Histological Evaluation of Pulp Response to Novel Bioceramic Materials in Deep Carious Lesions

Abstract

Vital pulp therapy (VPT) aims to maintain pulp vitality by promoting biological healing and dentin bridge formation after carious exposure. The introduction of novel bioceramic materials has enhanced the biological response of dental pulp through improved bioactivity, sealing ability, and biocompatibility. However, limited histological data exist comparing the pulpal tissue response to these materials in deep carious lesions.
This study aimed to histologically evaluate and compare the pulp response to novel bioceramic materials with conventional agents in deep carious lesions
A total of forty-five human permanent teeth with deep carious lesions but positive pulp vitality were selected and randomly divided into three groups: Group I—Mineral Trioxide Aggregate (MTA), Group II—Biodentine, and Group III—Novel Bioceramic Material (EndoSequence Root Repair Material). After standardized caries removal and pulp capping, the teeth were restored with resin-modified glass ionomer and extracted at 7, 30, and 90 days for histological examination. Tissue samples were stained with hematoxylin and eosin and evaluated for inflammatory cell infiltration, odontoblastic layer continuity, dentin bridge formation, and pulp tissue organization. Statistical analysis was performed using ANOVA and post hoc tests, with significance set at p < 0.05
Histological findings revealed mild inflammatory response and early odontoblastic differentiation in all groups at 7 days. By 30 and 90 days, Biodentine and the novel bioceramic material groups exhibited well-organized odontoblastic layers and continuous tubular dentin bridges with minimal inflammation. MTA showed similar healing patterns but slower tissue organization. The differences among materials were not statistically significant (p > 0.05), although the novel bioceramic material demonstrated a slightly enhanced regenerative pattern and better structural integrity of the reparative dentin.
All tested materials induced favorable pulpal healing and dentin bridge formation, confirming their biocompatibility and regenerative potential. The novel bioceramic material exhibited comparable, and in some aspects superior, histological outcomes to MTA and Biodentine, suggesting its suitability for vital pulp therapy in deep carious lesions (Singh, 2019; Careddu & Duncan, 2018; Kabel & Salem, 2017).