Histopathological and immunohistochemical characterization of pulp tissue reaction to ACTIVA BioACTIVE base/liner in primary teeth pulpotomy: a randomized clinical trial

Abstract

BACKGROUND: Mineral trioxide aggregate (MTA) is the gold standard pulpotomy agent with some shortcomings, such as lengthy setting time, difficult manipulation, and a costly price. A new bioactive material, ACTIVA BioACTIVE Base/Liner, may prevail over these drawbacks. AIM: The purpose of the study was to evaluate and compare the pulp reaction in primary teeth to ACTIVA BioACTIVE Base/Liner and conventional powder-liquid MTA (WhiteProRoot®MTA) as pulpotomy agents. MATERIALS AND METHODS: Eighty primary first molars in children aged 7-9 years were assigned into two groups (40 molars/group) in which the pulpotomy procedure was done. The pulp tissue was dressed in ACTIVA BioACTIVE Base/Liner (group I) and MTA (group II). Twenty teeth from each group were extracted after 15 days, and the remaining twenty teeth in each group were extracted after 30 days. All teeth specimens underwent a decalcification treatment for histological and immunohistochemical assessment for fibronectin and osteopontin (OPN) expressions. RESULTS: Significant statistical differences were identified between ACTIVA BioACTIVE and MTA groups concerning the total scoring of pulp vascularity, pulp fibrosis, and presence or absence of pulp stone (P = 0.015, P < 0.001, P = 0.038, respectively), whereas a non-significant difference was noted concerning the odontoblastic layer organization. Fibronectin and OPN in both ACTIVA BioACTIVE and MTA groups were positive at the fibrotic and calcified areas. CONCLUSION: ACTIVA BioACTIVE Base/Liner demonstrated encouraging outcomes concerning enhanced systemic tissue responses. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05300152, "Pulpotomy Medications in Primary Teeth", Registered: 29/03/2022, https://clinicaltrials.gov/study/NCT05300152?cond=NCT05300152&rank=1.