The Expression of Tumor Necrosis Factor Alpha and Alkaline Phosphatase Due to Induction of Combination Calcium Hydroxides and Propolis

Exposed pulp will produce pro-inflammatory cytokines, which are the main target in inhibiting inflammation of the pulp. Early reparative dentin formation begins with the synthesis of extracellular matrix dentin such as type I collagen, which is believed to be the key of successful pulp capping treatment. Propolis is an alternative pulp capping material that is known to reduce inflammation in the exposed pulp. Calcium hydroxide (CH) is the gold standard for pulp capping material but many studies have shown some limitations on calcium hydroxide. This study was conducted to determine the expression of TNF-α and ALP after the application of a combination of calcium hydroxide and propolis extract as pulp capping material. The maxillary first molars of sixty rats (Wistar) were mechanically perforated. Teeth were divided into 3 groups containing 20 each. Group I as a control, group II treated with calcium hydroxide, group III treated with calcium hydroxide and propolis. The final restoration is done by Cention. Teeth were extracted on days 3 and 7 and processed for immunohistochemical evaluation. The differences in expression of TNF-α and ALP after treatment with calcium hydroxide compared with a combination of calcium hydroxide and propolis were statistically significant (p <0.05). After application of the combination of Calcium hydroxide and propolis, the expression of TNF-α decreases and ALP expression increase, rather than only Calcium hydroxide.