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Dental cement materials have been developed with the aim to replace hard dental tissues. The first material used for pulp capping, root canal obturation, bifurcation perforation and apexification is calcium hydroxide (in 1920). A half century later, glass-ionomer cements began to suppress it as dentine substitutes. Finally, in the 1990s, calcium silicate (CS) material appeared in the dental research community as the most promising dentine substitute capable to adequately meet all clinical requirements. The aim of this paper is to present an overview of literature related to studies about CS materials taking into account their physical, chemical and biological properties and clinical applications. This review aims to discuss beneficial and adverse characteristics of CSs concerning interactions to the hard dentine and soft pulp/periodontal tissues. This review article deals with the literature data about currently commercially available CS concerning laboratory and clinical findings. 109 scientific articles were analyzed of which 62 references reported in vitro and 26 in vivo investigations while 21 references comprised reports, reviews and books dealing with both, in vitro and in vivo investigations. Although further data collection is necessary, CSs are promising materials that represent a gold standard for numerous dental clinical procedures. © 2019, Association of Chemists and Chemical Engineers of Serbia. All rights reserved.

Introduction Direct pulp capping is an important therapeutic method that has goal to provide formation of dentin bridge and healing process of the pulp. The aim of this study was to investigate the effects of new nanostructural materials based on calcium silicate systems and hydroxyapatite on exposed dental pulp in Vietnamese pigs. Material and Methods The study was conducted on 30 teeth of two Vietnamese pigs (Sus scrofa verus). On buccal surfaces of incisors, canines and first premolars, class V cavities were prepared with a small round bur and pulp horn was exposed. In the first experimental group (10 teeth) the perforation was covered with new nanostructural material based on calcium silicate systems (CS). In the second experimental group, the perforation was covered with compound of calcium silicate systems and hydroxyapatite (HA-CS) (10 teeth). In the control group, exposed pulp was covered with Pro Root MTA® (Dentsply Tulsa Dental, Johnson City, TN, USA) (10 teeth). All cavities were restored with glass ionomer cement (GC Fuji VIII, GC Corporation, Tokyo, Japan). Observation period was 28 days. After sacrificing the animals, histological preparations were done to analyze the presence of dentin bridge, inflammatory reaction of the pulp, pulp tissue reorganization and the presence of bacteria. Results Dentin bridge was observed in all teeth (experimental and control groups). Inflammation of the pulp was mild to moderate in all groups. Neoangiogenesis and many odontoblast like cells responsible for dentin bridge formation were detected. Necrosis was not observed in any case, neither the presence of Gram-positive bacteria in the pulp. Conclusion Histological analysis indicated favorable therapeutic effects of new nanostructural materials based on calcium silicate systems and hydroxyapatite for direct pulp capping in teeth of Vietnamese pigs., Uvod Direktno prekrivanje pulpe je važan terapijski postupak koji ima zadatak da obezbedi zatvaranje pulpne komore i omogući proces zarastanja. Cilj ovog rada je bio da se ispita efekat novih nanostrukturnih materijala na bazi kalcijum-silikatnih sistema i hidroksiapatita na eksponiranu pulpu zuba vijetnamskih svinja. Materijal i metode rada Istraživanje je sprovedeno na 30 zuba kod dve vijetnamske svinje (Sus scrofa verus). Na vestibularnim površinama sekutića, očnjaka i prvih premolara urađene su preparacije kaviteta V klase, pri čemu je malim okruglim svrdlom napravljena namerna eksploracija komore pulpe. U prvoj eksperimentalnoj grupi (10 zuba) perforacija je prekrivana novim nanostrukturnim materijalom na bazi kalcijum-silikatnih sistema (CS). U drugoj eksperimentalnoj grupi (10 zuba) perforacija je prekrivana smešom kalcijum-silikatnog sistema i hidroksiapatita (HA-CS). U kontrolnoj grupi (10 zuba) perforacija je prekrivana sa MTA® (Dentsply Tulsa Dental, Džonson Siti, Tenesi, SAD). Svi kaviteti su restaurirani glas-jonomer cementom (GC Fuji VIII, GC Corporation, Tokio, Japan). Opservacioni period iznosio je 28 dana. Nakon žrtvovanja životinja napravljeni su histološki preparati na kojima su analizirani postojanje dentinskog mostića, inflamatorna reakcija pulpe, reorganizacija pulpnog tkiva i prisustvo bakterija. Rezultati Na svim zubima eksperimentalnih grupa i kontrolne grupe zabeleženo je stvaranje dentinskog mostića. Zapaljenje pulpe je bilo blago do umereno i u eksperimentalnim i u kontrolnoj grupi. Uočeni su znaci neoangiogeneze i mnoštvo ćelija sličnih odontoblastima koje su odgovorne za stvaranje dentinskog mostića. Nekroza nije zabeležena ni u jednom slučaju, kao ni prisustvo gram-pozitivnih bakterija u pulpi. Zaključak Histološka analiza je ukazala na povoljne terapijske efekte novih nanostrukturnih materijala na bazi kalcijum-silikatnih sistema i hidroksiapatita u direktnom prekrivanju pulpe zuba vijetnamskih svinja.

Introduction Direct pulp capping procedure is a therapeutic application of a drug on exposed tooth pulp in order to ensure the closure of the pulp chamber and to allow the healing process to take place. Objective The aim of this study was to examine the histological effects of Emdogain® on exposed tooth pulp of a Vietnamese pig (Sus scrofa verus). Methods The study comprised 20 teeth of a Vietnamese pig. After class V preparation on the buccal surfaces of incisors, canines and first premolars, pulp was exposed. In the experimental group, the perforations were capped with Emdogain® (Straumann, Basel, Switzerland), while in the control group pulp capping was performed with MTA® (Dentsply Tulsa Dental, Johnson City, TN, USA). All cavities were restored with glass-ionomer cement (GC Fuji VIII, GC Corporation, Tokyo, Japan). The observational period was 28 days, after which the animal was sacrificed and histological preparations were made. A light microscope was used to analyze dentin bridge formation, tissue reorganization and inflammation, and the presence of bacteria in the pulp. Results The formation of dentin bridge was observed in the experimental and control groups. Inflammation of the pulp was mild to moderate in both groups. Angiogenesis and many odontoblast-like cells, responsible for dentin bridge formation, were observed. Necrosis was not observed in any case, nor were bacteria present in the pulp. Conclusion Histological analysis indicated a favorable therapeutic effect of Emdogain® Gel in direct pulp capping of Vietnamese pigs. Pulp reaction was similar to that of MTA®., Uvod Direktno prekrivanje pulpe je važan terapijski postupak primene leka na eksponiranu pulpu zuba, čiji je cilj da obezbedi zatvaranje pulpne komore i omogući proces zarastanja. Cilj rada Cilj ovog rada je bio da se histološki ispita efekat gleđnog emdogaina na eksponiranu pulpu zuba vijetnamske svinje (Sus scrofa domesticus). Metode rada Istraživanje je urađeno na 20 zuba vijetnamske svinje. Na vestibularnim površinama sekutića, očnjaka i prvih premolara urađene su preparacije kaviteta V klase s eksponiranjem komora pulpe. U eksperimentalnoj grupi perforacija je prekrivana proizvodom Emdogain® (Straumann, Bazel, Švajcarska), a u kontrolnoj sa MTA® (Dentsply Tulsa Dental, Džonson Siti, Tenesi, SAD). Svi kaviteti su restaurirani glasjonomer-cementom (GC Fuji VIII, GC Corporation, Tokio, Japan). Period posmatranja trajao je 28 dana, a nakon žrtvovanja životinja, napravljeni su histološki preparati na kojima su analizirani postojanje dentinskog mostića, zapaljenjska reakcija pulpe, reorganizacija pulpnog tkiva i postojanje bakterija. Rezultati Na svim zubima eksperimentalne i kontrolne grupe uočeno je stvaranje dentinskog mostića. Upala pulpe je bila blaga do umerena i u eksperimentalnoj i u kontrolnoj grupi. Uočeni su znaci neoangiogeneze i mnoštvo ćelija sličnih odontoblastima koje su odgovorne za stvaranje dentinskog mostića. Nekroza nije zabeležena ni u jednom slučaju, kao ni prisustvo bakterija u pulpi. Zaključak Histološka analiza je ukazala na povoljne terapijske efekte emdogaina u direktnom prekrivanju pulpe zuba vijetnamskih svinja. Reakcija pulpe bila je slična onima koje je izazvao MTA.

