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ePaper created 2016-09-20, 16:58:27 | version 1.38.0
Journal of Oral Science & Rehabilitation 38 Volume 2 | Issue 3/2016 P u l p r e s p o n s e a f t e r c a p p i n g w i t h P D G F obliteratingthe pulp chamberwas observed.The general state of the pulp close to the remaining defect was moderately disorganized. This area contained many fibroblasts, some extravasated red blood cells and few inflammatory cells (Fig. 3). No signs of abscess were observed. The pulptissueadjacenttothereactiveareaappeared normal, with no signs of inflammation or necro- sis (Figs. 4 & 5). S i t e B Debris occurred along and over the cavity walls, butwithouttouchingthe pulptissue (Fig.6).The hard bridgeformationwas moderate and incom- plete, leaving a small area of communication between the capping material and the dental pulp. The reparative dentin was tubular and well oriented(Fig.7),withoutinvadingthepulpspace. The generalstate ofthe pulpwas normallyorga- nized without inflammatory cells beneath the dentin bridge formation. Only a limited area of tissue disorganization and pulp reaction similar to that observed in Site A was adjacent to the hard-barrier interruption and separated the nor- mal pulp tissue from the contaminated drill- created cavity (Fig. 8). No tunnel-like defect ap- peared in any section. The hard-tissue thickness was greater in the central portion, and the thick- nessatthedistalsidewasnotcalculatedbecause of the interruptions (Table 1). Discussion The present pilot studywas designedto evaluate the response of noninflamed mechanically ex- posed human pulps after capping performed using PDGF-BB. In Site A, an area of moderate disorganizationwasevidentbelowtheremaining pulp exposure site. In Site B, only a limited area ofslight reactionwas observed atthe lateralside ofthe defect, closetothe dentin bridge interrup- tion. No signs of abscess or inflammatory infil- trate in the connective tissue were detected in either sample. The pulp was overall normal and asymptomatic, despite the use of nonsealing cement.Tubularreparativedentinandanadjacent well-organized odontoblast-like cell layer were detected in both samples. No extensive dentin matrix deposition obliterating the pulp chamber was found. In the literature, tunnel defects are often described throughout the newly formed dentin bridges of teeth capped with calcium hy- droxide.8 In the present study, in both samples, the reparative dentin was compact and without defects. Since the aim of the present study was toassesstheresponseofnoninflamedpulptissue after PDGF-BB treatment, no control samples were evaluated to compare the amount of new- lyformeddentinmatrix.Also,theexperimentwas conducted on a limited numberofcases andthus did not allow for statistical analysis. In the treat- ed teeth, access to the pulp chamberwas oftwo different sizes to assess the response of capped pulp tissue to varying extents of such a trauma- tic event. Fig. 4 Detail of Figure 1. The pulp tissue (P) adjacent to the reactive area and under the original dentin (D) appears healthy and well organized, with no signs of necrosis or abscess. H&E staining (at original 100× magnification). Fig. 5 Detail of Figure 1. Photomicro- graph of the pulp in the area adjacent to the reactive tissue. No extravasated red blood cells, suffering pulp or inflam- matory cells are detectable. H&E staining (at original 400× magnification). Figs. 4 & 5