criteria for grading hard tissue formation

Table 4.

Inflammatory responses and hard tissue formation with 4 experimental pulp capping materials at 3 observation intervals

References

1. Herman BW. Dentin obliteration after treatment with calcium. Zahna‥rztl Rundschau 39:888–899. 1930;(In German).

2. Schro¨der U. Effects of calcium hydroxide-containing pulp-capping agents on pulp cell migration, proliferation and differentiation. J Dent Res 64(suppl 1):541–548. 1985;

3. Pitt Ford TR, Torabinejad M, Albedi HR, Bakland LK, Kariyawasam SP. Using mineral trioxide aggregate as a pulp-capping material. J Am Dent Assoc 127:1491–1494. 1996;

4. Goldberg M, Six N, Decup F, Lasfargues JJ, Salih E, Tompkins K, Veis A. Bioactive molecules and the future of pulp therapy. Am J Dent 16:66–76. 2003;

5. Schuurs AHB, Gruythuysen RJM, Wesselink PR. Pulp capping with adhesive resin based composite versus calcium hydroxide: a review. Endod Dent Traumatol 16:240–250. 2000;

6. Lee SJ, Monsef M, Torabinejad M. Sealing ability of a mineral trioxide aggregate for repair of lateral root perforations. J Endod 19:541–544. 1993;

7. Abedi HR, Torabinejad M, Pitt Ford TR, Bakland LK. The use of mineral trioxide aggregate cement as a direct pulp capping material. J Am Dent Assoc 127:1491–1494. 1996;

8. Dominguez MS, Witherspoon DE, Gutmann JL, Opperman LA. Histological and scanning electron microscopy assessment of various vital pulp-therapy materials. J Endod 29:324–333. 2003;

9. Iwamoto CE, Adachi E, Pameijer CH, Barnes D, Romberg EE, Jefferies S. Clinical and histological evaluation of white ProRoot MTA in direct pulp capping. Am J Dent 19:85–90. 2006;

10. Goldberg M, Six N, Decup F. et al. Application of bioactive molecules in pulp-capping situations. Adv Dent Res 15:91–95. 2001;

11. Decup F, Six N, Palmier B, Buch D. Bone sialopro-tein-induced reparative dentinogenesis in the pulp of rat's molar. Clin Oral Invest 4:110–119. 2000;

12. Six N, Decup F, Lasfargues JJ, Salih E, Goldberg M. Osteogenic proteins (bone sialoprotein and bone morphogenetic protein-7) and dental pulp mineralization. J Mater Sci Mater Med 13:225–232. 2002;

13. Wang J, Kennedy JG, Glimcher MJ, Salih E. Novel bioactive property of purified native bone sialoprotein in bone repair of calvarial defect. Trans Orthop Res Soc 23:1007. 1998;

14. George A, Bannon L, Sabsay B, Dillon JW, Malone J, Veis A, Jenkins NA, Gilbert DJ, Copeland NG. The carboxyl-terminal domain of phosphophoryn contains unique extended triplet amino acid repeat sequences forming ordered carboxyl-phosphate interaction ridges that may be essential in the biomineralization process. J Biol Chem 271:32869–32873. 1996;

15. Qin C, Brunn JC, Ridall A. et al. the expression of dentin sialophosphoprotein gene in bone. J Dent Res 81:392–394. 2002;

16. Butler WT. Sialoprotein of bone and dentin. J Bio Buccale 19:83–89. 1991;

17. Pitt Ford TR, Torabinejad M, Abedi HR, Bakland LK, Kariyawasam SP. Using mineral trixoide aggregate as a pulp capping material. J Am Dent Assoc 127:1491–1494. 1996;

18. Aeinehchi M, Eslami B, Ghanbariha M, Saffar AS. Mineral trioxide aggregate (MTA) and calcium hydroxide as pulp-capping agents in human teeth: a preliminary report. Int Endod J 36:225–231. 2002;

19. Nair PNR, Duncan HF, Pitt Ford TR, Luder HU. Histological, ultrastructural and quantitative investigations on the response of health human pulps to experimental capping with mineral trioxide aggregate: a randomized controlled trial. Int Endod J 41:128–150. 2008;

