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

Jae-Hoon Kim; Jun-Bae Hong; Bum-Soon Lim; Byeong-Hoon Cho

doi:10.5395/JKACD.2009.34.2.120

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Original Article Histological evaluation of direct pulp capping with DSP-derived synthetic peptide in beagle dog: Jae-Hoon Kim¹, Jun-Bae Hong¹, Bum-Soon Lim², Byeong-Hoon Cho^1,*; Journal of Korean Academy of Conservative Dentistry 2009;34(2):120-129.
DOI: https://doi.org/10.5395/JKACD.2009.34.2.120
Published online: January 14, 2009

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: November 28, 2008 • Revised: December 15, 2008 • Accepted: March 3, 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

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

Group	Experimental period
Group	2 weeks	1 month	3 months
PEP	6	6	6
CH	6	6	6
PEP+CH	6	6	6
WMTA	6	6	6

Table 2.

Criteria for grading inflammatory cell response

Grade	Characterization
0	None or a few scattered inflammatory cells present in the pulpal area corresponding to pulp
	exposure, characteristic of normal tissue
1	Slight inflammatory cell infiltration with polymorphonuclear or mononuclear leukocytes
2	Moderate inflammatory cell infiltration involving the coronal pulp
3	Severe inflammatory cell infiltration involving the coronal pulp or abscess present

Table 3.

Criteria for grading hard tissue formation

Grade	Characterization
0	Absent
1	Modest hard tissue deposition beneath the exposed area
2	Moderate hard tissue deposition beneath the exposed area
3	Heavy hard tissue deposition beneath the exposed area, appearing as a complete dentin bridge

Table 4.

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

Group	Experimental period	Number of specimens	Inflammatory response				Hard tissue formation
Group	Experimental period	Number of specimens	0	1	2	3	0	1	2	3
PEP	2 weeks	6	0	3	1	2	4	1	1	0
	1 month	6	0	2	2	2	6	0	0	0
	3 months	5	0	3	2	0	4	1	0	0
CH	2 weeks	5	1	2	2	0	0	2	2	1
	1 month	6	4	1	1	0	1	1	1	3
	3 months	6	2	2	2	0	2	0	2	2
PEP+CH	2 weeks	6	2	1	1	2	4	0	2	0
	1 month	6	1	4	1	0	2	3	1	0
	3 months	6	1	1	1	3	5	1	0	0
WMTA	2 weeks	4	0	3	1	0	1	3	0	0
	1 month	6	3	2	0	1	1	1	2	2
	3 months	5	4	1	0	0	2	1	0	2

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

J Korean Acad Conserv Dent. 2009;34(2):120-129. Published online January 14, 2009

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

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Figure

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

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

Figure 6.

Figure 7.

Figure 8.

Figure 9.

Figure 10.

Figure 11.

Figure 12.

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

Group	Experimental period
Group	2 weeks	1 month	3 months
PEP	6	6	6
CH	6	6	6
PEP+CH	6	6	6
WMTA	6	6	6

Grade	Characterization
0	None or a few scattered inflammatory cells present in the pulpal area corresponding to pulp
	exposure, characteristic of normal tissue
1	Slight inflammatory cell infiltration with polymorphonuclear or mononuclear leukocytes
2	Moderate inflammatory cell infiltration involving the coronal pulp
3	Severe inflammatory cell infiltration involving the coronal pulp or abscess present

Grade	Characterization
0	Absent
1	Modest hard tissue deposition beneath the exposed area
2	Moderate hard tissue deposition beneath the exposed area
3	Heavy hard tissue deposition beneath the exposed area, appearing as a complete dentin bridge

Group	Experimental period	Number of specimens	Inflammatory response				Hard tissue formation
Group	Experimental period	Number of specimens	0	1	2	3	0	1	2	3
PEP	2 weeks	6	0	3	1	2	4	1	1	0
	1 month	6	0	2	2	2	6	0	0	0
	3 months	5	0	3	2	0	4	1	0	0
CH	2 weeks	5	1	2	2	0	0	2	2	1
	1 month	6	4	1	1	0	1	1	1	3
	3 months	6	2	2	2	0	2	0	2	2
PEP+CH	2 weeks	6	2	1	1	2	4	0	2	0
	1 month	6	1	4	1	0	2	3	1	0
	3 months	6	1	1	1	3	5	1	0	0
WMTA	2 weeks	4	0	3	1	0	1	3	0	0
	1 month	6	3	2	0	1	1	1	2	2
	3 months	5	4	1	0	0	2	1	0	2

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