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Influence of selective immunosuppressive drug regimens on the healing of exposed dogs’ dental pulp capped with a recent calcium silicate-based cement

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Abstract

Objectives

In the clinical medicine, immunosuppressive drugs are used for an assortment of disorders, while their effect on the pulp healing is a controversial issue. This study evaluated the effect of different immunosuppressive drugs on the healing capacity of mechanically exposed dogs’ dental pulps after direct pulp capping (DPC) with calcium silicate-based cement.

Materials and methods

Twelve healthy male dogs were randomly allocated into four equal groups, 3 dogs each: group I allocated as a control group where no drugs were received; group П given prednisone (Pred); group III given a combination of Pred and cyclosporine A (CsA); and group IV given triple dose including Pred, CsA, and mycophenolate mofetil (MMF) for 45 days before the operative procedures and until the dogs were euthanized. In each dog, 16 class V cavities were prepared on the labial surfaces of anterior teeth. Following mechanical exposure, the pulps were capped with Biodentine, calcium silicate-based cement. The pulpal tissues response to Biodentine was assessed 65 days postoperatively.

Results

The pulp healing response was inferior in the Pred-CsA- and Pred-CsA-MMF-treated groups compared with the control and Pred-treated groups (P < 0.05). Non-significant difference was found between control and Pred-treated groups (P > 0.05).

Conclusions

Within the limitation of this study, DPC with calcium silicate-based cement performed under strict aseptic condition for traumatically exposed dental pulp can be considered as a successful treatment option for those who receiving Pred immunosuppressive therapy. Meanwhile, DPC with those receiving a combination of Pred, CsA, and/or MMF immunosuppressive drug regimens demonstrated unfavorable results.

Clinical relevance

Direct capping of mechanically exposed pulps with calcium silicate-based cement performed with special care for preventing infection considered a suitable strategic measure for preserving pulp vitality in patients receiving corticosteroid immunosuppressive drug.

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Acknowledgements

We are grateful to professor Hamdi Hosni, Department of Operative Dentistry, Faculty of Dentistry, Mansoura University for kindly reviewing the manuscript and sharing his knowledge about academic research. The authors thank Dr. Sarah Eldesoky Elshahat and Dr. Aya Elsaied Abd Elhameed, Veterinary, Medical Experimental Research Center, Faculty of Medicine, Mansoura University, for their valuable assistance during the procedures of this research.

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Authors and Affiliations

  1. Operative Dentistry Department, Faculty of Dentistry, Kafrelsheikh University, Kafr El Sheikh, Egypt

    Hanan A. Soliman

  2. Operative Dentistry Department, Faculty of Dentistry, Mansoura University, 77 Al Gomhoria St, Mansoura, 35516, Egypt

    Radwa Ibrahim EL-Toukhy & Salah Hasab Mahmoud

  3. Oral Pathology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt

    Mona Mohsen Ebrahim

  4. Oral Biology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt

    Mohammed E. Grawish

  5. Nephrology Department, Urology and Nephrology Center, Faculty of Medicine, Mansoura, Egypt

    Mohamed Abdel kader Sobh

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  1. Hanan A. Soliman
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  2. Radwa Ibrahim EL-Toukhy
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  3. Mona Mohsen Ebrahim
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  5. Mohamed Abdel kader Sobh
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  6. Salah Hasab Mahmoud
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Correspondence to Salah Hasab Mahmoud.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was obtained by Ethical Committee of the faculty of dentistry, Mansoura University, Egypt (NO. M12040820).

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Soliman, H.A., EL-Toukhy, R.I., Ebrahim, M.M. et al. Influence of selective immunosuppressive drug regimens on the healing of exposed dogs’ dental pulp capped with a recent calcium silicate-based cement. Clin Oral Invest 26, 1417–1425 (2022). https://doi.org/10.1007/s00784-021-04116-y

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