20. Tziafas D, Kolokuris I, Alvanou A, Kaidoglou K. Short-term dentinogenic response of dog pulp tissue after its induction by demineralized or native dentine or by pre-dentine. Arch Oral Biol 37:119–128. 1992;

21. Schroder U. Evaluation of healing following experimental pulpotomy of intact human teeth and capping with calcium hydroxide. Odontol Revy 23:329–340. 1972;

22. Heithersay GS. Calcium hydroxide in the treatment of pulpless teeth with associated pathology. J Br Endod Soc 8:74–93. 1975;

23. Siqueira JR, Lopez HP. Mechanism of antimicrobial activity of calcium hydroxide; a critical review. Int Endod 32:361–369. 1999;

24. Cox CF, Bergenholtz G, Heys DR, Syed SA, Fitzgerald M, Heys RJ. Pulp-capping of dental pulp mechanically exposed to oral microflora: a 1-to-2-year observation of wound healing in the monkey. J Oral Pathol 14:156–168. 1985;

25. Stanley HR, Pameijer CH. Dentistry's friend, calcium hydroxide. Oper Dent 22:1–3. 1997;

26. Cox CF, Bergenholtz G, Fitzgerald M, Heys DR, Heys RJ, Avery JK, Baker JA. Capping of the dental pulp mechanically exposed to the oral microflora: 5-week observation of wound healing in the monkey. J Oral Pathol 11:327–339. 1982;

27. Holland R, De souza V, Nevy NJ, Otobone Filho JA, Bernabe DF, Dezan Jr E. Reaction of rat connective tissue to implanted dentin tubes filled with mineral trioxide aggregate or calcium hydoxide. J Endod 25:161–166. 1999;

28. Torabinejad M, Watson EF, Pitt Ford TR. Sealing ability of mineral trioxide aggregate when used as a root end filling material. J Endod 19:591–595. 1993;

29. Fischer EJ, Arens DE, Miller CH. Bacterial leakage of mineral trioxide aggregate as compared with zinc-free amalgam, intermediate restorative material, and Super-EBA as a root-end filling material. J Endod 24:176–179. 1998;

30. Wu MK, Kontakiotis EG, Wesselink PR. Long-term seal provided by some root-end fillng materials. J Endod 24:557–560. 1998;

31. Torabinejad M, Pitt Ford TR, McKendry DJ, Abedi HR, Miller DA, Kariyawasam SP. Histological assessment of mineral trioxide aggregate as a root-end filling in monkeys. J Endod 23:225–228. 1997;

32. Holland R, de Souza V, Nery MJ, Otoboni Filho JA, Bernabe PF, Dezan Jr E. Reaction of dog's teeth to root canal filling with mineral trioxide aggregate or a glass ionomer sealer. J Endod 25:728–730. 1999;

33. Keiser K, Johnson CC, Tipton DA. Cytotoxicity of mineral trioxide aggregate using human periodontal ligament fiboroblasts. J Endod 26:288–291. 2000;

34. Myers K, Kaminski E, Lautenschalger E, Miller D. The effects of mineral trioxide aggregate on the dog pulp (Abstract). J Endod 22:198. 1996;

35. Song JS, Mante FK, Romanow WJ, Kim S. Chemical analysis of powder and set forms of Portland cement, gray ProRoot MTA, white ProRoot MTA, and gray MTA-Angelus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 102:809–815. 2006;

36. Agamy HA, Bakry NS, Mounir MF, Avery DR. Comparison of mineral trioxide aggregate and formocresol as pulp-capping agents in pulpotomized primary teeth. Pediatr Dent 26:302–309. 2004;

37. Maroto M, Barberia E, Vera V, Garcia-Godoy F. Dentin bridge formation after white trioxide aggregate (white MTA) pulpotomies in primary molars. Am J Dent 19:75–79. 2006;

38. Parirokh M, Asgary S, Eghbal MJ, Stowe S, Eslami B, Eskandarizade A, Shabahang S. A comparative study of white and grey mineral trioxide aggregate as pulp capping agents in dog's teeth. Dent Traumatol 21:150–154. 2005;

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