Evaluation of reparative dentin formation of ProRoot MTA, Biodentine and BioAggregate using micro-CT and immunohistochemistry

Jia Kim, Young-Sang Song, Kyung-San Min, Sun-Hun Kim, Jeong-Tae Koh, Bin-Na Lee, Hoon-Sang Chang, In-Nam Hwang, Won-Mann Oh, Yun-Chan Hwang, Jia Kim, Young-Sang Song, Kyung-San Min, Sun-Hun Kim, Jeong-Tae Koh, Bin-Na Lee, Hoon-Sang Chang, In-Nam Hwang, Won-Mann Oh, Yun-Chan Hwang

Abstract

Objectives: The purpose of this study was to assess the ability of two new calcium silicate-based pulp-capping materials (Biodentine and BioAggregate) to induce healing in a rat pulp injury model and to compare them with mineral trioxide aggregate (MTA).

Materials and methods: Eighteen rats were anesthetized, cavities were prepared and the pulp was capped with either of ProRoot MTA, Biodentine, or BioAggregate. The specimens were scanned using a high-resolution micro-computed tomography (micro-CT) system and were prepared and evaluated histologically and immunohistochemically using dentin sialoprotein (DSP).

Results: On micro-CT analysis, the ProRoot MTA and Biodentine groups showed significantly thicker hard tissue formation (p < 0.05). On H&E staining, ProRoot MTA showed complete dentin bridge formation with normal pulpal histology. In the Biodentine and BioAggregate groups, a thick, homogeneous hard tissue barrier was observed. The ProRoot MTA specimens showed strong immunopositive reaction for DSP.

Conclusions: Our results suggest that calcium silicate-based pulp-capping materials induce favorable effects on reparative processes during vital pulp therapy and that both Biodentine and BioAggregate could be considered as alternatives to ProRoot MTA.

Keywords: BioAggregate; Biodentine; Dentin sialoprotein; MTA; Micro-CT.

Conflict of interest statement

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

Figures

Figure 1. Micro-CT image of pulp capped…
Figure 1. Micro-CT image of pulp capped rat molar teeth after 4 weeks. MTA and Biodentine showed thicker hard tissue formation than did BioAggregate. (a, b) Normal pulp; (c, d) MTA; (e, f) Biodentine; (g, h) BioAggregate group. Color scale bar indicates mineral density from 0 (corresponding to black in radiograph) to 100 (corresponding to white in radiograph). White arrow indicates reparative dentin.
Figure 2. The relative ratio of newly…
Figure 2. The relative ratio of newly formed reparative dentin to pulp cavity. Area of mineralized tissue and pulp cavity was measured by Image J (version 1.47, National Institutes of Health, Bethesda, MD, USA). MTA and BioAggregate differed significantly in forming a hard tissue.
*p < 0.05. MTA, Mineral trioxide aggregate.
Figure 3. Histological analysis of rat molar…
Figure 3. Histological analysis of rat molar teeth. (a, b) MTA; (c, d) Biodentine; (e, f) BioAggregate. At 4 weeks, hematoxylin and eosin stained sections showed reparative dentin bridge formation in all samples. A thick, homogeneous reparative dentin bridge and reactionary dentin could be seen in the MTA group (a, b). Reparative tissue was continuous and thick in the Biodentine group (c, d). Bridges in the BioAggregate group had a dense mineralized structure (e, f).
*Biomaterial. P, pulp; RD, reparative dentin.
Figure 4. Immunohistochemical results with DSP antibody.…
Figure 4. Immunohistochemical results with DSP antibody. (a) Positive control; (b) negative control; (c, d) MTA; (e, f) Biodentine; (g, h) BioAggregate. The positive control showed positive immunoreactivity to DSP in dentin and pulp (a), while the negative control was immunonegative to the DSP antibody (b). Reparative dentin from the MTA group showed strong immunoreactivity to DSP (c, d). Newly formed tissue from the Biodentine group stained lightly positive to DSP (e, f). Weakly-stained DSP immunolabeled tissue was seen in the BioAggregate group (g, h). Some immunolabeled cells were embedded within the newly formed tissue.
DSP, dentin sialoprotein; RD, reparative dentin.

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