Evaluation of Carbonate Apatite Cement in Inducing Formation of Reparative Dentin in Exposed Dental Pulp


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Carbonate apatite (CO3Ap) cement is a biocompatible material with the ability to induce osteogenesis and is widely studied as the bone substitute material. The similarity of bone to tooth structure in their organic and inorganic composition offers a good prospect of the application of CO3Ap for regeneration of dentin and pulp tissue repair. This study is a sequel of the previous study in the development of CO3Ap cement for dental application, particularly in pulp capping treatment. In this study, the CO3Ap cement is used to cover an exposed dental pulp in rats and histological evaluation was carried out to evaluate the formation of reparative dentin, which is one of the signs of positive pulp capping treatment outcome. The CO3Ap cement was made by combining 60% dicalcium phosphate anhydrous (DCPA) and 40% vaterite with 1 mol/L Na2HPO4 aqueous solution at liquid to powder ratio of 0.5 and conventional calcium hydroxide [Ca(OH)2], which is the golden standard for pulp capping material was used for control. The coronal part of dental pulp in Wistar Rat was exposed with a small dental bur until bleeding were visible. The CO3Ap cement was applied to the exposed pulp and covered with light cured glass ionomer cement. The same protocol was applied to the control groups using Ca(OH)2. The Evaluation of formation of reparative dentin was done in 3 weeks after application by histological observation. Reparative dentin was histologically visible for all samples in CO3Ap group, as well as in the Ca(OH)2 groups. None of the dental pulps were necrotic and the pulp showed no heavy chronic inflammation. The CO3Ap cement was able to maintain the vitality of the pulp with no sign of chronic inflammation. The formation of reparative dentin was observable in 3 weeks of evaluation. Investigation on other properties and in vivo studies in different types of perforation and animal are to be carried out for further development of this material in dental application.



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Edited by:

Christian Rey, Christèle Combes and Christophe Drouet




M. N. Zakaria et al., "Evaluation of Carbonate Apatite Cement in Inducing Formation of Reparative Dentin in Exposed Dental Pulp", Key Engineering Materials, Vol. 758, pp. 250-254, 2017

Online since:

November 2017




* - Corresponding Author

[1] A. Cahyanto, M. Maruta, K. Tsuru, S. Matsuya, K. Ishikawa, Fabrication of bone cement that fully transforms to carbonate apatite, Dent. Mat. J. 34 3 (2005) 394-401.

DOI: https://doi.org/10.4012/dmj.2014-328

[2] A. Cahyanto, M. Maruta, K. Tsuru, S. Matsuya, K. Ishikawa, Basic properties of carbonate apatite cement consisting of vaterite and dicalcium phosphate anhydrous, Key Eng. Mater. 529-530 (2013) 192-196.

DOI: https://doi.org/10.4028/www.scientific.net/kem.529-530.192

[3] A. Cahyanto, K. Tsuru, K. Ishikawa. Transformation of apatite cement to B-type carbonate apatite using different atmosphere, Key Eng. Mater. 696 (2016) 9-13.

DOI: https://doi.org/10.4028/www.scientific.net/kem.696.9

[4] P. Habibovic, M.V. Juhl, S. Clyens, R. Martinetti, L. Dolcini, N. Theilgaard, C.A. van Blitterswijk. Comparison of two carbonated apatite ceramics in vivo, Acta Biomater. 6(6) (2010) 2219-26.

DOI: https://doi.org/10.1016/j.actbio.2009.11.028

[5] M.N. Zakaria, A. Cahyanto, A. El-Ghannam, Basic properties of novel bioactive cement based on silica-calcium phosphate composite and carbonate apatite, Key Eng. Mater. 720 (2017) 147-152.

DOI: https://doi.org/10.4028/www.scientific.net/kem.720.147

[6] S. Cohen, R.C. Burns, Pathways of the pulp, 10th ed., St. Louis, Mosby Inc., (2011).

[7] T.J. Hilton, J.L. Ferracane, J.C. Broome, Summitt's fundamentals of operative dentistry: a contemporary approach. 4th ed. Quintessence Publishing Co. Inc. (2013).

[8] T.J. Hilton, Key to success with pulp capping: A review of the Literature, Oper. Dent. 34 5 (2009) 615–625.

[9] M.N. Zakaria, Save the pulp is the essential issues on pulp capping treatment. J. Dentomaxillofac. Sci. 1 2 (2016) 301-5.

DOI: https://doi.org/10.22208/jdmfs.1.2.2016.294-298

[10] A. Qureshi, E. Soujanya, Nandakumar, Pratapkumar, Sambashivarao, Recent advances in pulp capping materials: An overview, J. Clin. Diagn. Res. 8 1 (2014) 316-321.

[11] G.A.B. Silva, A. Moreira, J. Bento, Histological processing of teeth and periodontal tissues for light microscopy analysis, Springer Science and Business Media, (2011)19-36.

DOI: https://doi.org/10.1007/978-1-60761-950-5_2

[12] M. Kuratate, K. Yoshiba, Y. Shigetani, N. Yoshiba, H. Ohshima, T. Okiji, Immunohistochemical analysis of nestin, osteopontin, and proliferating cells in the reparative process of exposed dental pulp capped with mineral trioxide aggregate. J Endod 34 (2008).

DOI: https://doi.org/10.1016/j.joen.2008.03.021

[13] P. Louwakul, V. Lertchirakarn, Response of inflamed pulps of rat molars after capping with pulp-capping material containing fluocinolone acetonide, J. Endod. 41(4) (2015) 508-512.

DOI: https://doi.org/10.1016/j.joen.2014.12.004

[14] P.N.R. Nair, H.F. Duncan, T.R. Pitt Ford, H.U. Lunder, Histological, ultrastructural and quantitative investigations on the response of healthy human pulps to experimental capping with mineral trioxide aggregate: a randomized controlled trial, Int. Endod. J. 41 (2008).

DOI: https://doi.org/10.1111/j.1365-2591.2007.01329.x

[15] A. Parolia, M. Kundabala, N.N. Rao, A comparative histological analysis of human pulp following direct pulp capping with propolis, mineral trioxide aggregate and dycal. J. Aust Dent J. 55 (2010) 59-64.

DOI: https://doi.org/10.1111/j.1834-7819.2009.01179.x