Direct Pulp Capping with Mineral Trioxide Aggregate: An Immunohistologic Comparison with Calcium Hydroxide in Rodents

Introduction: The aim was to evaluate the proliferation of pulp cells 1, 3, and 7 days after direct pulp capping with Pro Root MTA (MTA) and to compare the results with calcium hydroxide (Ca(OH)(2)). Methods: An occlusal cavity was prepared in 36 molar teeth of 18 Wistar rats. Then MTA or Ca(OH)(2) was placed on the exposed pulp. All cavities were restored with composite. After 1, 3, and 7 days the animals were killed. One hour before scarification 5-bromo-2'-deoxyuridine (BrdU) was injected into the intraperitoneal cavity for immunohistologic analysis. BrdU was incorporated into the cell nucleus during the S phase of the cell cycle. Proliferating cells were tagged and counted by using alkaline phosphatase and anti-alkaline phosphatase antibody staining. Three animals (6 molar teeth) served as controls and were not further treated. The number of the tagged cells was statistically analyzed by comparing the results of the 3 groups. A Bonferroni correction was performed, because the data of the Ca(OH)(2)- group was used 3 times for pairwise comparison. Results: The marked cells were identified as fibroblasts, endothelial cells (after 1, 3, and 7 days), and HMI cells (after 7 days). The MTA group showed a similar amount of HMI cells when compared with the Ca(OH)(2) group (P > .05). One day and 7 days after capping, no significant differences were observed between the 2 tested groups and the controls (P>.05). After 3 days, significantly more cells were stained in the MTA and Ca(OH)(2) groups than in the control group (P<.016). Conclusions: Immunohistologic analysis demonstrated that MTA showed similar results when compared with Ca(OH)(2) within the first week after direct pulp capping. (J Endod 2010;36:814-819)