Biologic effects of pulp capping material containing fluocinolone acetonide on human dental pulp cells

Main Article Content

Phumisak Louwakul
Veera Lertchirakarn
Tadkamol Krongbaramee


The aims of this study were to test some biological properties of pulp capping material containing fluocinolone acetonide (PCFA). The PCFA is hard setting calcium hydroxide cement containing 50 mmol/L of fluocinolone acetonide (FA). Cytotoxicity and cell proliferation were evaluated by MTT assay. RT-PCR and Western blotting were used to study the effects of PCFA on RNA (dentin sialophosphoprotein: DSPP) and protein (dentin sialoprotein: DSP) synthesis. Anti-inflammatory effect of PCFA was determined by analysis of cyclooxygenase 2 (COX-2) expression. Dycal® was used as control. The results suggested that the diluted conditioned media from PCFA slightly increased cell proliferation, significantly increased DSPP expression and decreased COX-2 expression (p < .05). In term of biologic properties, the PCFA may promote cell proliferation, mineralization and decrease pre-existing inflammation in human dental pulp cells. It may be considered as an alternative pulp capping material in the treatment of inflamed dental pulp.


Download data is not yet available.

Article Details

How to Cite
Louwakul, P., Lertchirakarn, V., & Krongbaramee, T. (2021). Biologic effects of pulp capping material containing fluocinolone acetonide on human dental pulp cells. Chiang Mai Dental Journal, 42(3), 85–94. Retrieved from
Original article


