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VOLUME 1 ISSUE 2, APRIL- JUNE 2013
11
INTERNATIONAL JOURNAL OF ORAL HEALTH SCIENCES AND ADVANCES
EVALUATION OF HISTOLOGICAL RESPONSE OF DENTAL PULP TO
BIOGRAFT HA A RESEARCH STUDY
Capt. Tapan Singh* Maj. Gen. Jatinder Pal Singh** Maj. Ronauk Singh*** Dr. Ripin Garewal****
*Command Military Dental Centre, Kolkata **Commandant, Command Military Dental Centre, Kolkata ***Corps Dental Unit,
Siliguri, ****Sr. Lecturer Department of Pedodontics and Preventive Dentistry, National Dental College & Hospital, Punjab.
INTRODUCTION
The pulp in primary teeth has a high potential for
repair because of a high degree of cellularity and
vascularity in this tissue
1
. The rationale for the
pulpotomy procedure is that the radicular pulp tissue
is healthy and capable of healing after amputation of
the coronal pulp. Thus pulpotomy helps to maintain
the primary dentition in an intact state until normal
exfoliation occurs.
There is ample information about pulpotomy in
deciduous molars using formocresol, glutaraldehyde,
electrosurgery, ferric sulphate, calcium hydroxide,
etc. The vital pulpotomy process using formocresol
has been widely accepted in primary tooth pulp
therapy because of its simplicity and good prognosis
2
.
However, much concern has arisen over the
mutagenic and carcinogenic potential of
formaldehyde containing products, the cytotoxic
effects of formocresol and the possible diffusion into
the surrounding and systemic tissues
3
. In order to
avoid the possible harmful effects of formocresol and
other pulpotomy agents, an ideal agent for vital
pulpotomy procedure is being sought. Synthetic
hydroxyapatite (HA) is promising biomaterials
specifically in the orthopaedic and dental fields, as
their chemical composition is similar to that of bone.
Due to the need for safer bone graft applications,
these bone graft substitutes are gradually gaining
increased acceptability. In our endeavour to find an
ideal pulpotomy agent, the use of hydroxyapatite
crystals was assessed for its regenerative potential.
Hydroxyapatite has been shown to be an extremely
biocompatible material for soft tissues and bone
4
. It
has been reported to be effective in alveolar ridge
augmentation
4
, healing of periodontal bone defects
5
,
osseointegration of titanium implants
6
and direct pulp
capping
7
. Hydroxyapatite, which is the main
constituent of dental hard tissues, may immediately
ABSTRACT
Purpose: To evaluate Histological assessment of dental pulp response to BioGraft HA
Method: fifteen deciduous molars were treated with pulpotomy using BioGraft HA.
Results: histological evaluation was observed at the end of 4 weeks. On light microscopic observations, minimal
inflammatory reaction, hyperemia and formation of dentinal bridge was observed. None of the samples showed Pulpal
necrosis
Clinical significance: The results of this study revealed that BioGraft HA is a potential pulpotomy agent for
deciduous molars.
KEYWORDS: Pulpotomy, Bioceramics, Deciduous molars, Pulpal response, Formocresol, Hydroxyapatite.
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VOLUME 1 ISSUE 2, APRIL- JUNE 2013
12
INTERNATIONAL JOURNAL OF ORAL HEALTH SCIENCES AND ADVANCES
provide an artificial barrier. Despite the putative
abilities of hydroxyapatite to be osteoconductive,
osteogenic and dentinogenic
7
, little research has been
done with this material as a pulp healing agent. The
present study was undertaken to evaluate
histologically the response of pulp to hydroxyapatite
crystals (BioGraft HA).
MATERIALS AND METHOD
This study was carried out on fifteen patients, with
deep carious primary mandibular teeth indicated for
pulpotomy deemed for serial extraction. All
experimental procedures were carried out according
to the protocol approved by the Ethical Committee.
The criteria for tooth selection in this study were:
1- Primary dentition with vital carious pulp exposures
that bleed upon entering the pulp chambers.
2- No clinical symptoms or evidence of pulp
degeneration, such as pain on percussion, history of
swelling, or sinus tracts.
3- No radiographic signs of internal or external
resorption and no periapical or furcation
radiolucency.
4- Teeth would be restorable with posterior stainless
steel crowns.
Following profound local anaesthesia and rubber dam
application, a sterile No 1 round high-speed bur was
used to remove the roof of the coronal pulp chamber.
The coronal pulp tissue was amputated using a sterile
sharp spoon excavator. Pulpal hemorrhage was
controlled by moist cotton pellet. Amputated pulpal
stumps were covered with BioGraft HA
. In all
treated teeth, Cavit (3M ESPE, Germany) base
material was placed over the treated pulps, followed
by a layer of light cured glass ionomer cement (GC
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