Introduction Direct pulp capping is therapeutic method of applying medication on exposed pulp in order to allow bridge formation and healing process. The aim of this study was to investigate the effect of Biodentine on exposed dental pulp of Vietnamese pigs. Material and Methods The study was conducted on 20 teeth of Vietnamese pigs (Sus scrofa domesticus). On buccal surfaces of incisors, canines and first premolars, class V cavities were prepared and pulp was exposed. In the experimental group (six incisors, two canines and two premolars) the perforation was covered with BiodentineR (Septodont, Saint-Maur-des-Fosses, France). In the control group, the perforation was covered with MTAR (Dentsply Tulsa Dental, Johnson City, TN, USA). All cavities were restored with glass ionomer cement (GC Fuji VIII, GC Corporation, Tokyo, Japan). Observation period was 28 days. After sacrificing the animals, histological preparations were done to analyze the presence of dentin bridge, an inflammatory reaction of the pulp, pulp tissue reorganization and the presence of bacteria. Results Dentin bridge was observed in all teeth (experimental and control groups). Inflammation of the pulp was mild to moderate in both groups. Neoangiogenesis and many odontoblast like cells responsible for dentin bridge formation were detected. Necrosis was not observed in any case, neither the presence of Gram-positive bacteria in the pulp. Conclusion Histological analysis indicated favorable therapeutic effects of Biodentine for direct pulp capping in teeth of Vietnamese pigs. Findings were similar with Biodentine and MTA., Uvod Direktno prekrivanje pulpe je terapijski postupak primene leka na eksponiranu pulpu zuba radi zatvaranja pulpne komore i omogućavanja procesa zarastanja. Cilj ovog rada je bio da se ispita efekat biodentina na eksponiranu pulpu zuba vijetnamske svinje. Materijal i metode rada Istraživanje je izvršeno na 20 zuba vijetnamske svinje (Sus scrofa domesticus). Na vestibularnim površinama sekutića, očnjaka i prvih premolara urađene su preparacije kaviteta V klase, pri čemu je napravljena namerna eksploracija komora pulpe. U eksperimentalnoj grupi (šest sekutića, dva očnjaka i dva premolara) perforacija je prekrivana preparatom Biodentine ® (Septodont, Sent Mor de Fos, Francuska). U kontrolnoj grupi perforacija je prekrivana sa MTA® (Dentsply Tulsa Dental, Džonson Siti, Tenesi, SAD). Svi kaviteti su restaurirani glasjonomer- cementom (GC Fuji VIII, GC Corporation, Tokio, Japan). Opservacioni period trajao je 28 dana. Nakon žrtvovanja životinja napravljeni su histološki preparati na kojima su analizirani postojanje dentinskog mostića, inflamatorna reakcija pulpe, reorganizacija pulpnog tkiva i prisustvo bakterija. Rezultati Na svim zubima eksperimentalne i kontrolne grupe zabeleženo je stvaranje dentinskog mostića. Zapaljenje pulpe je bilo blago do umereno i u eksperimentalnoj i u kontrolnoj grupi uzoraka. Uočeni su znaci neoangiogeneze i mnoštvo ćelija sličnih odontoblastima koje su odgovorne za stvaranje dentinskog mostića. Nekroza nije zabeležena ni u jednom slučaju, kao ni prisustvo Gram-pozitivnih bakterija u pulpi. Zaključak Histološka analiza je ukazala na povoljne terapijske efekte biodentina u direktnom prekrivanju pulpe zuba vijetnamskih svinja. Reakcija pulpe bila je slična onima koje je izazvao MTA.

