Citation Information :
Kaul S, Kumar A, Jasrotia A, Gorkha K, Kumari S, Jeri SY. Comparative Analysis of Biodentine, Calcium Hydroxide, and 2% Chlorhexidine with Resin-modified Glass Ionomer Cement as Indirect Pulp Capping Materials in Young Permanent Molars. J Contemp Dent Pract 2021; 22 (5):511-516.
Aim and objective: This study was carried out to compare the effectiveness of biodentine, calcium hydroxide, and 2% chlorhexidine gluconate used along with resin-modified glass ionomer cement (RMGIC) as indirect pulp capping (IPC) materials in young permanent molars.
Materials and methods: In this study, 54 patients were selected. Among these patients, 72 young permanent molars were selected randomly in which IPC was required. These teeth were randomly categorized into three different groups and each group consisted of 24 teeth. The first group was group A consisting of teeth treated with biodentine, the second group was group B consisting of teeth treated with 2% chlorhexidine gluconate being followed by RMGIC, while the third was group C consisting of teeth treated with calcium hydroxide. All cases were subjected to follow-up for clinical and radiographic evaluation at 4, 8, and 16 months. The data were recorded and analyzed statistically by utilizing the Chi-square test.
Results: After 16 months, 95.83% of cases in group A consisting of teeth treated with biodentine showed successful results both clinically and radiographically. While 87.5% of cases in group B consisting of teeth treated with 2% chlorhexidine gluconate being followed by RMGIC showed successful results. And finally, 91.66% of cases in group C consisting of teeth treated with calcium hydroxide showed successful results.
Conclusion: Biodentine can be efficiently used as an IPC agent in young permanent molars although all three materials were effective in IPC with a nonsignificant difference statistically. This study highlights the success of IPC in young permanent molars and the choice of better IPC material can be biodentine.
Clinical significance: Indirect pulp capping is one of the procedures in which preservation of carious affected dentin nearest to the pulp is carried out to protect the pulp. Several new IPC agents like biodentine have been introduced. Hence, it is necessary to evaluate their effectiveness.
Ward J. Vital pulp therapy in cariously exposed young permanent teeth and its limitations. Aust Endod J 2002;28(1):29–37. DOI: 10.1111/j.1747-4477.2002.tb00364.x.
Cvek M. A clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fracture. J Endod 1978;4(8):232–237. DOI: 10.1016/S0099-2399(78)80153-8.
Aguilar P, Linsuwanont P. Vital pulp therapy in vital permanent teeth with cariously exposed pulp: a systematic review. J Endod 2011;37(5):581–587. DOI: 10.1016/j.joen.2010.12.004.
Dammaschke T, Leidinger J, Schafer E. Long-term evaluation of direct pulp capping—treatment outcomes over an average period of 6.1 years. Clin Oral Investig 2010;14(5):559–567. DOI: 10.1007/s00784- 009- 0326-9.
Caplan DJ, Cai J, Yin G, et al. Root canal filled versus non-root canal filled teeth: a retrospective comparison of survival times. J Public Health Dent 2005;65(2):90–96. DOI: 10.1111/j.1752-7325.2005.tb02792.x.
Al-Hiyasat AS, Barrieshi-Nusair KM, Al-Omari MA. The radiographic outcomes of direct pulp-capping procedures performed by dental students: a retrospective study. J Am Dent Assoc 2006;137(12):1699–1705. DOI: 10.14219/jada.archive.2006.0116.
Seltzer S, Bender IB, Ziontz M. The dynamics of pulp inflammation: correlations between diagnostic data and actual histologic findings in the pulp. Oral Surg Oral Med Oral Pathol 1963;16:969–977. DOI: 10.1016/0030-4220(63)90201-9.
Tabarsi B, Parirokh M, Eghbal MJ, et al. A comparative study of dental pulp response to several pulpotomy agents. Int Endod J 2010;43(7):565–571. DOI: 10.1111/j.1365-2591.2010.01711.x.
Mitchell DF, Tarplee RE. Painful pulpitis; a clinical and microscopic study. Oral Surg Oral Med Oral Pathol 1960;13:1360–1370. DOI: 10.1016/0030-4220(60)90301-7.
Hirschman WR, Wheater MA, Bringas JS, et al. Cytotoxicity comparison of three current direct pulp-capping agents with a new bioceramic root repair putty. J Endod 2012;38(3):385–388. DOI: 10.1016/j.joen.2011.11.012.
Nowicka A, Lipski M, Parafiniuk M, et al. Response of human dental pulp capped with biodentine and mineral trioxide aggregate. J Endod 2013;39(6):743–747. DOI: 10.1016/j.joen.2013.01.005.
Soliman AF, Abu-Hamila NA, Ebiary MAE. Assessment of biodentine as an indirect pulp capping material in young permanent molars. Tanta Dent J 2019;16(1):1–5. DOI: 10.4103/tdj.tdj_16_18.
Boddeda KR, Rani CR, V Vanga NR, Chandrabhatla SK. Comparative evaluation of biodentine, 2% chlorhexidine with RMGIC and calcium hydroxide as indirect pulp capping materials in primary molars: An in vivo study. J Indian Soc Pedod Prev Dent. 2019;37(1):60-66. DOI: 10.4103/JISPPD.JISPPD_213_17.
Al-Zayer MA, Straffon LH, Feigal RJ, et al. Indirect pulp treatment of primary posterior teeth: a retrospective study. Pediatr Dent 2003;25(1):29–36.
Mickenautsch S, Yengopal V, Banerjee A. Pulp response to resin-modified glass ionomer and calcium hydroxide cements in deep cavities: a quantitative systematic review. Dent Mater 2010;26(8): 761–770. DOI: 10.1016/j.dental.2010.03.021.
Hayashi M, Fujitani M, Yamaki C, et al. Ways of enhancing pulp preservation by stepwise excavation—a systematic review. J Dent 2011;39(2):95–107. DOI: 10.1016/j.jdent.2010.10.012.
Marchi JJ, de Araujo FB, Fröner AM, et al. Indirect pulp capping in the primary dentition: a 4 year follow-up study. J Clin Pediatr Dent 2006;31(2):68–71. DOI: 10.17796/jcpd.31.2.y4um5076341226m5.
Farooq NS, Coll JA, Kuwabara A, et al. Success rates of formocresol pulpotomy and indirect pulp therapy in the treatment of deep dentinal caries in primary teeth. Pediatr Dent 2000;22(4):278–286.
Matsuo T, Nakanishi T, Shimizu H, et al. A clinical study of direct pulp capping applied to carious-exposed pulps. J Endod 1996;22(10): 551–556. DOI: 10.1016/S0099-2399(96)80017-3.
Mejàre I, Cvek M. Partial pulpotomy in young permanent teeth with deep carious lesions. Endod Dent Traumatol 1993;9(6):238–242. DOI: 10.1111/j.1600-9657.1993.tb00279.x.
Calişkan MK. Pulpotomy of carious vital teeth with periapical involvement. Int Endod J 1995;28(3):172–176. DOI: 10.1111/j.1365-2591.1995.tb00293.x.
Teixeira LS, Demarco FF, Coppola MC, et al. Clinical and radiographic evaluation of pulpotomies performed under intrapulpal injection of anaesthetic solution. Int Endod J 2001;34(6):440–446. DOI: 10.1046/j.1365-2591.2001.00414.x.
Malkondu Ö, Karapinar Kazandağ M, Kazazoğlu E. A review on biodentine, a contemporary dentine replacement and repair material. Biomed Res Int 2014;2014:160951. DOI: 10.1155/2014/160951.