World Journal of Dentistry

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VOLUME 12 , ISSUE 5 ( September-October, 2021 ) > List of Articles


Comparative Evaluation of Resin-modified Glass Ionomer Cement, Mineral Trioxide Aggregate, and Calcium Hydroxide When Used as a Direct Pulp Capping Material on Carious Pulp Exposures of Human Permanent Teeth: A Randomized Clinical Trial

M Agrawal Aanchal, Vanitha U Shenoy, V Margasahayam Sumanthini, S Satpute Tanvi

Keywords : Calcium hydroxide, Direct pulp capping, Mineral trioxide aggregate, Resin-modified glass ionomer cement

Citation Information : Aanchal MA, Shenoy V U, Sumanthini VM, Tanvi SS. Comparative Evaluation of Resin-modified Glass Ionomer Cement, Mineral Trioxide Aggregate, and Calcium Hydroxide When Used as a Direct Pulp Capping Material on Carious Pulp Exposures of Human Permanent Teeth: A Randomized Clinical Trial. World J Dent 2021; 12 (5):381-385.

DOI: 10.5005/jp-journals-10015-1862

License: CC BY-NC 4.0

Published Online: 29-09-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Aim and objective: To evaluate the clinical efficacy of resin-modified glass ionomer cement (RMGIC), mineral trioxide aggregate (MTA), and calcium hydroxide (CH) when used as a direct pulp capping (DPC) material on carious exposure of human permanent teeth. Materials and methods: Forty-five participants in the age group of 15–52 years, with deep carious lesions diagnosed with reversible pulpitis, were selected and divided into three groups, i.e., group I: RMGIC, group II: MTA, and group III: CH. Recall evaluation after 24 hours, 3 weeks, 3 months, and 6 months was carried out for recording self-reports from participants, a clinical inspection of the tooth, evaluating radiographs, testing vitality, palpation, percussion, mobility, and probing depths. Results: Of the 45 participants, 42 presented without any abnormal signs or symptoms. Three participants presented with symptoms of irreversible pulpitis, which indicated DPC failure. Chi-square test gave a p value > 0.05. Conclusion: There was no significant association between different parameters and the DPC materials used in the study. Clinical significance: Carious pulp exposure poses a challenge to the endodontist and maintaining the vitality of the pulp by DPC is one of the treatment modalities. This study has attempted to compare the efficacy of commonly used pulp capping materials like MTA and CH in addition to RMGIC, which has routinely been used for restorations.