The aim of this study was to examine the effect of Biodentine® and two new nanostructured materials based on active silicate cements on exposed tooth pulp of Vietnamese pigs. The study comprised 40 teeth in two Vietnamese pigs (24 months old). After class V cavity preparation, the pulp on each tooth was exposed using a small round bur. The following materials were applied on pulp exposures: Biodentine® (10 teeth), ALBO MPCA-I (10 teeth), and aLbO MPCA-II (10 teeth). In the control group, exposed pulp was covered with ProRoot MTA® (10 teeth). After the observation period of 28 days, the animals were sacrificed and the teeth prepared for histological analysis. Light microscope was used for the analysis of dentin bridge formation, tissue reorganization and inflammation, and the presence of bacteria in the pulp. In the group of Biodentine®, a complete dentin bridge was noted in 3 cases, while incomplete dentin bridge in the form of dental islets was detected in 4 cases. Nanostructured material ALBO-MPCA I provided complete dentin bridge formation in 5 teeth, in 3 teeth the formed dentin bridge was incomplete. ALBO MPCA-II showed complete closure of the pulp opening by dentin bridge in 4 samples, while in the same number of teeth it was incomplete. In the control group, 4 teeth showed a complete dentin bridge, whereas in 6 teeth it was incomplete. Histological analysis indicated favourable therapeutic effects of Biodentine® and the two materials ALBO-MPCA I and ALBO-MPCA II after teeth pulp capping in Vietnamese pigs. Pulp reaction was similar to that caused by ProRoot MTA®., Cilj ovog rada je bio dase ispita efekat Biodentina i dva nova nanostrukturna materijala na bazi aktivnih cilikatnih cemenata na eksponiranu pulpu zuba vijentamskih svinja. Istraživanje je obuhvatilo 40 zuba i dve vijetnamske svinje starosti 24 meseca. Na svima zubima je urađena preparacije kaviteta V klase i malim okruglim svrdlom eksponirana komora pulpe. Na perforaciju pulpe aplikovani su materijali: Biodentin (10 zuba), ALBO-MPCA I (10 zuba), ALBO-MPCA II (10 zuba). U kontrolnoj grupi pulpa je prekrivena MTA-om (10 zuba). Nakon observacionog perioda od 28 dana, životinje su žrtvovane i pripremljene za histološku analizu. Svetlosnom mikroskopijom analizirano je formiranje dentinskog mostića, postojanje reorganizacije tkiva, prisustvo inflamacije i bakterija u pulpi. Kod Biodentina kompletan dentinski mostić je zabeležen u 3 slučaja, a inkompletan dentinski mostić u vidu dentinskih ostrvaca u 4 slučaja. Nanostrukturni materijal ALBO-MPCA I je doveo do stvaranja kompletnog dentinskog mostića kod 5 zuba, a kod 3 zuba dentinski mostić je bio inkompletan. ALBO-MPCA II je pokazao kompletno zatvaranje komore pulpe dentinskim mostićem u 4 uzorka, dok je kod 4 uzorka on bio inkompletan. Kontrolni materijal MTA je kod 4 zuba imao stvoren kompletan dentinski mosti}, a u kod 6 zuba je on bio inkompletan. Histološka analiza je ukazala na povoljne terapijske efekte i Biodentina i dva novosintetisana materijala ALBO-MPCA I i ALBO-MPCA II u direktnom prekrivanju pulpezuba vijentamskih svinja. Reakcija pulpe bilaje slična onima koje je izazvao MTA.

