The Effect Of Herbal Extracts Added To Calcium Hydroxyde As A Potential Direct Pulp Capping Material From A Biological Marker Perspective : A Systematic Review

Abstract

This study was aimed to evaluate the biomarkers used to mark the formation of reparative dentin on an exposed pulp following application of combination of herbal extracts with Ca(OH)2 as a potential pulp capping material. Databases are obtained from PUBMED, Wiley Online Library, Google Scholar and ScienceDirect for the last 10 years from 2013 to 2023. The keywords used to search for electronic articles are: (herbal extract OR natural product OR natural medicine) AND (direct pulp capping) AND (reparative dentin). Screening of full-text articles included in the systematic review based on inclusion and exclusion criteria. A structured Population-Intervention-Comparison-Outcome of the review was as follows: Population: formation of reparative dentin; Intervention: combination of herbal extracts and Ca(OH)2; Comparison: Ca(OH)2; Main Outcome: biomarkers. The study selection process was included in the data using PRISMA-2020. We assessed the risk of bias using SYRCLE's Rob tool. The search yielded a total of 8 articles that fulfilled the eligibility criteria. We found the biomarkers used to evaluate the herbal extract (cocoa pod husk, green tea, propolis, mauli banana stem) combined with Ca(OH)2 on the reparative dentin formation process, namely macrophage, NF-kβ, TNF-α IL-1, IL-8, IL-12, IL-6, IFN δ; IL-10, p38 MAPK, VEGF, TGF‐β, DMP-1, ALP and type 1 collagen. Studies showed that limited type of biomarker used to evaluate the effect the herbal extract combined with Ca(OH)2 as the potential pulp capping material on the process of reparative dentin formation. Further studies should be directed to evaluate other biomarkers to asses reparative dentin formation