FEATURES OF SUCCESSFUL PULP CAPPING 8. The dental pulp occupies the center of each tooth and shapes itself to a maturation of the tooth .  |  Pulp treatment for extensive decay in primary teeth is generally successful. Indirect Pulp Treatment (IPT) was a success in 95%. A two-year prospective clinical trial carried out by Cho et al. Under the premise of correct indication and technical implementation, direct pulp capping using calcium hydroxide can reach success rates of nearly 60 % after 10 years [76, 110]. When would you do a direct pulp cap in primary teeth? Calcium hydroxide success rate was 74% at 6-months, 65% at 1-year, 59% at 2-3 years and 56% at 4-5 years. Alqaderi H, Lee CT, Borzangy S, Pagonis TC (2016) Coronal pulpotomy for cariously exposed permanent posterior teeth with closed apices: A systematic review and meta-analysis. Conclusion: Direct pulp capping as a method of choice for treatment of reversible inflammation of the pulp of primary teeth has its advantages which should be proven through more quality studies. Objective: Recommendations against direct pulp capping (DPC) for carious primary teeth are based on old, low level evidence.This study investigates the medium to long term clinical and radiographic outcomes of such treatment. direct pulp capping with calcium hydroxide. This article will provide a general discussion of direct and indirect pulp capping procedures, offering practitioners a pragmatic and science-based clinical protocol for treatment of vital pulp exposures. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Caplan DJ, Cai J, Yin G, White BA. 16. Indirect pulp capping is a very successful procedure. 6. The pooled success rate differed based on material and follow-up. deep caries; direct pulp capping; exposed pulp; pulpitis; vital pulp treatment. Therefore, the aim of this study was to evaluate and compare the clinical and radiographical success of calcium sulfate and calcium hydroxide used as a direct pulp-capping material in primary teeth. They are only successful if the pulpal infection is very mild 2014 Aug 6;(8):CD003220. 0000011761 00000 n Outcomes of direct pulp capping in vital primary teeth with cariously and non‐cariously exposed pulp: A systematic review. The lack of influence of treatment delay is demonstrated once more. When dental caries is removed from a tooth, all or most of the infected and softened enamel and dentin are removed. 0000011784 00000 n 0000004855 00000 n trailer << /Size 90 /Info 46 0 R /Root 52 0 R /Prev 1600903 /ID[<40f17eebb06b4cb185efd3442ec0cf8d><3bffe181b46c34d924d63633d3cab744>] >> startxref 0 %%EOF 52 0 obj << /Type /Catalog /Pages 45 0 R /PageMode /UseNone /FICL:Enfocus 47 0 R /OpenAction 53 0 R /Metadata 50 0 R /PageLayout /OneColumn >> endobj 53 0 obj << /S /GoTo /D [ 54 0 R /Fit ] >> endobj 88 0 obj << /S 149 /T 285 /Filter /FlateDecode /Length 89 0 R >> stream 0000002364 00000 n ... evidence-based recommendations on three vital pulp therapies: indirect pulp treatment (IPT; also known as indirect pulp cap), direct pulp cap (DPC), and pulpotomy. The direct pulp capping is taught by 68.7% of schools and calcium hydroxide (97%) was the capping material most indicated. Biodentine® is the most recent material and its success rate for direct pulp capping is poorly documented. The meta-analysis revealed MTA had better success than calcium hydroxide at 1-year (OR 2.66, 95% CI; 1.46- 4.84, P = 0.001) and 2- to 3-year follow-up (OR 2.21, 95% CI; 1.42-3.44, P = 0.0004). Background: Direst pulp capping (DPC) has been literally abolished from the repertoire of endodontic procedures for primary teeth. Background Direst pulp capping (DPC) has been literally abolished from the repertoire of endodontic procedures for primary teeth. 0000010505 00000 n Some studies have concluded that MTA is superior to FC (gold standard for pulpotomy therapy in deciduous teeth) 0000009070 00000 n Marchi JJ, de Araujo FB, Froner AM, et al. 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How will a dentist restore a severly decayed and endodontically treated primary tooth? The listed success rates in the literature for direct pulp capping during caries excavation vary substantially [12, 56, 76]. COVID-19 is an emerging, rapidly evolving situation. A direct pulp cap is done on permanent teeth when the removal of deep decay results in exposing the pulp. ... - Indirect pulp tx - direct pulp capping - Pulpotomy. The success rate is be-tween 80% and 100% and this gives reason for more stud-ies in this scientific direction [7, 15 - 27]. 41-45 Direct pulp capping of a carious pulp exposure in a primary tooth is not recommended. ... [5,6,7] DPC with calcium hydroxide in primary teeth has a low success rate. Radiographic study,103 teeth Success rate of 31%. Initial searches identified 83 potentially relevant studies on DPC in primary teeth. 