A television radiographic evaluation of the association between dentin sclerosis and pulpal floor width

Abstract

The purpose of this investigation was to evaluate the association between the depth of a carious lesion and the sclerotic dentin deposited beneath a calcium hydroxide methyl cellulose base material. The sample chosen consisted of teeth with deep caries and possible pulp exposure, as evidenced by a critical radiographic examination. Clinical procedures consisted of a preoperative serial radiograph, followed by complete caries removal. A barium sulphate radiopaque solution was then applied to the base of the preparation, followed by a second serial radiograph. The barium sulphate was removed and a calcium hydroxide methyl cellulose base was applied and the tooth restored with a silver amalgam alloy. Subsequently one, three, six, and nine month serial radiographs were taken postoperatively. Calcification change of sclerotic dentin overlying the pulp was measured in relation to pulpal floor width by the television instrumentation. The conclusions of this study are as follows:

A calcium hydroxide methyl cellulose base material acts as a "trigger mechanism," in deep cavities, stimulating the deposition of sclerotic dentin. The thinner the initial pre-restored pulpal floor, the more rapid and dramatic is the postoperative pulpal floor increase in width, which is apparently a protective pulpal response. During the periods of time when a significant increase in pulpal floor width was noted, the percent change in calcification of this area decreased. Conversely, when little pulpal floor width increase occurred, the percent change in calcification increased.