There are very few data about the effects of endogenous growth factors in vital pulp therapy, and still they are often controversial. This study was undertaken with the aim to evaluate the effects of platelet rich plasma (PRP) in conjugation with hydroxyapatite (HAP), as pulp capping materials, on root and periodontium formation. Eight young monkeys (Cercopithecus Aethiops) with permanent dentition and incomplete root formation were involved in this study. After pulpotomy, the pulp lesion was capped with calcium hydroxide (control), HAP (experimental) or HAP in conjugation with PRP (experimental). Six moths later, the animals were sacrificed, the tissue was removed en block, and prepared for histological analysis in a routine way. The results of histological analysis revealed that the healing process, characterized by dentin bridge formation, maintained morphological and functional integrity of dental pulp and complete formation of dental root and surrounding periodontium. The inflammatory reaction was scored as mild to moderate, in almost all samples in all groups, suggesting the biocompatibility of the used materials. Materials used in this study are convenient as capping agents, contributing in maintaining the integrity of the pulp tissue and facilitating root and periodontium formation. According to histological data it could be suggested that hydroxyapatite in conjugation with endogenous growth factors, represent a superior alternative to other materials used in this study., Podaci iz literature o primeni faktora rasta u vitalnoj terapiji pulpe su oskudni i često kontraverzni. Cilj našeg rada je bio da se ispita uticaj plazme bogate trombocitima u kombinaciji sa hidroksiapatitom, kao materijala za direktno prekrivanje pulpe, na završetak rasta korena i formiranje okolnog parodoncijuma. Istraživanje je sprovedeno na osam mladih majmuna (Cercopithecus aethiops), sa stalnom denticijom i nezavršenim rastom korena. Nakon pulpotomije, pulpna lezija je prekrivena kalcijum hidroksidom (kontolna grupa), hidroksiapatitom (eksperimentalna grupa I) ili hidroksiapatitom u kombinaciji sa plazmom bogatom trombocitima (eksperimentalna grupa II). Šest meseci kasnije životinje su žrtvovane, a uzeto tkivo pripremljeno je za histološku analizu. Rezultati histološke analize ukazali su da je zarastanje bilo karakterisano stvaranjem mineralizovanog dentinskog mostića, uz očuvanje morfološkog i funkcionalnog integriteta pulpe i završetak rasta korena i okolnog parodoncijuma u uzorcima svih ispitivanih grupa. Zapaljenska reakcija je gotovo u svim ispitivnim uzorcima bila ocenjena kao blaga ili umerena, što govori u prilog biokompatibilnosti primenjenih materijala. Na osnovu dobijenih rezultata može se reći da su svi primenjeni materijali pogodni za direktno prekrivanje pulpe, da doprinose očuvanju integriteta pulpe i ubrzavaju završetak rasta korena i formiranje apikalnog parodoncijuma, s tim što hidroksipatit u kombinaciji sa endogenim faktorima rasta predstavlja superiorniju alternativu u odnosu na druge materijale korišćene u ovoj studiji.

