Portland cement alternative to calcium hydroxide direct pulp covering

Introduction

Portland cement is chemically and physically similar to MTA material and the only difference is the presence of Bismuth in the later, still the Portland cement is more available and less expensive; still no clinical study was conducted to compare it effectiveness as a direct pulp covering material.

The Objectives: was to compare clinically and radiographically the effect of Portland cement with the Calcium Hydroxide in accidental pulp exposure. .

Methods: 50 upper premolars were used in this study; all the samples were scheduled for extraction for orthodontic treatment.

The study sample was divided into two groups (25 each) and the roof of pulp chamber was penetrated, then the pulp was covered with either Portland cement or the conventional calcium hydroxide and restored with amalgam filling.

Patients returned for follow-up on days 7, 15, 30, 60, 120 for vital test and radiographic examination.

All the steps were performed by the researcher himself and under restricted infection control conditions.

Results: Failure was detected by either non vital test or PDL widening for more than 2m.

Failure of direct covering was observed in 5 teeth from the CH group starting from day 30, and in 2 teeth from the PC group starting from day 60, with no statistical significance.

Still the percentage of failure in CH was greater than that observed by the PC group with 20% and 8% respectively.

The radiographically study showed dentin bridge formation beneath the uncovering area starting from day 30 in 4 teeth in the CH group and 3 teeth in the PC group with no statistically significance difference. There was no correlation between detecting dentin bridge formation radiographically and the failure of the treatment.

Conclusions: PC can be used as an alternative to calcium hydroxide in the accidental pulp uncovering.