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Histological evaluation of a novel phosphorylated pullulan-based pulp capping material : An in-vivo study

Islam, Rafiqul 北海道大学

2021.03.25

概要

The properties of a pulp capping material play a major role in the prognosis of pulp cappingtreatment. A pulp capping material is considered ideal when it exhibits favourable pulpalresponse, good sealing ability, excellent biocompatibility, effective antibacterial property, andease of manipulation. In these regards, performance of several materials has already beenevaluated. A new biomaterial, Phosphorylated Pullulan (PPL) has recently gained attention inthis field because of its bioadhesive behavior, high biocompatibility, and dentin regenerationability. Based on PPL's above-mentioned advantageous properties, an innovative MineralTrioxide Aggregate based material was introduced by adding phosphorylated pullulan(MTAPPL).
　
This study aimed to evaluate the dental pulp responses to novel mineral trioxide aggregatecontaining Phosphorylated Pullulan (MTAPPL) pulp capping material after direct pulpcapping.
　
Ninety-six cavities were prepared from fifty-six male Wister rat’s maxillary first molar teeth.The pulps were intentionally exposed and randomly divided into four groups according to pulpcapping materials: an experimental pulp capping material containing Mineral TrioxideAggregate with Phosphorylated Pullulan (MTAPPL, GC, Tokyo, Japan), an anotherexperimental material containing Phosphorylated Pullulan (PPL, GC, Tokyo, Japan),conventional Nex-Cem MTA (NCMTA, GC, Tokyo, Japan) and Super Bond (SB, SunMedical, Shiga, Japan). The rats were observed postoperatively after direct pulp capping atfour observational time intervals of 1, 3, 7, and 28 days. Six teeth were allocated for each timeinterval. The maxillary sections, together with molar teeth were dissected and fixed in 4%paraformaldehyde solution for 24 hours at 4ºC. The tissues were demineralized in 10% EDTAsolution and embedded in paraffin. The 5 µm-thick serial sections were cut in the mesiodistal2 direction and prepared according to routine histological techniques to observe pulpal reactionswith a scoring system. DMP1 and CD34 antigen were used to check odontoblast differentiationand pulpal vascularization, respectively. Statistical analysis was performed using the KruskalWallis test and the Bonferroni corrected Mann–Whitney U test, for evaluating differencesbetween the groups during each observation period. The level of significance was set at .05.
　
On day 1, mild inflammatory cells were present in MTAPPL and NCMTA groups, fewinflammatory cells were present in PPL group, whereas SB showed mild to a moderateinflammatory response. Significant difference was observed between PPL and SB groups (p <0.05). On day 3, moderate to severe inflammatory cells were present in PPL and SB group,whereas MTAPPL and NCMTA groups showed a mild inflammatory response. No significantdifference was observed between all the groups (p ˃ 0.05). On day 7, a thin layer of mineralizedtissue formation was observed in all tested groups with no or mild inflammatory response. Nosignificant difference was observed between the groups (p ˃ 0.05). On day 28, no inflammatoryresponses were observed in the group MTAPPL and NCMTA, whereas PPL and SB groupsshowed a mild inflammatory response. significant difference was observed between MTAPPLand SB groups (p < 0.05). Complete mineralized tissue barrier formation was observed in thegroup MTAPPL, NCMTA and PPL with no significant difference (p > 0.05). the SB groupexhibited incomplete mineralized tissue barrier formation, which was significantly differentfrom NCMTA, MTAPPL, and PPL (p < 0.05). Positive staining of CD34 and DMP1 wasobserved in all the group.
　
This study demonstrated that MTAPPL material showed similar favourable cellular andinflammatory pulp responses and mineralized tissue formation as pulp capping material.Therefore, MTAPPL can be considered as promising direct pulp capping material.

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