Clinical and histological response of human pulp tissue to direct pulp capping with mineral trioxide aggregate, Biodentine and propolis

Abstract

Background: This study clinically and histologically compared the human pulp response to direct
pulp capping (DPC) with mineral trioxide aggregate (MTA), Biodentine, and propolis in 2 months.
Materials and Methods: In this clinical trial evaluated 41 premolars candidate for extraction
due to orthodontic purposes of patients between 15 and 25 years of age. A group of 5 was
separated randomly as the negative control. The remaining teeth were randomly divided into three
experimental groups of 12 after mechanical exposure of the pulp by bur in high‑speed handpiece
under air and water spray. The exposed areas were capped with MTA, Biodentine, or propolis.
Glass ionomer was applied as base over the cap. The teeth were restored with composite resin.
Patients were recalled in 2 months for clinical and radiographic examinations and also pulp vitality
test. Teeth were then extracted. Slides were prepared and tissue sections were evaluated for the
presence and severity of inflammation, dentinal bridge, and continuity. Data were analyzed using
the Chi‑square and Fisher’s exact tests.
Results: The clinical success rate was 100% in the MTA and 91.7% in both the propolis and
Biodentine groups. The presence and severity of pulpal inflammation and dentinal bridge formation
were similar in all the experimental groups (P > 0.05). Dentinal bridge formation was similar
in the MTA and Biodentine groups and was higher than in the propolis group. Continuation of
dentinal bridge in the MTA group was significantly higher than that in the Biodentine and propolis
groups (P < 0.05).
Conclusion: MTA, Biodentine, and propolis are equally effective for DPC.
Key Words: Biodentine, direct pulp capping, mineral trioxide aggregate, propolis