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Aim Methodology Results Conclusions Calcium hydroxide (CH) has been considered as a direct pulp capping materials (DPC) for the last decades despite having some limitations. Phosphorylate pullulan (PPL) incorporated with CH (CHPPL) is a novel biomaterial that was introduced as a promising DPC material. Thus, the aim of the study was to evaluate the inflammatory response and mineralized tissue formation (MTF) ability of PPL‐based CH formulations on rat molars after DPC.This study consisted of six groups: CH with 1% PPL (CHPPL‐1); 3% PPL (CHPPL‐3); 5% PPL (CHPPL‐5); Dycal and NEX MTA Cement (N‐MTA) as the positive control, and no capping materials (NC). One hundred twenty maxillary first molar cavities were prepared on Wistar rats. After capping, all the cavities were restored with 4‐META/MMA‐TBB resin and pulpal responses were evaluated at days 1, 7, and 28. Kruskal–Wallis followed by Mann–Whitney U‐test was performed with a significance level of 0.05. Immunohistochemical expression of IL‐6, Nestin, and DMP‐1 was observed.At day 1, CHPPL‐1, N‐MTA, and Dycal exhibited no to mild inflammation, whilst CHPPL‐3, CHPPL‐5, and NC showed mild to moderate inflammation, and the results were significantly different (p < .05). At day 7, mild to moderate inflammation was observed in CHPPL‐1, N‐MTA, and Dycal, whereas CHPPL‐3, CHPPL‐5, and NC exhibited moderate to severe inflammation. Significant differences were observed between CHPPL‐1 and N‐MTA with NC (p < .05), CHPPL‐1 and CHPPL‐3 with CHPPL‐5 and Dycal (p < .05), and CHPPL‐3 with N‐MTA (p < .05). A thin layer of mineralized tissue formation (MTF) was observed in all groups. At day 28, CHPPL‐1, Dycal, and N‐MTA showed no to mild inflammation, whilst CHPPL‐3, CHPPL‐5, and NC exhibited mild to severe inflammation, and statistically significant difference was detected (p < .05). CHPPL‐1, Dycal, and N‐MTA exhibited continuous MTF, whilst CHPPL‐3, CHPPL‐5, and NC had thicker and interrupted MTF. Significant differences were observed between CHPPL‐1, CHPPL‐3, and N‐MTA with NC group (p < .05). Variable expressions of IL‐6, Nestin, and DMP‐1 indicated differences in the materials' impact on odontoblast‐like cell formation and tissue mineralization.These findings suggest that CHPPL‐1 has the potential to minimize pulpal inflammation and promote MTF and had similar efficacy as MTA cement. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the dental pulp response to a novel mineral trioxide aggregate containing phosphorylated pullulan (MTAPPL) in rats after direct pulp capping. Methods: Ninety‐six cavities were prepared in the maxillary first molars of 56 male Wistar rats. The dental pulps were intentionally exposed and randomly divided into four groups according to the application of pulp capping materials: MTAPPL; phosphorylated pullulan (PPL); a conventional MTA (Nex‐Cem MTA, NCMTA; positive control); and Super‐Bond (SB; negative control). All cavities were restored with SB and observed for pulpal responses at 1‐, 3‐, 7‐ and 28‐day intervals using a histological scoring system. Statistical analysis was performed using Kruskal–Wallis and Mann–Whitney U‐test with Bonferroni's correction, and the level of significance was set at 0.05. DMP1 and CD34 antigen were used to evaluate odontoblast differentiation and pulpal vascularization, respectively. Results: On day 1, mild inflammatory cells were present in MTAPPL and NCMTA groups; fewer inflammatory cells were present in the PPL, whereas SB was associated with a mild‐to‐moderate inflammatory response. A significant difference was observed between PPL and SB (p <.05). No mineralized tissue deposition was observed. On day 3, moderate‐to‐severe inflammatory cells were present in PPL and SB, whereas MTAPPL and NCMTA had a mild inflammatory response. Initial mineralized tissue deposition was observed in the NCMTA, MTAPPL and SB. A significant difference was observed between MTAPPL and PPL (p <.05). On day 7, a thin layer of mineralized tissue was observed in all tested groups with no or mild inflammatory response. On day 28, no inflammatory response was observed in MTAPPL, whereas NCMTA, PPL and SB had mild inflammatory responses. A significant difference was observed between MTAPPL and SB (p <.05). Complete mineralized tissue barrier formation was observed in MTAPPL, NCMTA and PPL with no significant difference (p >.05). SB exhibited incomplete mineralized tissue barriers, significantly different from NCMTA, MTAPPL and PPL (p <.05). The staining with CD34 was positive in all the groups on all observation days. Conclusion: The favourable pulpal responses and induction of mineralized tissue formation associated with MTAPPL indicate its potential application as a direct pulp capping material. [ABSTRACT FROM AUTHOR]