The aim of the present study was to investigate the effects of caffeic acid phenethyl ester (CAPE) on wound healing capacity and repair of the pulp dentin complex on an experimental model. Eight young male pigs were used in this study. Arteficially preformed pulp lesions were treated either with calcium hydroxide (control group) or with CAPE powder (experimental group). The material for histological analysis was 4 and 14 weeks after pulp capping. Results of the histological analysis revealed that inflammatory reactions occurred in both groups. In the control group inflammation could be scored as mild to moderate, with a tendency to decrease during the observed period, while in the experimental group it was scored as severe in most of the specimens. Dentin bridge formation and complete reparation of the dentin-pulp complex was observed in most of the specimens of the control group, while the repair process in the experimental group was characterized by fibrous tissue proliferation. In the experimental group severe haemorrhagia, tissue oedema and dentin resorption were also observed. Based on reported results it could be concluded that capping material containing CAPE could not enhance the repair of the dentin-pulp complex, and healing of the dentin-pulp complex was characterized by scar tissue formation, rather than dentin bridge formation., Cilj rad je bio da se ispita efekat fenetil estra kafeinske kiseline na proces zarastanja rane i reparaciju dentinsko-pulpnog kompleksa. Istraživanje je izvršeno na 8 svinja muškog pola t.m. 60-65 kg. Njima je arteficijelno napravljena lezija u dentinsko-pulpnom kompleksu, koja je tretirana kalcijum hidroksidom (kontrolna grupa) ili fenetil estrom kafeinske kiseline (eksperimentalna grupa). Materijal za histološku analizu uzet je 4 i 14 nedelja nakon prekrivanja pulpe. Rezultati histološ ke analize su ukazali da se u obe grupe uzoraka pojavila zapaljenska reakcija. U kontrolnoj grupi, ona je ocenjena kao blaga do umerena, sa tendencijom smanjivanja tokom observacionog perioda, dok je u eksperimentalnoj grupi, u najvećem broju uzoraka ona ocenjena kao teška. Kompletna reparacija dentinsko- pulpnog kompleksa sa stvaranjem dentinskog mostića uočena je samo u kontrolnoj grupi, dok je u eksperimentalnoj, zarastanje bilo karakterisano vezivno tkivnom proliferacijom. U velikom broju uzoraka eksperimentalne grupe uočeni su znaci krvarenja, edema i resorpcije dentina. Na osnovu rezultata dobijenih u ovoj studiji može se reći da fenetil estar kafeinske kiseline ne podstiče reparativne procese u dentinsko-pulpnom kompleksu, tako da proces zarastanja rane nije bio praćen formiranjem reparativnog dentina već vezivno-tkivnog ožiljka.

Background/Aim. There are very few data about the effects of endogenous growth factors in vital pulp therapy, and still they are often controversial. The aim of the study was to evaluate the effects of platelet rich plasma (PRP) in conjugation with hydroxyapatite (HAP), as pulp capping materials, to root and periodontium formation. Methods. Eight young monkeys (Cercopithecus Aethiops) with permanent dentition and incomplete root formation were involved in this study. After pulpotomy, the pulp lesion was capped with calcium hydroxide (control), hydroxyapatite (experimental group I) or hydroxyapatite in conjugation with PRP (experimental group II). Six months later, the animals were sacrificed, the tissue was removed en block, and prepared for the histological analysis in a routine way. Results. The results of the histological analysis revealed that healing process was characterised by dentin bridge formation, maintained morphological and functional integrity of dental pulp and complete formation of dental root and surrounding periodontium. The inflammatory reaction was scored as mild to moderate, in almost all the samples in all groups, suggesting the biocompatibility of the used materials. Conclusion. Materials used in this study are convenient as capping agents, contributing maintaining the integrity of the pulp tissue and facilitating root and periodontium formation. According