1. Trope M. The vital tooth - its importance in the study and practice of endodontics. Endod Topics. 2003;5:1.
2. Fitzgerald M, Heys RJ. A clinical and histological evaluation of conservative pulpal therapy in human teeth. Oper Dent. 1991;16:101-12.
3. Kozlov M, Massler M. Histologic effects of various drugs on amputated pulps of rat molars. Oral Surg Oral Med Oral Pathol. 1960;13:455-69.
4. Tronstad L. Reaction of the exposed pulp to dycal treatment. Oral Surg Oral Med Oral Pathol. 1974;38:945-53.
5. Zander HA. Reaction of the pulp to calcium hydroxide. J Dent Res. 1939;18:373-9.
6. Baume LJ, Holz J. Long term clinical assessment of direct pulp capping. Int Dent J. 1981;31:251-60.
7. Cvek M. A clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fracture. J Endod. 1978;4:232-7.
8. Kakehashi S, Stanley HR, Fitzgerald RJ. The Effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol. 1965;20:340-9.
9. Mejare I, Cvek M. Partial pulpotomy in young permanent teeth with deep carious lesions. Endod Dent Traumatol. 1993;9:238-42.
10. Olsson H, Petersson K, Rohlin M. Formation of a hard tissue barrier after pulp cappings in humans. A systematic review. Int Endod J. 2006;39:429-42.
11. Barthel CR, Rosenkranz B, Leuenberg A, Roulet JF. Pulp capping of carious exposures: treatment outcome after 5 and 10 years: a retrospective study. J Endod. 2000;26:525-8.
12. Dammaschke T, Leidinger J, Schafer E. Long-term evaluation of direct pulp capping--treatment outcomes over an average period of 6.1 years. Clin Oral Investig. 2010;14:559-67.
13. Tronstad L, Mjor IA. Capping of the inflamed pulp. Oral Surg Oral Med Oral Pathol. 1972;34:477-85.
14. Trope M, McDougal R, Levin L, May KN, Jr., Swift EJ, Jr. Capping the inflamed pulp under different clinical conditions. J Esthet Restor Dent. 2002;14:349-57.
15. Komabayashi T, Zhu Q. Innovative endodontic therapy for anti-inflammatory direct pulp capping of permanent teeth with a mature apex. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:e75-81.
16. Rapoport L, Abramson II. Application of steroid hormones in pulp-capping and pulpotomy procedures; a preliminary report. Oral Surg Oral Med Oral Pathol. 1958;11:545-8.
17. Barker BC, Ehrmann EH. Human pulp reactions to a glucocorticosteroid-antibiotic compound. Aust Dent J. 1969;14:104-19.
18. Clarke NG. The corticosteroid-antibiotic dressing as a capping for inflamed dental pulps. Aust Dent J. 1971;16:71-6.
19. Ulmansky M, Sela J, Langer M, Yaari A. Response of pulpotomy wounds in normal human teeth to successively applied Ledermix and Calxyl. Arch Oral Biol. 1971;16:1393-8.
20. Buajeeb W, Pobrurksa C, Kraivaphan P. Efficacy of fluocinolone acetonide gel in the treatment of oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89:42-5.
21. Hooley JR, Hohl TH. Use of steroids in the prevention of some complications after traumatic oral surgery. J Oral Surg. 1974;32:864-6.
22. Lozada F, Silverman S, Jr. Topically applied fluocinonide in an adhesive base in the treatment of oral vesiculoerosive diseases. Arch Dermatol. 1980;116:898-901.
23. Fisher LB, Maibach HI. The effect of corticosteroids on human epidermal mitotic activity. Arch Dermatol. 1971;103:39-44.
24. Kirk D, Mittwoch U. Effects of topically potent glucocorticoids on human diploid fibroblasts in vitro. Br J Dermatol. 1977;97:69-75.
25. Liu Z, Jiang T, Wang Y, Wang X. Fluocinolone acetonide promotes the proliferation and mineralization of dental pulp cells. J Endod. 2013;39:217-22.
26. Muincharern W, Louwakul P, Pavasant P, Lertchirakarn V. Effect of fluocinolone acetonide on human dental pulp cells: cytotoxicity, proliferation, and extracellular matrix formation. J Endod. 2011;37:181-4.
27. Louwakul P, Lertchirakarn V. Incorporation of anti-inflammatory agent into calcium hydroxide pulp capping material: an in vitro study of physical and mechanical properties. Dent Mater J. 2012;31:32-9.
28. Chang YC, Huang FM, Yang SF, Liu CM, Lai CC, Chan Y, et al. Induction of cyclooxygenase-2 mRNA and protein expression in human pulp cells stimulated with black-pigmented bacteroides. J Endod. 2003;29:240-3.
29. Cushley S, Duncan H, Lappin M, Chua P, Elamin A, Clarke M, et al. Efficacy of direct pulp capping for management of cariously exposed pulps in permanent teeth: a systematic review and meta‐analysis. Int Endod J. 2021;54:556-71.
30. Fitzgerald M. Cellular mechanics of dentinal bridge repair using 3H-thymidine. J Dent Res. 1979;58:2198-206.
31. Heys DR, Heys RJ, Cox CF, Avery JK. The response of four calcium hydroxides on monkey pulps. J Oral Pathol. 1980;9:372-9.
32. Kitasako Y, Shibata S, Arakawa M, Cox CF, Tagami J. A light and transmission microscopic study of mechanically exposed monkey pulps: dynamics of fiber elements during early dentin bridge formation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89:224-30.
33. Mjor IA, Dahl E, Cox CF. Healing of pulp exposures: an ultrastructural study. J Oral Pathol Med. 1991;20:496-501.
34. Goldberg M, Smith AJ. Cells and extracellular matrices of dentin and pulp: A biological basis for repair and tissue engineering. Crit Rev Oral Biol Med. 2004;15:13-27.
35. Suzuki S, Sreenath T, Haruyama N, Honeycutt C, Terse A, Cho A, et al. Dentin sialoprotein and dentin phosphoprotein have distinct roles in dentin mineralization. Matrix Biol. 2009;28:221-9.
36. Wei X, Ling J, Wu L, Liu L, Xiao Y. Expression of mineralization markers in dental pulp cells. J Endod. 2007;33:703-8.
37. Wei X, Wu L, Ling J, Liu L, Liu S, Liu W, et al. Differentially expressed protein profile of human dental pulp cells in the early process of odontoblast-like differentiation in vitro. J Endod. 2008;34:1077-84.
38. Fitzgerald M, Chiego DJ, Jr., Heys DR. Autoradiographic analysis of odontoblast replacement following pulp exposure in primate teeth. Arch Oral Biol. 1990;35:707-15.
39. Alliot-Licht B, Bluteau G, Magne D, Lopez-Cazaux S, Lieubeau B, Daculsi G, et al. Dexamethasone stimulates differentiation of odontoblast-like cells in human dental pulp cultures. Cell Tissue Res. 2005;321:391-400.
40. Louwakul P, Lertchirakarn V. Response of inflamed pulps of rat molars after capping with pulp-capping material containing fluocinolone acetonide. J Endod. 2015;41:508-12.
41. Kim YS, Min KS, Lee HD, Oh HW, Kim EC. Effect of cytosolic phospholipase A2 on proinflammatory cytokine-induced bone resorptive genes including receptor activator of nuclear factor kappa B ligand in human dental pulp cells. J Endod. 2010;36:636-41.
42. Cohen BD, Combe EC. Development of new adhesive pulp capping materials. Dent Update. 1994;21:57-62.
43. Katoh Y, Suzuki M, Kato C, Shinkai K, Ogawa M, Yamauchi J. Observation of calcium phosphate powder mixed with an adhesive monomer experimentally developed for direct pulp capping and as a bonding agent. Dent Mater J. 2010;29:15-24.
44. Niinuma A. Newly developed resinous direct pulp capping agent containing calcium hydroxide (MTYA1-Ca). Int Endod J. 1999;32:475-83.
45. Shinkai K, Taira Y, Suzuki M, Kato C, Ebihara T, Wakaki S, et al. Dentin bond strength of a new adhesive system containing calcium phosphate experimentally developed for direct pulp capping. Dent Mater J. 2009;28:743-9.
46. Tziafas D, Koliniotou-Koumpia E, Tziafa C, Papadimitriou S. Effects of a new antibacterial adhesive on the repair capacity of the pulp-dentine complex in infected teeth. Int Endod J. 2007;40:58-66.