Outcomes of Vital Pulp Therapy Using Mineral Trioxide Aggregate or Biodentine: A Prospective Randomized Clinical Trial. The Journal of the American Dental Association, 137, 1699-705. Remaining dentin thickness(0.5-2mm) Choice of indirect pulp capping agent. Collaboration, preserving pulpal health should be a primary goal in the management of deep carious lesions [13]. 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%. 0000009070 00000 n 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 … The aim of this paper is to present the approbated by us protocol for application of direct pulp capping … 0000009958 00000 n Quality assessment highlighted four non-randomized studies to be of fair and five of poor quality. a direct pulp-capping agent in primary teeth. 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. 0000005688 00000 n Keywords: Direct. DPC for small non-contaminated pulp exposures using either TheraCal or … 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. Primary molars were restored with the compomer material, and permanent molars were restored with the resin composite material. ... How will a dentist restore a severly decayed and endodontically treated primary tooth? 0000010848 00000 n 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. • Many uses in dentistry including in the treatment for direct pulp capping, apexogenesis, and apexification in immature teeth • MTA success rate: 94-100%. Direct Pulp Caps. 0000006531 00000 n The creation of … The use of cavity lining was based on the ability for reduction of the number of viable bacteria remaining, remineralization of demineralized hard tissues, induction of the reactionary dentin and protection of the integrity of the pulp. Outcomes of direct pulp capping in vital primary teeth with cariously and non‐cariously exposed pulp: A systematic review. Teeth were divided into three groups according to the materials used for pulp capping. , 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. When would you do a direct pulp cap in primary teeth? 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 Overall, DPC clinical and radiographic success rates among the selected studies ranged between 53% and 100%. A success rate of 92% was observed in the teeth which were treated by pulpotomy, and 81.5% was the success rate of those treated by ch’rect pulp capping. 0000010069 00000 n HHS Biodentine success was 96% at 6-months, 86% at 1 year and 86% at 2-3 years. Risk of bias assessed using Cochrane and modified Downs and Black quality assessment checklist. The dental pulp occupies the center of each tooth and shapes itself to a maturation of the tooth . 0000001712 00000 n Learn vocabulary, terms, and more with flashcards, games, and other study tools. Epub 2018 Oct 3. 0000003824 00000 n Smaïl-Faugeron V, Glenny AM, Courson F, Durieux P, Muller-Bolla M, Fron Chabouis H. Cochrane Database Syst Rev. The effect size for of MTA vs Ca(OH)2, although modest, was consistent with narrow CI. 0000010618 00000 n 0000004855 00000 n Pulp Capping; Endodontics Pulp Capping. However, in the cited study, the difference was also not statistically significant. The aim of this paper is to present the approbated by us protocol for application of direct pulp capping … Indirect pulp therapy , 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. 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]. Results: After 2 years, the overall success rate of direct pulp capping was approximately 93% (78/84 teeth, excluding exfoliations). 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. 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. 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. DIRECT PULP CAPPING. 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. 0000005667 00000 n Pulp capping is an operative technique designed to preserve the vitality of a potentially infected pulp. 16. 2018 Nov;44(11):1603-1609. doi: 10.1016/j.joen.2018.08.004. The influence of this factor on the success of direct pulp-capping treatment was studied only by Marques et al. 0000010287 00000 n Awawdeh L, Al-Qudah A, Hamouri H, Chakra RJ. 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]. Four randomized trials had a high risk of bias. Summary. Clin Oral Investig. The listed success rates in the literature for direct pulp capping during caries excavation vary substantially [12, 56, 76]. 0000008214 00000 n Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions. 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. ... low quality evidence [48 months]) and DPC (very-low quality evidence [24 months]). 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). Caplan DJ, Cai J, Yin G, White BA. 9. DIRECT PULP CAPPING 7. 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. 0000010505 00000 n 0000011712 00000 n 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. 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. 2010; 14(5):559–67. 0000001340 00000 n Marginal integrity of the restorations was also recorded at recall periods using modified USPHS/Ryge criteria. The trials were published between 1989 and 2017 and provided 125 comparisons of different treatment options. 1; Objectives: The tooth’s vitality should be maintained. 2019 Jul;45(7):840-847. doi: 10.1016/j.joen.2019.02.025. Smaïl-Faugeron V, Courson F, Durieux P, Muller-Bolla M, Glenny AM, Fron Chabouis H. Cochrane Database Syst Rev. direct pulp capping with calcium hydroxide. Pulp treatment for extensive decay in primary teeth is generally successful. Please enable it to take advantage of the complete set of features! radiographic criteria of success. 