Abstract
To find a more biologically acceptable and effective alternative to gentle hemostatic techniques and pharmacologic agents in difficult cases of stopping bleeding from amputated dental pulp in vital pulpotomy, we examined the fibrin material Bolheal® that has biological affinity. Thepurpose of this study was to evaluate the hemostatic effect of the fibrin material Bolheal® on dental pulp tissue in the case of vital pulpotomy and to observe the healing process of the remaining pulpal tissue histopathologically and immunohistologically. We divided the permanent teeth of 15 young mongrel dogs into 3 groups (control group A: the placement of Ca(OH)2 after cotton pellets hemostating, experimental group B: the placement of Ca(OH)2, after Bolheal® hemostating, experimental group C: no placement of Ca(OH)2, Bolheal® used only). All groups were sealed with a ZOE base.193 teeth were obtained for this study. The period of observation was 3,7,14,30,60 days after the operation. The results were as follows.
1) The hemostatic effect was higher using Bolheal® than using cotton pellets(p<0.01). Bleeding after the placement of Ca(OH)2 was less with Bolheal® hemostating than with cotton pellets(p<0.01).
2) With the histopathological analysis, we found a slight delay of the dentin bridge formation in group B. We did not however notice an obvious difference between group A and group B with respect to dentin formation. The mean distance from the pulpal stump to the starting position of the dentin bridge formation was as follows; groupA: 721.3 μm, group B: 260.9 μm, group C: 23.0μm. There was a significant difference among all of the groups(p<0.01). Especially in group B, we considered that Bolheal® weakened the alkaline stimulus of Calvital® and decreased the width of the necrotic layer, and consequently the starting position of dentin bridge formation rose. As for histopathological marks, there was a significant difference between group B and group C at 3 days (p <0.05), and in addition, between group A and group C(p<0.01), group B and group C(p<0.01) at each of the periods after 7 days. The group C showed the lowest marks at all observation periods.
3) PCNA positive cells were observed around the amputated pulp surface until 14 days in group A and group B by immunohistostaining. Otherwise, in group C, they were observed at 3 days only. There was no significant difference between group A and group B proliferative activity and differentiation of pulp cells.
These findings suggested that Bolheal® had a very quick and certain hemostatic effect on dental pulp tissue and no harmful effects on the pulp tissue. This technique can be useful in vital pulpotomy.
