The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 23 , ISSUE 11 ( November, 2022 ) > List of Articles


Is Bioactive Glass an Effective Agent in Pulp-capping Treatments?: A Randomized Controlled Clinical Trial with One-year Follow-up

Merve Abaklı İnci, Emre Korkut

Keywords : Bioactive glasses, Biocompatible materials, Calcium hydroxide, Dental pulp, Pulp capping agents

Citation Information : İnci MA, Korkut E. Is Bioactive Glass an Effective Agent in Pulp-capping Treatments?: A Randomized Controlled Clinical Trial with One-year Follow-up. J Contemp Dent Pract 2022; 23 (11):1128-1135.

DOI: 10.5005/jp-journals-10024-3428

License: CC BY-NC 4.0

Published Online: 17-03-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Aims: Indirect pulp-capping treatment is a procedure applied to teeth with deep and close-to-pulp caries lesions and without pulp degeneration symptoms. This study aimed to explore the use of a material containing bioactive glass for indirect pulp capping in primary and permanent teeth. Materials and methods: The study included 145 patients, aged 4–15 years, without any systemic disease and 100 primary second molars and 100 permanent first molars in total. Four material groups were determined: calcium hydroxide (Dycal-DC group), glass ionomer (Biner LC–BC group), calcium silicate (TheraCal LC–TC group), and Bioactive glass-containing ACTIVA BioACTIVE-AC group. Clinical and radiographic evaluations were made 1, 3, 6, 9, and 12 months after the treatment. The data obtained were statistically analyzed using the Chi-square test. Results: During the 12-month follow-up period, the DC and TC groups were more successful clinically (94%), while the DC and AC groups were found to be more successful radiographically (94%). However, no statistically significant difference was found between the groups (p > 0.05). Conclusions: The results of this study supported the view that the success of indirect pulp-capping treatments was independent of the material used. Clinical significance: This study demonstrated that a material containing bioactive glass, ACTIVA BioACTIVE-Base/Liner, can be used safely in indirect pulp-capping processes.

