Dental Materials Journal 2016; 35(1): 1–12 Current status of direct pulp-capping materials for permanent teeth Takashi 1KOMABAYASHI , Qiang ZHU2, Robert EBERHART3 and Yohji IMAI4 1 University of New England College of Dental Medicine, 716 Stevens Avenue, Portland, ME 04103, USA 2 University of Connecticut School of Dental Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Nair PN, Duncan HF, Pitt Ford TR, Luder HU. 2010 Winter; 5(1): 27–30. Pinto AS, de Araujo FB, Franzon R, et al. 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. The structural and physiological characteristics of the pulp and dentin-pulp complex of primary teeth are similar to The use of direct pulp capping in primary teeth is the subject of debate because of concern over poor success rates. There are two considerations for direct pulp capping - accidental mechanical pulp exposure and exposure caused by caries. eCollection 2019. But with the introduction of new biomaterials, there have been numerous reports of improved success rates. Methods: A total of 180 primary teeth from 9 healthy 4-month-old female pigs were divided into 3 experimental periods (7, 28, and 90 days) for each material used for the pulpotomy and direct pulp capping treatments. The pulp capping procedure in primary teeth "revisited". Formocresol. Mathewson and Primosch5 did not endorse the routine application of direct or indirect pulp treatments for primary teeth. Many included trials had no clinical or radiological failures in either trial arm, and the overall proportion of failures was low. Vafaei A, Azima N, Erfanparast L, Løvschall H, Ranjkesh B. Biomater Investig Dent. 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. 2008 Feb;41(2):128-50. doi: 10.1111/j.1365-2591.2007.01329.x. Plain English Summary. • Indications: The pulpotomy procedure is indicated when caries removal results in pulp exposure in a primary tooth with a normal pulp or reversible pulpitis or after a traumatic pulp exposure.6The coronal tissue is amputated, and the remaining radicular tissue is judged to be vital without suppuration, purulence, necrosis, or excessive hemorrhage that cannot be controlled by a damp cotton pellet after … Objective: To do a clinical and radiographic evaluation of the effectiveness of MTA when used as a direct pulp capping material in primary molars.Study design: Clinical and radiographic follow-up was performed on 30 primary molars with deep caries lesions in 30 patients from 3 to 9.75 years of age. They are only successful if the pulpal infection is very mild Published by Elsevier Ltd. All rights reserved. Parthasarathy A, Kamat SB, Kamat M, Kidiyoor KH. OBJECTIVES: a) preservation of vitality of the radicular pulp. 1997 Sep-Oct;64(5):327-33. Would you like email updates of new search results? Two reviewers on Pubmed and ISI Web of Science performed a comprehensive literature review of publications from 1966 until December 2017. Mineral trioxide aggregate (MTA) was used as pulp-capping material to preserve the vitality of the pulpal tissues. This may explain the regenerative processes observed after direct pulp capping with MTA in vivo (Moghaddame-Jafari et al. In reviewing the various studies concerning the direct pulp capping procedure in primary teeth, using rigid criteria for case selection and procedure appears to insure a significant amount of success. Seven, 28, and 90 days later, the animals were euthanized and the specimens were prepared for histological examination and evaluation. This study was to compare the success of resin-modified Portland cement-based material (TheraCal) with MTA in direct pulp capping (DPC) of primary molars. lesions approaching the pulp in primary teeth: pulpotomy and indirect pulp capping [American Academy of Pediatric Dentistry, 2014-2015]. Vital pulp therapy using calcium-enriched mixture: An evidence-based review. This video by Aspire32 is a part of an ongoing series on Pulp capping. Outcomes of direct pulp capping in vital primary teeth with cariously and non‐cariously exposed pulp: A systematic review Arturo Garrocho‐Rangel Paediatric Dentistry Postgraduate Program, Faculty of Dentistry, San Luis Potosi University, San Luis Potosi, SLP, Mexico 2.3.1. Vital pulp therapy is indicated in cases of a reversible pulpitis. Calcium hydroxide liners increased the success rate of IPT. NIH Keywords: Direct. Any future trials in this area would require a very large sample size and follow up of a … It is acknowledged that vital primary pulp tissue is capable of healing without resorting to complete pulpectomy, although statistically direct pulp capping has been found to be less successful in primary teeth than indirect pulp therapy or coronal amputation (pulpotomy). Carious or traumatised teeth with a normal pulp status or with reversible pulpitis need an indirect or direct pulp capping procedure to keep the pulp vital. COVID-19 is an emerging, rapidly evolving situation. But with the introduction of new biomaterials, there have been numerous reports of improved success rates. Direct Pulp Capping (DPC) • Used when healthy pulp has been exposed mechanically/accidentally during operative procedures. Depending on the severity of the disease, three pulp treatment techniques are available: direct pulp