to histological data it could be suggested that hydroxyapatite in conjugation with endogenous growth factors, represents superior alternative to other materials used in this study., Uvod/Cilj. Podaci o primeni endogenih faktora rasta u terapiji vitalne pulpe zuba sa nezavršenim rastom korena su veoma oskudni i često kontraverzni. Cilj ovog rada bio je da se ispita uticaj plazme bogate trombocitima (PRP) u kombinaciji sa hidroksiapatitom (HAP), kao materijala za direktno prekrivanje pulpe, na završetak rasta korena i formiranje okolnog parodoncijuma. Metode. Istraživanje je obavljeno na osam mladih majmuna Cercopithecus Aethiops. Sve životinje imale su zube stalne denticije, sa nezavršenim rastom korena. Nakon trepanacije pulpnog prostora, pulpa je uklonjena do nivoa gleđnocementnog spoja, a lezija u pulpi prekrivena je kalcijum hidroksidom (kontrolna grupa), hidroksiapatitom (eksperimentna grupa I) i hidroksiapatitom u kombinaciji sa autogenim PRP faktorom (eksperimentna grupa II). Šest meseci nakon amputacije pulpe, životinje su žrtvovane, a tkivo za histološku analizu uzeto je u obliku blok sekcije i pripremljeno za mikroskopsku analizu. Rezultati. Zarastanje rane u pulpno-dentinskom kompleksu u obe eksperimentne i u kontrolnoj grupi bilo je karakterisano stvaranjem dentinskog mostića procesom reparativne dentinogeneze, očuvanjem morfološkog i funkcijskog integriteta pulpe, kao i završetkom rasta korena i stvaranjem okolnog parodoncijuma. U većini uzoraka obe grupe, zapaljenska reakcija ocenjena je kao blaga do umerena, što govori u prilog biokompatibilnosti primenjenih materijala. Zaključak. Svi primenjeni materijali pogodni su za direktno prekrivanje pulpe, doprinose očuvanju njenog morfološkog i funkcionalnog integriteta i omogućavaju završetak rasta korena i formiranje okolnog parodoncijuma. Ipak, povoljniji rezultati dobijeni su u grupi koja je tretirana HAP/PRP, pa se može reći da HAP obogaćen endogenim faktorima rasta predstavlja superiorniju alternativu u odnosu na ostale materijale primenjene u ovoj studiji.

This study was conducted to observe the response of dog's dental pulp to hydrpxylapatite (Hap) and calcium hydroxide when used as pulp capping materials. After the pulps of 22 teeth were exposed, they were capped with either Hap or calcium hydroxide. Histological analysis was performed 8 weeks after treatment. Results showed that pulp exposure caused irreversible injury of odontoblasts, which were subsequently replaced by similar, odontoblast-like cells. These cells were able for reparative dentin bridge formation in 6 cases treated with calcium hydroxide and almost all the cases treated with hydroxylapatite. The presence of odontoblast-like cells seemed to be crucial for reparative dentinogenesis. The capping material was of less importance. In conclusion neither calcium hydroxide nor hydrxylapatite had completely satisfied all the requirements of an ideal capping material, although Hap can be recognized as a superior alternative to calcium hydroxide., Cilj ovog rada je bio ispitivanje odgovora zubne pulpe pasa nakon njenog direktnog prekrivanja hidroksilapatitom (Hap) ili kalcijum hidroksidom. U eksperimentu su korišćena 22 zuba kod kojih je nakon arteficijelnog otvaranja, zubna pulpa prekrivana Hap-om ili kalcijum-hidroksidom. Osam nedelja nakon prekrivanja, urađena je histološka analiza. Dobijeni rezultati su ukazali da je tokom arteficijelnog otvaranja pulpe došlo do ireverzibilnog oštećenja odontoblasta i njihove zamene ćelijama sličnim odontoblastima. Odontoblastima-slične ćelije stvorile su mostić reparativnog dentina u 6 uzoraka iz grupe tretirane kalcijum hidroksidom i skoro svim uzorcima tretiranih Hap-om. Uočeno je da je prisustvo odontoblastima- sličnih ćelija presudno za uspeh reparativne dentinogeneze, dok je vrsta korišćenog materijala za direktno prekrivanje, bila od manje važnosti. Pri tome ni hidroksilapatit ni kalcijum hidroksid ne zadovoljavaju sve zahteve koji se postavljaju pred idealne materijale za direktno punjenje. Hap ipak predstavlja superiorniju alternativu u odnosu na kalcijum hidroksid.

