Enhancement of MTA Repair HP with Hyaluronic Acid and TGFβ1 in Rabbit Pulpotomy

A Chemical-Histological and Immunohistochemical Evaluation

Authors

  • Salih Ali Muhsin Department of Conservative Dentistry College of Dentistry, University of Mosul, Mosul, Iraq
  • Nadia Hameed Hasan
  • Faehaa Azher MoheAldeen

DOI:

https://doi.org/10.5195/d3000.2026.1652

Keywords:

Endodontics, Odontoblast, Pulp, Transforming Growth Factor

Abstract

Vital pulp therapy (VPT) preserves the pulp’s vitality, enabling its defense and reparative functions. This is a well-known property of mineral trioxide aggregate (MTA), but the use of bioactive modifiers can be added to improve healing. There are known factors that affect inflammation, odontoblastic differentiation and tissue regeneration such as hyaluronic acid (HA) and transforming growth factor beta 1 (TGFβ1). The objective of this work was to compare histological and immunohistochemical reactions of the pulp in the MTA Repair HP modified with HA and/or TGF-β1 in a pulpotomy rabbit model. Methods: 9 male albino rabbits, Oryctolagus cuniculus were subjected to pulpotomies in four incisors, which were randomized to MTA (control), MTA+HA, MTA+TGFβ1 and MTA+HA+TGFβ1 groups. At 1, 3 and 7 days, the animals were sacrificed. Histological evaluation was done to evaluate inflammatory cell infiltration, cellular organization and odontoblast-like cell formation. The expression of TGFβ1 was analyzed by immunohistochemistry. Nonparametric tests were used (p ≤ 0.05). There was the least inflammation in MTA+HA+TGFβ1 group at day 7, and the most organized pulpal architecture: aligned odontoblast-like cells and dense collagen fibrils (p<0.05 vs. control). The cell formation of odontoblasts was the highest in the group treated with TGFβ1, especially in the HA co-treatment group. The MTA+HA+TGFβ1 group expressed the highest level of TGFβ1 at all time points, and it was strongly expressed in odontoblast-like cells, fibroblasts and endothelial cells. HA and TGFβ1 when combined in MTA Repair HP, synergistically increased early pulp healing through minimizing inflammation, enhancing tissue organization and upregulating the expression of TGFβ1, suggesting its potential as a biologically based modification for VPT.

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Published

2026-10-22

Issue

Vol. 14 No. 3 (2026): Fall

Section

Adults & the Elderly

License

Copyright (c) 2026 Salih Ali Muhsin, Nadia Hameed Hasan, Faehaa Azher MoheAldeen

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