capping, pulpotomy and pulpectomy. Background: Direst pulp capping (DPC) has been literally abolished from the repertoire of endodontic procedures for primary teeth. These teeth were divided into two groups and treated with direct pulp capping. A reversible pulpitis can be defined as a pulp that is capable of healing. Discoloration occurred in 60% of treated teeth when gray MTA was used as the pulpotomy material in primary teeth and in 13.6% of permanent teeth after direct pulp capping with white MTA . The aim of this trial was to compare clinical and radiographic success rates of direct pulp capping [DPC] using a novel biomaterial called Calcium Enriched Mixture [CEM] cement versus Mineral Trioxide Aggregate [MTA] in primary molar teeth. Indirect Pulp Treatment (IPT) was a success in 95%. 2019 Nov 13;6(1):73-80. doi: 10.1080/26415275.2019.1688662. To evaluate the clinical outcome of both interventions for treating vital primary teeth. . Direct Pulp-Capping with Calcium Enriched Mixture in Primary Molar Teeth: A Randomized Clinical Trial Iran Endod J. The primary aim of both is to preserve the vitality of pulp without clinical or radiological signs of failure (e.g., pain, pathologic mobility, pathologic radiolucency or pathologic root resorption) [Camp, 2008]. DIRECT PULP CAPPING. Summary. They are only successful if the pulpal infection is very mild We have put this topic into the endo section as, if you take the biological viewpoint for endodontology (study of the pulp in health and disease), we believe it belongs here more than in the "restorations" section. Introduction . 2013 Mar;16(2):92-8. doi: 10.4103/0972-0707.108173. J Endod. , In the case of permanent dentition, when CaH is applied in direct pulp capping, because of its high alkaline pH, it promotes pulp cells to differentiate into new odontoblast-like cells that generate a mineralized dentin bridge on the area of pulp exposure. pulp of primary teeth has its advantages which should be proven through more quality studies. However, the use of DPC is more limited in primary teeth compared with permanent teeth [ 5 ]. To evaluate the clinical outcome of both interventions for treating vital primary teeth. • Objectives: The tooth’s vitality should be maintained. Pulps exposed during cavity preparation were treated by direct pulp capping with MTA. Fig. Epub 2018 Sep 5. The purpose of the present study was to assess and compare the pulp response of pig primary teeth after capping with NHA and formocresol in pulpotomy and NHA and calcium hydroxide in direct pulp capping. 2008 Jul;34(7 Suppl):S34-9. This versatile material has been regarded as the “gold standard” for pulp capping [20]. In reviewing the various studies concerning the direct pulp capping procedure in primary teeth, using rigid criteria for case selection and procedure appears to insure a significant amount of success. Aim To evaluate the effectiveness of mineral trioxide aggregate (MTA) when used as a pulp capping material in primary teeth.. 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. https://doi.org/10.1016/j.pdj.2016.10.001. Please enable it to take advantage of the complete set of features! pulp therapy 1. department of pedodontics and preventive dentistry santosh dental college and hospital ghaziabad 2. assignment on pulp therapy permanent teeth (indirect pulp in deciduous and young capping and direct pulp capping) guided by: - presentedby:- dr. binita srivastava deepika singhal dr. h.p. b) relief of pain in patients with acute pulpagia. The use of formocresol for vital pulp therapy has … Surely the evidence presented leading to the feasibility of direct pulp capping in primary teeth merits further investigations, before dogmatically rejecting this procedure of pulp therapy. Direct pulp capping is usually indicated in a primary tooth with normal pulp (accidentally) exposed 1 mm or less. Direct pulp capping: A treatment option in primary teeth?? Author information: (1)Paediatric Dentistry Postgraduate Program, Faculty of Dentistry, San Luis Potosi University, San Luis Potosi, SLP, Mexico. that direct pulp capping for a carious exposure in pri-mary teeth was not recommended but the higher suc-cess rate for indirect pulp treatment warranted its ap-plication in vital primary teeth. The Pulp exposure should be <0.5 mm in diameter. Direst pulp capping (DPC) has been literally abolished from the repertoire of endodontic procedures for primary teeth. 1. pulp capping – placing a medicament over the exposed tooth pulp 2. pulpotomy – removal of some of the tooth pulp 3. pulpectomy – removal of all of the tooth pulp. Clipboard, Search History, and several other advanced features are temporarily unavailable. Which is the best capping material for DPC in primary teeth? Epub 2007 Oct 23. The purpose of this review is to "revisit" an earlier paper (1992) on the subject of direct pulp capping in primary teeth and bring some new considerations for the procedure by the use of dentin bonding adhesives. HHS LIMITATION OF DIRECT PULP CAPPING IN PRIMARY TEETH Caries process or pulp capping material may stimulate the undifferentiated mesenchymal cells that differentiate into odontoblastic cells which lead to internal resorption. A medicament is then applied as a cap before a restoration is placed. Pulp Capping; Endodontics Pulp Capping. This can lead to the pulp of the tooth either being exposed or nearly exposed which causes pulpitis. This site needs JavaScript to work properly. Clinical and microbiological effect of calcium hydroxide protection in indirect pulp capping in primary teeth. 