0000010069 00000 n H��W�n�0��+tk�5_�cl'� �Z(У,3KT)9��G��ҍ�. Clinical Oral Investigations, 17, 431-39. Direct pulp capping and vital pulpotomy are two accepted clinical modalities to preserve tooth vitality in cases of pulp exposure in carious young permanent teeth but the success rates are often less than 50%. • Indirect pulp capping is the favorable technique for treating primary teeth with deep caries and no exposure of inflamed pulp tissue. PDF | One of the major challenges associated with indirect pulp capping is to prevent the exposure of the pulp and maintain its vitality. CONCLUSION 10.REFERENCES 3. There are numerous reports about a positive outcome of direct pulp capping, with success rates of 93% 1 year after direct pulp capping with 13,19Calxyl.19In this case, the high success rate might have resulted from the low number of treated cases and a non- randomized patient collective. involving a total of 100 primary molars carried out to evaluate the outcome of DPC using different pulp capping materials showed an overall success rate of 93% . The influence of this factor on the success of direct pulp-capping treatment was studied only by Marques et al. DIRECT PULP CAPPING. The aim of this study was to evaluate and compare, both clinically and radiographically, the effects of calcium silicate-based materials (i.e., ProRoot MTA [PR-MTA], MTA-Plus [MTA-P], and Biodentine [BD]) and ferric sulfate [FS] in pulpotomy of primary molars.Materials and Methods. Discussion: Keywords: Indirect pulp capping in the primary dentition: a four year follow-up study. Outcomes of Vital Pulp Therapy Using Mineral Trioxide Aggregate or Biodentine: A Prospective Randomized Clinical Trial. In case of direct pulp capping, the procedure is carried out in a single sitting with follow up appointments to determine the success of the procedure. 2019 Jul;45(7):840-847. doi: 10.1016/j.joen.2019.02.025. [34] Am J Dent. We included 87 trials that investigated the success of pulp treatment of milk teeth. The purpose of this study is to evaluate the success rate of direct pulp capping performed with MTA-Angelus® or calcium hydroxide in mechanical-exposed or carious-exposed mature permanent human teeth. Mineral trioxide aggregate (MTA) success was 91%, 86%, 84% and 81% at the same time points. Among the unsuccessful teeth, 69% showed evidence of internal resorption. 0000003803 00000 n Sixty‐four of these studies were excluded, whereas 19 articles satisfied the inclusion criteria and were retrieved in full text for data extraction and a methodological quality assessment. (16) agree with this study. Overall, DPC clinical and radiographic success rates among the selected studies ranged between 53% and 100%. Thus it may not be rational to completely abandon DPC as an alternative vital pulp therapy procedure. The success rate for replantation of permanent teeth is highest when the tooth is replanted within ____ of the avulsion. The Journal of the American Dental Association, 137, 1699-705. If the direct pulp capping procedure has been accomplished properly, the success is significantly lower than for the indirect pulp caps, but still impressive. HHS Results: 0000005667 00000 n Materials and methods This clinical study was conducted with 40 primary • >90% clinical success (absence of symptoms or pathology) at 3 years follow up 2.1.5 Level of evidence (Grade B) Evidence has been obtained from a number of well-designed retrospective descriptive studies. Studies on indirect pulp capping had clinical success ranging from 73 to 97% after a follow-up period of 2 weeks to 11 years . CiteSeerX - Document Details (Isaac Councill, Lee Giles, Pradeep Teregowda): Objective: To compare the success rate between the one session and two session indirect pulp capping of asymptomatic pulpitis for 1 year after the treatment was performed in children with different caries risk. If the pulp appears infected or symptomatic, the dentist may decide a root canal is the best treatment option. Keywords: Direct. 9. The trials were published between 1989 and 2017 and provided 125 comparisons of different treatment options. Defined as a procedure in which the exposed vital pulp is covered with a protective dressing or base placed directly over the site of exposure in an attempt to preserve the pulp vitality. Please enable it to take advantage of the complete set of features! Direct Pulp Caps. Outcomes of Direct Pulp Capping by Using Either ProRoot Mineral Trioxide Aggregate or Biodentine in Permanent Teeth with Carious Pulp Exposure in 6- to 18-Year-Old Patients: A Randomized Controlled Trial. Indirect Pulp Capping • a procedure in which a material is placed on a thin partition of remaining carious dentin that, if removed, might expose the pulp in immature permanent teeth. Type of One Sided Exact 0000006510 00000 n Methods: Case report: A 13 year old boy presented with an immature and grossly carious 37. Table 1. 