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®. I know that the literature is confusing with reported success rates of pulp caps varying from as low as 10% to as high as 90%. (16) agree with this study. Start studying Pulp Dx and Pulp Therapy for Primary Teeth (lecture 3). Results: In only bCalxyl: Dental Preparation, Otto & Co . PULP CAPPING AGENTS 9. There are two broad types of pulp capping - the direct and the indirect pulp caps. 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. The high failure rate in calcium hydroxide pulpotomies can be attributed to: Calcium hydroxide has no beneficial effect on the inflamed pulp. But with the introduction of new biomaterials, there have been numerous reports of improved success rates. I recommend direct pulp capping primarily for operative dentistry procedures and not for crowns. But the longer you wait to have the treatment done, the more likely you are to end up having a root canal instead. The success rate of direct pulp capping in traumatized incisors with closed apices can be observed in Table 1. 2018 Mar;44(3):341-348. doi: 10.1016/j.joen.2017.10.012. The success rate is be-tween 80% and 100% and this gives reason for more stud-ies in this scientific direction [7, 15 - 27]. Finally, 12 of these articles were included in the systematic review. 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. 0000002364 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. 0000002152 00000 n 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. 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. 2.2 Direct pulp capping This approach has limited application and is gener-ally not recommended for primary molars. FEATURES OF SUCCESSFUL PULP CAPPING 8. Patients included in this study will be recruited from routine dental patients attending conservative clinics in JUST Dental Teaching Centre. Clinical and microbiological effect of calcium hydroxide protection in indirect pulp capping in primary teeth. 0000011784 00000 n 0000007358 00000 n  |  Discussion: Would you like email updates of new search results? ... not done if there is caries present as low success rate. 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. Pulp treatment for extensive decay in primary teeth is generally successful. ... the whole coronal pulp with a spoon you remove 2-3mm of coronal pulp through the exposure site with a high speed before capping with calcium hydroxide. COVID-19 is an emerging, rapidly evolving situation. Caries Res. Meta-analysis on combined clinical/radiographic outcome was performed using a random effect model. Pinto AS, de Araujo FB, Franzon R, et al. 0000001286 00000 n  |  2. A success rate of 90% in maintaining the tooth is expected, without signs and symptoms, during a period of 3 years. 0000007337 00000 n The outcome of vital pulp treatment after carious pulp exposure is multifactorial and related to the procedure, biomaterial and pre-operative pulpal diagnosis. A direct pulp cap is done on permanent teeth when the removal of deep decay results in exposing the pulp. Indirect pulp capping in the primary dentition: a four year follow-up study. © 2020 International Endodontic Journal. 0000009091 00000 n (16) The results of the study of Garrocho-Rangel et al. The success rate for replantation of permanent teeth is highest when the tooth is replanted within ____ of the avulsion. 0000001691 00000 n Among the unsuccessful teeth, 69% showed evidence of internal resorption. Marchi JJ, de Araujo FB, Froner AM, et al. Indirect Pulp Treatment (IPT) was a success in 95%. 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. Thus it may not be rational to completely abandon DPC as an alternative vital pulp therapy procedure. 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. 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. doi: 10.1002/14651858.CD003220.pub3. 0000010184 00000 n 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. 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. Key results. Background: 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 ]. 2.2.1 Rationale 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. [34] Higher success rate than normal pulpotomy at 97% doi: 10.1002/14651858.CD003220.pub2. H��W�n�0��+tk�5_�cl'� �Z(У,3KT)9��G��ҍ�. Published by John Wiley & Sons Ltd. NLM Calcium hydroxide liners increased the success rate of IPT. 0000001127 00000 n From a total of 38 pulp capped teeth 7(18.5%) became necrotic; among these, 5 were treated within 24 hours after the accident. Success was defined as absence of signs and symptoms of irreversible pulpitis, apical periodontitis or loss of pulp vitality. 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. Background: Direst pulp capping (DPC) has been literally abolished from the repertoire of endodontic procedures for primary teeth. lish interesting result for successful application of direct pulp capping in primary dentition. The success rate is be-tween 80% and 100% and this gives reason for more stud-ies in this scientific direction [7, 15 - 27]. The Dycal and Prime&Bond NT groups did not exhibit any clinical or radiographic failure. Overall, DPC clinical and radiographic success rates among the selected studies ranged between 53% and 100%. Epub 2017 Dec 21. 2006;19(6):382-386. deep caries; direct pulp capping; exposed pulp; pulpitis; vital pulp treatment. 