Histological evaluation of the regenerative potential of a novel treated dentin matrix hydrogel in direct pulp capping

Objectives To produce a novel injectable treated dentin matrix hydrogel (TDMH) to be used as a novel pulp-capping agent for dentin regeneration compared with Biodentine and MTA. Materials and methods Thirty intact fully erupted premolars scheduled to be extracted for orthodontic reasons were included. Pulps were mechanically exposed in the middle of the cavity floor. TDMH was composed of TDM powder (500-mu m particle size) and sodium alginate as an injectable scaffold. The capped teeth were divided into three equal groups (n= 10): TDMH, Biodentine, and MTA respectively. Clinical examination and assessment of periapical response were performed. The teeth were extracted after 2-weeks and 2-month intervals, stained with hematoxylin-eosin, and categorized by using a histologic scoring system. Statistical analysis was performed using chi-square and Kruskal-Wallis test (p= 0.05). Results All teeth were vital during observation periods. Histological analysis after 2 months showed complete dentin bridge formation and absence of inflammatory pulp response with no significant differences between groups. However, the formed dentin was significantly thicker with the TDMH group with layers of well-arranged odontoblasts that were found to form a homogenous tubular structure with numerous dentinal tubule lines showing a positive trend to dentin regeneration. Conclusions TDMH could achieve dentin regeneration and conservation of pulp vitality and might serve as a feasible natural substitute for silicate-based cements in restoring in vivo dentin defect in direct pulp-capping procedure.

Automated summary

In this clinical study, it was found that using TDMH, Biodentine, and MTA for direct pulp capping showed good dentin regeneration ability with no inflammatory response. However, the dentin formed in the TDMH group was significantly thicker with well-arranged odontoblasts, indicating a positive trend towards dentin regeneration.