0000006531 00000 n Al-Hiyasat AS, Barrieshi-Nusair KM, Al-Omari MA (2006) The radiographic outcomes of direct pulp-capping procedures performed by dental students. In a randomized multicenter study on direct pulp capping or partial pulpotomy with calcium hydroxide involving 58 patients with exposed pulps after caries excavation in permanent teeth, the authors reported a low success rate (31.8 % vs. 34.5 %, respectively) and no significant difference in pulp vitality between the two pulp capping procedures after a 1-year or more follow-up [ 17 ]. FACTORS DETERMINING SUCCESS OF IPC. Pulp Capping; Endodontics Pulp Capping. Exclusion: Primary teeth, mechanical, traumatic or not specified pulp exposure, teeth with irreversible pulpitis or no pulpal diagnosis. Direct pulp capping (DPC) and calcium hydroxide has been widely used with high success rates in young permanent teeth, but the results in primary teeth are less satisfactory [3,4]. 0000001340 00000 n Low-quality evidence suggests a high success rate for direct pulp capping in teeth with cariously exposed pulps with better long-term outcomes for MTA and Biodentine compared with calcium hydroxide. 0000003694 00000 n If the pulp appears infected or symptomatic, the dentist may decide a root canal is the best treatment option. 0000008235 00000 n 0000003824 00000 n 0000009091 00000 n A success rate of 90% in maintaining the tooth is expected, without signs and symptoms, during a period of 3 years. 0000002257 00000 n Pulp Capping; Endodontics Pulp Capping. Direct Pulp Caps. Aguilar P, Linsuwanont P (2011) Vital pulp therapy in vital permanent teeth with cariously exposed pulp: a systematic review. There are two broad types of pulp capping - the direct and the indirect pulp caps. Key results. %PDF-1.4 %���� Pulp capping is used to save a diseased tooth from extraction. The teeth were evaluated clinically and radiographically for 24 months. Epub 2018 Oct 3. 0000007337 00000 n Primary molars were restored with the compomer material, and permanent molars were restored with the resin composite material. primary teeth with reversible pulp inflammation. be performed to prevent leakage. 1; Objectives: The tooth’s vitality should be maintained. J Endod. Epub 2019 May 16. Objectives: 0000002114 00000 n , who used MTA and reported 88.9% treatment success in teeth with secondary caries, compared to 94.7% treatment success in teeth with primary caries. ... Low and moderate risks of bias were observed. Calcium hydroxide liners increased the success rate of IPT. 2018 Nov;44(11):1603-1609. doi: 10.1016/j.joen.2018.08.004. The aim of this paper is to present the approbated by us protocol for application of direct pulp capping … 4. CiteSeerX - Document Details (Isaac Councill, Lee Giles, Pradeep Teregowda): Abstract: The purpose of this study was to compare the clinical and radiographic success rate of direct pulp capping (DPC) and partial pulpotomy (PP) treatment using MTA as pulp capping agent in treatment of primary teeth with pulp exposure after direct complete excavation. Direct pulp capping (level of evidence C – lack of good quality study. lish interesting result for successful application of direct pulp capping in primary dentition.  |  Low-quality evidence suggests a high success rate for direct pulp capping in teeth with cariously exposed pulps with better long-term outcomes for MTA and Biodentine compared with calcium hydroxide. Finally, 12 of these articles were included in the systematic review. I recommend direct pulp capping primarily for operative dentistry procedures and not for crowns. A direct pulp cap is done on permanent teeth when the removal of deep decay results in exposing the pulp. Published by John Wiley & Sons Ltd. NLM Parinyaprom N, Nirunsittirat A, Chuveera P, Na Lampang S, Srisuwan T, Sastraruji T, Bua-On P, Simprasert S, Khoipanich I, Sutharaphan T, Theppimarn S, Ue-Srichai N, Tangtrakooljaroen W, Chompu-Inwai P. J Endod. 2.2 Direct pulp capping This approach has limited application and is gener-ally not recommended for primary molars. Clipboard, Search History, and several other advanced features are temporarily unavailable. Meta-analysis on combined clinical/radiographic outcome was performed using a random effect model. The effect size for of MTA vs Ca(OH)2, although modest, was consistent with narrow CI. This clinical success rate is similar to that of other materials such as calcium hydroxide and MTA when used as indirect pulp capping agents in permanent teeth [14, 15]. J Endod. 