[Long-term clinical follow-up of the pulp of teeth filled with adhesive composites using 3 technics for pulp and dentin protection].
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Biomedical subjects
Publications and source records attributed to J Holz.
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This study was designed to investigate by SEM the ultrastructure of the dentinal bridge formed upon pulp capping and its attachment to the contiguous dentinal walls. The pulps of 20 sound premolars and third molars were deliberately exposed and capped with a calcium hydroxide paste, Pulpdent. After 4 to 15 weeks the teeth were extracted. SEM observations suggested complete bridging, increasing in thickness after succeeding postoperative periods. Cross-sections of the specimens older than 6 weeks showed the presence of three different layers within the bridges: the superior amorphous layer was composed of tissue debris and Ca(OH)2, in the medial portion a coarse meshwork of fibers was identified as fibrodentine and the pulpal aspects exhibited tubularlike orthodentinal structures. The bridge attachment was secured by bundles of fibres linking the intertubular dentine of the pulpal walls with the dentine of the neodentinal bridge.
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The main intention of this study was to examine the effect of cyclic somatostatin (SRIF) on bovine adrenal cell activity in vitro. beta-Endorphin was applied in another course of experiments. Basal aldosterone secretion when measured was found to be 0.86 +/- 0.33 ng per 10(5) cells and 1.5 h incubation time in the glomerulosa cell fractions. Cortisol production was 1.6 +/- 0.3 ng per 10(5) cells in the fasciculata/reticularis cell incubates respectively. No effect was observed when cyclic somatostatin (SRIF) was added to cell incubates of the bovine adrenal cortex. However, aldosterone secretion was increased 4.5-fold in the presence of 10(-9)M ACTH or 10(-8)M At II. Cortisol production was enhanced similarly after addition of 10(-9)M ACTH.
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Appropriate definitions, history and success rates of direct pulp capping procedures are reviewed. Two of the disadvantages of this form of treatment are infection of the pulp, either preoperatively or postoperatively due to a non-sterile procedure or bacterial leakage at the capping site. Past results of directly capping potential inflamed pulps have been unsatisfactory, but now an increasing number of endodontists advocate capping when conditions are favourable. Direct capping should only be used on vital pulp which has been accidentally injured and shows no other symptoms. Direct capping with calcium hydroxide should not be used on pulp which has been exposed as a result of penetrating caries. Clinical studies 2338 cases have shown that the risk of failure is increased if the pulp is diseased before capping, but that the age of the tooth does not have an adverse effect. It also appears that capping performed by skilled practitioners is more successful than that performed by students. The results of a re-examination of 110 patients, a minimum of 4 years after they had received direct capping treatment from students, showed a success rate of 80 per cent. In skilled hands, the success rate for direct capping with calcium hydroxide is now 90 per cent provided that a hermetic seal is obtained.
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