  1. American Academy of Pediatric Dentistry (AAPD) Guideline on pulp therapy for primary and immature permanent teeth 2014;37(6): 244–252.
  2. Akhlaghi N, Khademi A. Outcomes of vital pulp therapy in permanent teeth with different medicaments based on review of the literature. Dent Res J 2015;12(5):406–417. DOI: 10.4103/1735-3327.166187.
  3. Fagundes TC, Barata TJ, Prakki A, et al. Indirect pulp treatment in a permanent molar: Case report of 4-year follow-up. J Appl Oral Sci 2009;17(1):70–74. DOI: 10.1590/s1678-77572009000100014.
  4. Cox CF, Sübay RK, Ostro E, et al. Tunnel defects in dentin bridges: Their formation following direct pulp capping. Oper Dent 1996;21(1):4–11. PMID: 8957909.
  5. Murray PE, Hafez AA, Smith AJ, et al. Bacterial microleakage and pulp inflammation associated with various restorative materials. Dent Mater 2002;18(6):470–478. DOI: 10.1016/s0109-5641(01)00072-0.
  6. Hilton T. Keys to clinical success with pulp capping: A review of the literature. Oper Dent 2009;34(5):615–625. DOI: 10.2341/09-132-0.
  7. Gökcek M, Bodrumlu EH. Vital pulpa tedavilerinde güncel yaklaşımlar. Atatürk Üniv Diş Hek Fak Derg 2016;14:118–129.
  8. Komabayashi T, Zhu Q, Eberhart R, et al. Current status of direct pulp-capping materials for permanent teeth. Dent Mater J 2016;35(1):1–12. DOI: 10.4012/dmj.2015-013.
  9. Kunert M, Lukomska-Szymanska M. Bio-inductive materials in direct and indirect pulp capping – A review article. Materials (Basel) 2020;13(5):1204. DOI: 10.3390/ma13051204.
  10. Lee J-B, Park S-J, Kim H-H, et al. Physical properties and biological/odontogenic effects of an experimentally developed fast-setting α-tricalcium phosphate-based pulp capping material. BMC Oral Health 2014;14:87. DOI: 10.1186/1472-6831-14-87.
  11. Colon P. Interactions between a calcium silicate cement (Biodentine) and its environment. J Dent Res 2010;89.
  12. Brunner TJ, Stark WJ, Boccaccini AR. Nanoscale bioactive silicate glasses in biomedical applications. Wiley-VCH GmbH & Co KGaA 2009, pp. 203–220.
  13. Stanley HR, Clark AE, Pameijer CH, et al. Pulp capping with a modified bioglass formula (#A68-modified). Am J Dent 2001;14(4):227–232. PMID: 11699742.
  14. Farooq I, Imran Z, Farooq U, et al. Bioactive glass: A material for future. World J Dent 2012;3(2):199–201. DOI: 10.5005/jp-journals-10015-1156.
  15. Cannio M, Bellucci D, Roether JA, et al. Bioactive glass applications: A literature review of human clinical trials. Materials (Basel) 2021;14(18):5440. DOI: 10.3390/ma14185440.
  16. Frankl SN, Shiere FR, Fogels HR. Should the parent remain with the child in the dental operatory? J Dent Child 1962;29:150–163.
  17. Falster CA, Araujo FB, Straffon LH, et al. Indirect pulp treatment: In vivo outcomes of an adhesive resin system vs calcium hydroxide for protection of the dentin-pulp complex. Pediatr Dent 2002;24(3): 241–248. PMID: 12064499.
  18. Cvar JF, Ryge G. Reprint of criteria for the clinical evaluation of dental restorative materials. 1971. Clin Oral Invest 2005;9(4):215–232. DOI: 10.1007/s00784-005-0018-z.
  19. Qureshi A, Soujanya E, Nandakumar SN, et al. Recent advances in pulp capping materials: An overview. J Clin Diagn Res 2014;8(1):316–321. DOI: 10.7860/JCDR/2014/7719.3980.
  20. Brizuela C, Ormeno A, Cabrera C, et al. Direct pulp capping with calcium hydroxide, mineral trioxide aggregate and biodentine in permanent young teeth with caries: A randomizal clinical trial. J Endod 2017;43(11):1776–1780. DOI: 10.1016/j.joen.2017.06.031.
  21. Garrocho-Rangel A, Quintana-Guevara K, Vazquez-Viera R, et al. Bioactive tricalcium silicate-based dentin substitute as an indirect pulp capping material for primary teeth: A 12-month follow-up. Pediatr Dent 2017;39(5):377–382. PMID: 29070160.
  22. Rosenberg L, Atar M, Daronch M, et al. Prospective study of indirect pulp treatment in primary molars using resin-modified glass ionomer and 2% chlorhexidine gluconate: A 12-month follow-up. Pediatr Dent 2013;35(1):13–17. PMID: 23635886.
  23. Al-Zayer M, Straffon LH, Feigal RJ, et al. Indirect pulp treatment of primary posterior teeth: A retrospective study. Pediatr Dent 2003;25(1):29–36. PMID: 12627699.
  24. George V, Janardhanan SK, Varma B, et al. Clinical and radiographic evaluation of indirect pulp treatment with MTA and calcium hydroxide in primary teeth (in-vivo study). J Ind Soc Ped Prev Dent 2015;33(2):104–110. DOI: 10.4103/0970-4388.155118.
  25. Gürcan AT, Seymen F. Clinical and radiographic evaluation of indirect pulp capping with three different materials: A 2-year follow-up study. Eur J Paediatr Dent 2019;20(2):105–110. DOI: 10.23804/ejpd. 2019.20.02.04.
  26. Jun S-K, Lee J-H, Lee H-H. The biomineralization of a bioactive glass-incorporated light-curable pulp capping material using human dental pulp stem cells. Biomed Res Int 2017:2017:2495282. DOI: 10.1155/2017/2495282.
  27. Long Y, Liu S, Zhu L, et al. Evaluation of pulp response to novel bioactive glass pulp capping materials. J Endod 2017;43(10): 1647–1650. DOI: 10.1016/j.joen.2017.03.011.
  28. Ningxin Z, Xanthippi C, Lihong G, et al. Biological properties of modified bioactive glass on dental pulp cells. J Dent 2019;83:18–26. DOI: 10.1016/j.jdent.2019.01.017.
  29. Zhu L, Li J, Dong Y. Effect of mesoporous bioactive glass on odontogenic differentiation of human dental pulp stem cells. Peer J 2021;23(9):e12421. DOI: 10.7717/peerj.12421.
  30. Karabulut B, Dönmez N, Göret CC, et al. Reactions of subcutaneous connective tissue to mineral trioxide aggregate, Biodentine®, and a newly developed BioACTIVE base/liner. Scanning 2020;2020:6570159. DOI: 10.1155/2020/6570159.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.