Other materials for capping
Materials other than calcium hydroxide may also permit the hard tissue repair of tooth pulp wounds. It gave strength to the theory that the adequate protection of the wound during the healing process can be as important as the choice of a specific packing materials. Accordingly, dentin bonding system is in favor of direct pulp floors, since the formation of a hybrid layer and subsequent recovery resin composite was considered that as a result of leakage-free tonic. Some animal studies, primarily in nonhuman primates have shown promising results dentin formation of a coating exposure site, similar results with calcium hydroxide (15, 48). Histological study on humans, however, was not able to confirm these findings and less than or only rare hard tissue found after the direct coverage of the pulp of the tooth with the help of these materials compared with calcium hydroxide.
On the contrary, inflammation of the pulp of the tooth, foreign body reactions and necrosis have been reported, despite the absence of infection(2, 21, 29, 41).
Because of degradation of resin bond, adhesive restorations not leak proof after some time in the oral cavity (20, 31). Therefore, the lack of hard tissue repair exposition will later infection pulp tissue. While "bridge can be permeable to some extent it provides better protection against a massive attack of microorganisms than not hard tissue barrier. If bacterial leakage can be completely prevented, hardtissue formation of the exposure site would not be necessary.
Searching for superior to calcium hydroxide with the stimulation of the cells pulp, to form a more solid bridge, interest has focused on the use of hydroxyapa-tite, tricalcium phosphate and mineral trioxide aggregate as potential corking materials (34, 64). However, if the hard tissues of the underlying hydroxyapatite happening, she was described as irregular and incomplete and the use of phosphate, seems to be most effective if calcium hydroxide (44, 79).
Mineral trioxide aggregate (MTA) has gained considerable interest in recent years (84). The material consists mainly of refined Portland cement with bismuth added to radiopacity. It establishes a slow hard after mixing cement with water. PH comparable pH calcium hydroxide and, therefore, wound healing events would be similar to those of calcium hydroxide (see above). There is mounting histological evidence of person's hard tissue to produce an effect similar or superior to that seen with calcium hydroxide (4, 43, 55). The advantage of this material in comparison with calcium hydroxide, it sets strict and will not be easily dissolves in the tissue fluid or saliva. Both materials have primary bacteriocidal effect due to the high pH.
Direct application of bioactive molecules important for terminal differentiation odontoblasts was proposed as an alternative way to achieve healing of the tooth pulp RAS (70, 83), and not the indirect effect of corrosive substances, such as calcium hydroxide and the MTA. Although promising in animal experiments, significant research and development must be carried out before bioactive molecules find clinical application (9).
In conclusion, the solid experimental and clinical documentation accumulated for many years supported the use of calcium hydroxide in the pulp capping and pulpotomy procedures. The projected to repair and healing of the tooth pulp wounds can be expected, provided the treatment is carried out on the basis of a careful case selection and use proper technique.
Increasing the number of concurrent results with the MTA expects this to cement can comprehend and calcium hydroxide as the preferred material for pulp capping and partial pulpotomy. It is not reasonable to suppose that both of these non-biological agents will be replaced in the future by methods that seek to not only save cellulose, as well as for the stimulation of pulp and dentin regeneration. However, much experimental-design works until it is taken before a stem cell transplant and biologically active proteins, for example, find clinical application...