The purpose of treating permanent teeth with exposed pulp, which can be a result of trauma or dental caries progression, is to preserve the vitality and function of the damaged pulp. The therapeutic procedure, along with an adequate indication, most often involves the use of methods of direct pulp capping or vital pulpotomy. Direct pulp capping (DPC) is a therapeutic aplication of drug on exposed dental pulp in order to ensure the closure of the pulp chamber and allow healing process. The treatment includes wound closure with a bioactive material that accelerates healing of the pulp by forming a reparatory dentin or dentin bridge at the site of injury. Recovery of the pulp involves migration of stem/progenitor cells of the pulp to the site of the injury and their proliferation and differentiation into odontoblasts like cells. These cells secrete tertiary dentin matrix with subsequent formation of a reparatory dentin bridge. The success of DPC therapy is often very uncertain and the ideal material does not yet exist. Recent decades have seen a considerable effort by researchers and clinicians in the development of biomaterials which should be characterized not only by biocompatibility, but by bioactivity and bioinductivity. Although MTA still represents the gold standard in DPC today, efforts have been made to overcome the disadvantages of this material (long setting time, difficult handling and application, high market price) along with the introduction of new materials which improved the therapeutic procedure of DPC. Biomimetic regenerative procedures, tissue engineering and nanotechnology provide such possibilities. Biomimetic therapeutic approach and application of amelogenin-enamel proteins in tissue regeneration or the application of new procedures by active regeneration and tissue engineering, can significantly improve the therapeutic results. Emdogain is a newer generation material which consists of enamel proteins and growth factors. For many years it has been successfully used in regenerative therapy of periodontal tissue, but its effect on the pulp tissue is not yet proven. Assumptions have been made about increasing amounts of growth factors at the site of the damaged pulp which can accelerate the healing of pulp wounds and stimulate regeneration..., Osnovni cilj terapije mladih stalnih zuba sa eksponiranom pulpom, koja nastaje kao posledica dentalne traume ili progresije karijesa, je očuvanje vitaliteta i funkcije oštećene pulpe. Terapijski postupak, uz pravilno postavljenu indikaciju, najčešće uključuje primenu metoda direktnog prekrivanja pulpe ili vitalne pulpotomije. Direktno prekrivanje pulpe (DPP) je terapijski postupak aplikacije leka na eksponiranu pulpu zuba sa ciljem da obezbedi zatvaranje pulpne komore i omogući proces zarastanja. Tretman obuhvata zatvaranje rane bioaktivnim materijalom koji pospešuje ozdravljenje pulpe formiranjem reparatornog dentina tj, dentinskog mosta na mestu povrede. Ozdravljenje pulpe podrazumeva migraciju stem/progenitor ćelija pulpe do mesta povrede i njihovu proliferaciju i diferencijaciju u ćelije slične odontoblastima. Ove ćelije sekretuju matriks tercijarnog dentina, sa posledičnim formiranjem reparatornog dentinskog mosta. Kako je uspeh terapije DPP često veoma neizvestan, a idealan materijal za DPP još uvek ne postoji, poslednjih decenija se ulažu veliki napori istraživača i kliničara u razvoj biomaterijala koji bi pored biokompatibilnosti, trebalo da odlikuje i bioaktivnost i bioinduktivnost. Iako danas MTA još uvek predstavlja zlatni standard u DPP, čine se napori kako bi se prevazišli nedostaci ovog materijala (dugo vreme vezivanja, teškoće u rukovanju i aplokaciji, visoka cena na tržištu) i uvođenjem novih materijala unapredila terapijska procedura DPP. Mogućnosti za to svakako postoje u biomimetičkim regenerativnim procedurama, tkivnom inžinjeringu i nanotehnologiji. Biomimetički terapijski pristup i moguća primena amelogenina-gleđnog proteina u tkivnoj regeneraciji, odnosno primena novih koncepata aktivne regeneracije i tkivnog inžinjeringa, može značajno unaprediti terapijske rezultate. Emdogain je materijal novije generacije koji u svom sastavu sadrži gleđne proteine i faktore rasta i kao takav se dugi niz godina uspešno upotrebljava u regenerativnoj terapiji parodoncijuma, ali njegov efekat na pulpno tkivo još uvek nije dokazan. Postoje pretpostavke da se povećanjem količine faktora rasta na mestu oštećenja pulpe može ubrzati zarastanje pulpne rane i stimulisati njena regeneracija...