Keywords
Dental pulp capping
Endodontics
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Abstract
Objective: Given the widespread use of bisphosphonates (BF) for treating conditions like osteoporosis and bone metastases, and the need to prevent bisphosphonate-induced osteonecrosis of the jaws (BON), understanding their impact on vital pulp therapy (VPT) is essential. Methods: This study evaluated the pulp and periapical response, as well as the repair capacity of direct pulp capping (DPC) in an animal model pretreated with bisphosphonates. Using 36 lower molars from 18 Wistar rats, the animals were divided based on restorative material (MTA or Cotosol) and pharmacological treatment (Zoledronic Acid or saline). Results: The ZA + MTA group demonstrated superior outcomes, with 44.5% mild inflammation (p=0.033), 88.9% absence of periapical pathology (p=0.034), and 55.6% slight dentin bridge formation (p=0.01). Additionally, 33.3% of the group maintained normal tissue morphology (p=0.024) with the lowest dystrophic calcification occurrence (37.5%) (p=0.032). Conclusion: The findings suggest that MTA reduces inflammatory infiltrates, promotes dentin formation, and supports periapical health, even in the presence of bisphosphonates. These results highlight MTA's potential to mitigate the adverse effects of bisphosphonates on pulp and periapical healing.
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