0000001127 00000 n 0000003931 00000 n Marginal integrity of the restorations was also recorded at recall periods using modified USPHS/Ryge criteria. However, if pulp exposure is sensible and non-symptomatic (i.e., presumably healthy), minimally invasive techniques should be considered for the man-agement of pulp exposure in vital teeth [14]. 2010; 14(5):559–67. The Dycal and Prime&Bond NT groups did not exhibit any clinical or radiographic failure. The tooth/teeth in question are examined and a decision is made to do direct or indirect pulp capping based on the condition of the tooth. To conduct a systematic review and meta-analysis determining the outcome of direct pulp capping (DPC) in mature permanent teeth with a cariously exposed pulp and a clinical diagnosis of reversible pulpitis, and ascertain whether the capping material influences the outcome. Name some NON-vital pulp therapy - pulpectomy - extraction. Four randomized trials had a high risk of bias. Biodentine success was 96% at 6-months, 86% at 1 year and 86% at 2-3 years. Sources: MEDLINE Ovid-SP, Cochrane Central Register of Controlled Trials (CENTRAL), International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, Embase and Web of Science until April 2020. ... which has more success rate, IPT or pulpotomy. 0000010184 00000 n The success rate of direct pulp capping in traumatized incisors with closed apices can be observed in Table 1. Patients included in this study will be recruited from routine dental patients attending conservative clinics in JUST Dental Teaching Centre. Caries Res. The high failure rate in calcium hydroxide pulpotomies can be attributed to: Calcium hydroxide has no beneficial effect on the inflamed pulp. 0000009958 00000 n Would you like email updates of new search results? Higher success rate than normal pulpotomy at 97% National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Vital pulp therapy, including direct pulp From a total of 38 pulp capped teeth 7(18.5%) became necrotic; among these, 5 were treated within 24 hours after the accident. 2018 Mar;44(3):341-348. doi: 10.1016/j.joen.2017.10.012. Collaboration, preserving pulpal health should be a primary goal in the management of deep carious lesions [13]. http://dx.doi.org/10.14219/jada.archive.2006.0116, http://dx.doi.org/10.1007/s00784-012-0712-6, http://dx.doi.org/10.4103/0972-0707.108173. JOA: This is a fantastic new study where the outcome of various procedures for pulp has been compared based on a large material on crown fractured teeth with pulp exposures. 0000008214 00000 n Pulp treatment for extensive decay in primary teeth is generally successful. These results were based on poor methodological quality studies. The creation of … treated with EMD and calcium hydroxide in direct pulp capping of primary molars at 12 months follow up. This site needs JavaScript to work properly. Pulp capping is a technique used in dental restorations to prevent the dental pulp from necrosis, after being exposed, or nearly exposed during a cavity preparation. Smaïl-Faugeron V, Glenny AM, Courson F, Durieux P, Muller-Bolla M, Fron Chabouis H. Cochrane Database Syst Rev. There was no difference between MTA and Biodentine. lish interesting result for successful application of direct pulp capping in primary dentition. The pulpotomy agents were ass… 0000010735 00000 n 0000011712 00000 n Dammaschke T, Leidinger J, Schafer E. Long-term evaluation of direct pulp capping-treatment outcomes over an average period of 6.1 years. However, in the cited study, the difference was also not statistically significant.  |  Quality assessment highlighted four non-randomized studies to be of fair and five of poor quality. PULP CAPPING AGENTS 9. Awawdeh L, Al-Qudah A, Hamouri H, Chakra RJ. • Many uses in dentistry including in the treatment for direct pulp capping, apexogenesis, and apexification in immature teeth • MTA success rate: 94-100%. They are only successful if the pulpal infection is very mild CONCLUSIONS: For DPC in primary teeth, this systematic review found that diverse new biologically and compatible agents with promising success rates are currently available for paediatric dentistry practitioners. It has a lower cost, long-term higher success rate and better exfoliation pattern • DPC is not recommended for primary teeth until … Pulp capping is an operative technique designed to preserve the vitality of a potentially infected pulp. The success rate is presented in percentage to the number of teeth treated in the group. For example, direct pulp capping isn’t usually recommended for young children due to a low success rate in baby teeth. Context : When a pulpal exposure happens on a vital tooth (without irreversible inflammation), direct pulp capping can be realized by using different biomaterials : CaOH2, MTA or Biodentine®. But the longer you wait to have the treatment done, the more likely you are to end up having a root canal instead. In only bCalxyl: Dental Preparation, Otto & Co . Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions. Risk of bias assessed using Cochrane and modified Downs and Black quality assessment checklist. Asgary S, Eghbal MJ, Ghoddusi J, Yazdani S (2013) One-year results of vital pulp therapy in permanent molars with irreversible pulpitis: an ongoing multicenter, randomized, non-inferiority clinical trial. Abstract: Among the goals of pulp capping are to manage bacteria, arrest caries progression, stimulate pulp cells to form new dentin, and produce a durable seal that protects the pulp complex. The tooth/teeth in question are examined and a decision is made to do direct or indirect pulp capping based on the condition of the tooth. the criteria for successfully conducted indirect pulp capping were evaluated. 0000010618 00000 n The listed success rates in the literature for direct pulp capping during caries excavation vary substantially [12, 56, 76]. Results: After 2 years, the overall success rate of direct pulp capping was approximately 93% (78/84 teeth, excluding exfoliations). Like other connective tissues, dental pulp has the capacity of healing against external stimuli.1 Direct pulp capping (DPC) is one of the vital pulp therapy modalities, attempting to maintain the in- In this randomized clinical trial, 29 healthy 5- to 7-year-old children with at least four carious primary molars with no clinical or radiographic evidence of pulp degeneration were enrolled. DIRECT PULP CAPPING 7. This study was conducted on 6-18 year old patients, while a comparable study conducted on mature permanent teeth found success rates of 84.6% using MTA and 92.3% using Biodentine. NIH Low and moderate risks of bias were observed. ... not done if there is caries present as low success rate. Results of success, 6 and 12 months after indirect pulp therapy (in one or two sessions) of asymptomatic pulpitis in primary teeth. Try to avoid exposing the pulp. doi: 10.1002/14651858.CD003220.pub2. Key results. Similar studies have been conducted of direct pulp capping, with one study comparing ProRoot Mineral Trioxide Aggregate (MTA) and Biodentine which found success rates of 92.6% and 96.4% respectively. Tziafas D. The future role of a molecular approach to pulp-dentinal regeneration. treatment of deep dentin caries lesions approximating the pulp in vital primary teeth: (1) indirect pulp treatment (IPT), also known as indirect pulp cap;7 (2) direct pulp cap (DPC); and (3) pulpotomy.2,7 For the purpose of this guideline, various interventions for vital pulp therapy were evaluated, including indirect pulp … Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Journal of Conservative Dentistry, 16, 92-8. The aim of this paper is to present the approbated by us protocol for application of direct pulp capping … Smaïl-Faugeron V, Courson F, Durieux P, Muller-Bolla M, Glenny AM, Fron Chabouis H. Cochrane Database Syst Rev. © 2020 International Endodontic Journal. Indications: This procedure is indicated in a primary tooth with a normal pulp following a small mechanical or traumatic exposure when conditions for a favorable response are optimal. USA.gov. Results: After 2 years, the overall success rate of direct pulp capping was approximately 93% (78/84 teeth, excluding exfoliations). The influence of this factor on the success of direct pulp-capping treatment was studied only by Marques et al. Traumatic injuries resulting in pulp exposure in young patients present a challenge in treatment. This can lead to the pulp of the tooth either being exposed or nearly exposed which causes pulpitis (inflammation). Overall, DPC clinical and radiographic success rates among the selected studies ranged between 53% and 100%. Study design: Each of 62 3-9 year old children with any deep, primary molar cavity was included if a pulp exposure occurred during caries excavation. Success of Direct Pulp Capping Using Mineral Trioxide Aggregate and Calcium Hydroxide in Mature Permanent Molars with Pulps Exposed during Carious Tissue Removal: 1-year Follow-up. 0000007358 00000 n doi: 10.1002/14651858.CD003220.pub3. Frankfurt/Main - … Indirect pulp therapy Efficacy of direct pulp capping for management of cariously exposed pulps in permanent teeth: A systematic review and meta-analysis S Cushley , H F Duncan, M J Lappin , …