Evaluation of pulpal blood flow and postoperative pain after direct pulp capping with different materials in teeth with irreversible pulpitis

This study aims to evaluate the pulpal blood flow and postoperative pain with laser Doppler flowmetry after direct pulp capping using calcium hydroxide, MTA, and Biodentine-containing capping materials in teeth with irreversible pulpitis. The present study included 47 mandibular molar teeth with irreversible pulpitis belonging to 39 systemically healthy patients (mean age 21 ± 8.21). When the pulp was exposed during the removal of caries tissue in the related teeth, the exposed area was disinfected with a sterile cotton pellet moistened with 2.5% NaOCl (Wizard, Guide Chemistry, Istanbul, Turkey). Hemostasis was achieved by applying light pressure to the exposed pulp with cotton pellets moistened with sterile physiological saline solution for up to 1-10 minutes. Teeth were randomly divided into 3 groups according to the capping material (n=15); Calcium hydroxide, Mineral Trioxide Aggregate, and Biodentine. In each group, the exposed pulp was covered with the relevant capping material and resin-modified glass ionomer cement was applied to it. In all groups, permanent restoration was completed in one session using composite resin (Estelite Sigma Quick Posterior; Tokuyama, Tokyo, Japan). Post-operative pain was evaluated using the Numerical Pain Rating Scale (NRS) in all cases before the capping procedure and 1 day, 1 week, and 1 month after the capping process was completed. Pulp blood flow was measured with a laser Doppler flowmeter (PeriFlux 4001, Perimed Instruments, Stockholm, Sweden, 780 nm λ) in all cases before and 1 day, 1 week, and 1 month after the capping process was completed. The obtained data were evaluated statistically (IBM, Armonk, NY, USA). A P value less than 0.05 was considered statistically significant. After DPC was performed with MTA, Dycal, and Biodentine, there was no significant difference in all time intervals evaluated in terms of post-operative pain (p˃0.05). Similarly, there was no significant difference between MTA, Dycal, and Biodentine in terms of time-dependent change in pulpal blood flow at all time intervals (p˃0.05). Within the limitations of the current study, MTA, Dycal, and Biodentine used in DPC performed in teeth with irreversible pulpitis were similar in terms of post-operative pain and changes in pulpal blood flow.