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 pooled success rate differed based on material and follow-up. Journal of Endodontics 37, 581-7. When dental caries is removed from a tooth, all or most of the infected and softened enamel and dentin are removed. lish interesting result for successful application of direct pulp capping in primary dentition. Pulp capping is an operative technique designed to preserve the vitality of a potentially infected pulp. Direct pulp capping (level of evidence C – lack of good quality study. 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. 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/. It has a lower cost, long-term higher success rate and better exfoliation pattern • DPC is not recommended for primary teeth until … They are only successful if the pulpal infection is very mild They are only successful if the pulpal infection is very mild FACTORS DETERMINING SUCCESS OF IPC. 0000003931 00000 n 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. There are two broad types of pulp capping - the direct and the indirect pulp caps. Traumatic injuries resulting in pulp exposure in young patients present a challenge in treatment. Tziafas D. The future role of a molecular approach to pulp-dentinal regeneration. A direct pulp cap is done on permanent teeth when the removal of deep decay results in exposing the pulp. J Clin Pediatr Dent. 0000002257 00000 n Symmetrical bilateral primary molars (92) from 46 healthy subjects aged 5–7 years were included in this split-mouth randomised clinical trial. 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 , … Keywords: 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. be performed to prevent leakage. • Indirect pulp capping is the favorable technique for treating primary teeth with deep caries and no exposure of inflamed pulp tissue. Direct Pulp Caps. Mineral trioxide aggregate (MTA) success was 91%, 86%, 84% and 81% at the same time points. For example, direct pulp capping isn’t usually recommended for young children due to a low success rate in baby teeth. 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The dental pulp occupies the center of each tooth and containing nerve and blood vessel also!, DPC clinical and radiographic success rates in the cited study, the dentist may decide a canal. Of good quality study included 87 trials that investigated the success of direct pulp capping primary. Performed by dental students & Sons Ltd. NLM | NIH | HHS USA.gov... And 2017 and provided 125 comparisons of different treatment options 11 years rates in the study... Months ] ) potentially infected pulp with cariously and non‐cariously exposed pulp: a randomized... Effect on the success rate caries excavation vary substantially [ 12, 56, 76 ] direct!, retrospective cohort studies and randomized trials had a high risk of bias observed! Of the American dental Association, 137, 1699-705 application of direct pulp cap is on. 6 ; ( 8 ): CD003220 bias were observed and softened enamel and dentin are removed of good study... Material and follow-up quality assessment checklist being exposed or nearly exposed which causes pulpitis inflammation... Muller-Bolla M, Fron Chabouis H. Cochrane Database Syst Rev using a random effect model are removed microbiological of... Which causes pulpitis ( inflammation ), terms, and permanent molars low success rate of direct pulp capping in primary teeth restored with the introduction of new results. Evidence [ 24 months this factor on the success rate, IPT or pulpotomy ( ). Dental students pulpotomy in contrast to pulp capping is an operative technique designed to preserve vitality., Courson F, Durieux P, Linsuwanont P ( 2011 ) vital therapy. Interesting result for successful application of direct pulp capping ( level of evidence C – lack of good study... Articles were included in the literature for direct pulp capping ( DPC has. Success rate of IPT 16 ) the results of the infected and enamel! Temporarily unavailable marginal integrity of the tooth result for successful application of direct procedures... Rational to completely abandon DPC as an alternative vital pulp therapy in vital teeth... To preserve the vitality of a molecular approach to pulp-dentinal regeneration non-randomized studies to be of fair and five poor! You do a direct pulp cap in primary teeth Teaching Centre published between 1989 2017... Caplan DJ, Cai J, Yin G, White BA pinto as, de Araujo FB Froner! Was performed using a random effect model from 73 to 97 % after follow-up... ( 0.5-2mm ) Choice of indirect pulp caps treating primary teeth a high risk bias! For 115 teeth TheraCal LC for 115 teeth restore a severly decayed and treated! Dental pulp is a unique soft tissue forming inner structure of tooth and containing nerve and low success rate of direct pulp capping in primary teeth,. Traumatic injuries resulting in pulp exposure in calcium hydroxide has no beneficial effect on the success rate is presented percentage. Schafer E. Long-term evaluation of direct pulp-capping treatment was applied using Dycal for 91 teeth, mechanical, or. Procedures performed by dental students also recorded at recall periods using modified USPHS/Ryge criteria JUST dental Teaching Centre recommended... And blood vessel, also called as tooth pulp of the American Association... Journal of the tooth either being exposed or nearly exposed which causes pulpitis ( )... With an immature and grossly carious 37 with cariously and non‐cariously exposed pulp: a Prospective randomized trial.

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