  1. Bogen G, Chandler NP. Vital pulp therapy. In: Ingle J, Bakland L, Baumgartner J, ed. Endodontics. 6th ed., Hamilton, Ontario: BC Decker;; 2008. pp. 1310–1313.
  2. Mente J, Geletneky B, Ohle M, et al. Mineral trioxide aggregate or calcium hydroxide direct pulp capping: an analysis of the clinical treatment outcome. J Endod 2010;36(5):806–813. DOI: 10.1016/j.joen.2010.02.024.
  3. Bogen G, Kim JS, Bakland LK. Direct pulp capping with mineral trioxide aggregate: an observational study. J Am Dent Assoc 2008;139(3):305–315. DOI: 10.14219/jada.archive.2008.0160quiz 305-15 Erratum in, J Am Dent Assoc 2008;139(5):541.
  4. Hilton TJ. 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.
  5. Barthel CR, Rosenkranz B, Leuenberg A, et al. Pulp capping of carious exposures treatment outcome after 5 and 10 years: a retrospective study. J Endod 2000;26(9):525–528. DOI: 10.1097/00004770-200009000-00010.
  6. Schröder U. Effects of calcium hydroxide-containing pulp-capping agents on pulp cell migration, proliferation, and differentiation. J Dent Res 1985;64(Spec No):541–548. DOI: 10.1177/002203458506400407.
  7. Hilton TJ, Ferracane JL, Mancl L. Northwest practice-based research collaborative in evidence-based dentistry (NWP). Comparison of CaOH with MTA for direct pulp capping: a PBRN randomized clinical trial. J Dent Res 2013;92(7 Suppl):16S–22S. DOI: 10.1177/0022034513484336.
  8. Camilleri J, Pitt, Ford TR. Mineral trioxide aggregate: a review of the constituents and biological properties of the material. Int Endod J 2006;39(10):747–754. DOI: 10.1111/j.1365-2591.2006.01135.x.
  9. Ford TR, Torabinejad M, Abedi HR, et al. Using mineral trioxide aggregate as a pulp-capping material. J Am Dent Assoc 1996;127(10):1491–1494. DOI: 10.14219/jada.archive.1996.0058.
  10. Modena KC, Casas-Apayco LC, Atta MT, et al. Cytotoxicity and biocompatibility of direct and indirect pulp capping materials. J Appl Oral Sci 2009;17(6):544–554. DOI: 10.1590/s1678-77572009000600002.
  11. Hse KM, Leung SK, Wei SH. Resin-ionomer restorative materials for children: a review. Aust Dent J 1999;44(1):1–11. DOI: 10.1111/j.1834-7819.1999.tb00529.x.
  12. Tarim B, Hafez AA, Cox CF. Pulpal response to a resin-modified glass-ionomer material on nonexposed and exposed monkey pulps. Quintessence Int 1998;29(8):535–542.
  13. Felton DA, Cox CF, Odom M, et al. Pulpal response to chemically cured and experimental light-cured glass ionomer cavity liners. J Prosthet Dent 1991;65(5):704–712. DOI: 10.1016/0022-3913(91)90210-n.
  14. Murray PE, García-Godoy F. The incidence of pulp healing defects with direct capping materials. Am J Dent 2006;19(3):171–177.
  15. do Nascimento AB, Fontana UF, Teixeira HM, et al. Biocompatibility of a resin-modified glass-ionomer cement applied as pulp capping in human teeth. Am J Dent 2000;13(1):28–34.
  16. American Academy of Pediatric Dentistry. Clinical guidelines on pulp therapy for primary and permanent teeth: Reference manual 2006-07. Pediatr Dent 2006;28:144–148.
  17. Geurtsen W, Spahl W, Leyhausen G. Residual monomer/additive release and variability in cytotoxicity of light-curing glass-ionomer cements and compomers. J Dent Res 1998;77(12):2012–2019. DOI: 10.1177/00220345980770121001.
  18. Stanislawski L, Daniau X, Lauti A, et al. Factors responsible for pulp cell cytotoxicity induced by resin-modified glass ionomer cements. J Biomed Mater Res 1999;48(3):277–288. DOI: 10.1002/(sici)1097-4636(1999);2-t.
  19. Shameem A, Muliyar S, Thankachan RP, et al. Study to evaluate the efficacy of resin-modified glass lonomer cement liner as a direct pulp capping material. J Contemp Dent Pract 2018;19(9):1065–1071. DOI: 10.5005/jp-journals-10024-2382.
  20. Momoi Y, Hirosaki K, Kohno A, et al. Flexural properties of resin-modified “hybrid” glass-ionomers in comparison with conventional acid-base glass-ionomers. Dent Mater J 1995;14(2):109–119. DOI: 10.4012/dmj.14.109.
  21. Yasuda Y, Ogawa M, Arakawa T, et al. The effect of mineral trioxide aggregate on the mineralization ability of rat dental pulp cells: an in vitro study. J Endod 2008;34(9):1057–1060. DOI: 10.1016/j.joen.2008.06.007.
  22. Torabinejad M, Hong CU, McDonald F, et al. Physical and chemical properties of a new root-end filling material. J Endod 1995;21(7):349–353. DOI: 10.1016/S0099-2399(06)80967-2.
  23. Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review--Part I: chemical, physical, and antibacterial properties. J Endod 2010;36(1):16–27. DOI: 10.1016/j.joen.2009.09.006.
  24. 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.
  25. Mohammadi Z, Shalavi S. Antifungal effects of root canal irrigants and medicaments. An update review. N Y State Dent J 2014;80(5):58–63.
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