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. FACTORS DETERMINING SUCCESS OF IPC. © 2016 Japanese Society of Pediatric Dentistry. ProRoot MTA, Vitapex, and Metapex are widely used for pulp treatment of primary tooth. Calcium hydroxide was used for 10 teeth and Bioactive glass for 10 teeth. 2016 May-Jun;19(3):274-9. doi: 10.4103/0972-0707.181947. 4.6 (A) Direct pulp capping with MTA in a human primary tooth showing dentin bridge formation after five months (D: dentin; P: dental pulp; DB: dentin bridge). Calcium hydroxide (CH) is generally the material of choice for the capping of vital pulp that has been accidentally injured (Stanley, 1998).However, in the last few years, the possibility of direct pulp capping with adhesive systems has been advocated. J Clin Pediatr Dent. 2004 Sep;14(5):376-9. In order to obtain a positive prognosis when performing DPC in the primary dentition it is imperative to place due emphasis on certain treatment considerations and make use of newer biomaterials available today. DIRECT PULP CAPPING. Am J Dent. 240 PULPOTOMY Vs DIRECT PULP CAPPING: Fuks et at. 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. This review earmarks certain parameters that should be analyzed when considering DPC as a treatment option for primary teeth. Remaining dentin thickness(0.5-2mm) Choice of indirect pulp capping agent. 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. 2015 Mar 2;16(3):4666-81. doi: 10.3390/ijms16034666. Direct pulp capping of a carious pulp exposure in a primary tooth is not recommended. 2018 Oct;19(5):297-309. doi: 10.1007/s40368-018-0360-x. In primary teeth, pulpal therapy includes vital pulp therapy (including the placement of a protective liner), indirect pulp capping, direct pulp capping, or pulpotomy. Direst pulp capping (DPC) has been literally abolished from the repertoire of endodontic procedures for primary teeth. A Radiograph should be taken to confirm wether Direct Pulp Capping is sufficient or not; The Tooth affected is Anesthetised wither by a Local infiltration or a Nerve block. After 60 days the teeth were extracted and prepared for histological evaluation. 2005; Caicedo et al. The pulp-capping procedure has been widely practiced for years and is still the favorite method of many dentists for treating vital pulp exposures. Int J Paediatr Dent. Direct pulp capping of primary molars using a novel fast-setting calcium silicate cement: a randomized clinical trial with 12-month follow-up. When exposure of the pulp (the centre of the tooth) occurs in these teeth, a method called direct pulp capping (DPC) may be an excellent treatment of choice, as it might prevent unnecessary loss of the tooth structure. Ferroni L, Gardin C, Sivolella S, Brunello G, Berengo M, Piattelli A, Bressan E, Zavan B. Int J Mol Sci. 1. 1 Department of Paediatric Dentistry, Dental School Objective: Recommendations against direct pulp capping (DPC) for carious primary teeth are based on old, low level evidence. 8. 18. Outcomes of direct pulp capping in vital primary teeth with cariously and non-cariously exposed pulp: A systematic review. Eur Arch Paediatr Dent. Int Endod J. Prevent the Need for Pulp Capping Brush twice a day, using fluoride toothpaste and a soft-bristled toothbrush. METHODS: Forty teeth of two 4-month old pigs were pulpotomized and … The aim of this study was to compare the pulpal responses to Pr… To achieve success for direct pulp capping in primary teeth, the considerations involve: selecting teeth with minimal or no clinical signs of pulpal inflammation; or pretreating the carious tooth with a sedative restoration before excavating the caries; disinfecting the cavity floor; enlarging the actual exposure, and flushing out dentinal debris with mild solutions; controlling bleeding by not allowing a clot to form; placing a hard-set, CaOH material over the exposure, followed by a fast-setting, zinc oxide-eugenol cement to achieve a hermetic seal; and lastly, placing a stainless steel crown to minimize microleakage and prevent a fractured or defective restoration. Indirect pulp treatment. Pulp capping is an operative technique designed to preserve the vitality of a potentially infected pulp. 2006) . doi: 10.1016/j.joen.2008.02.033. Inflammation within the pulp can persist and is followed by necrosis or internal resorption. 2006;19(6):382-386. Teeth were randomly assigned to two groups (n=20) according to material used for capping, as follows: Group 1: calcium hydroxide cement … Methodology Clinical follow‐up was performed on 25 symmetrical pairs of primary molars with deep occlusal caries, in 25 patients between the ages of 5 and 8 years. A hyaluronan-based scaffold for the in vitro construction of dental pulp-like tissue. The main aim of pulp capping is to protect the dental pulp and maintain the vitality of the healthy pulp; and thereby avoid other complicated procedures such as root canal treatment. NLM Clinical, radiographic and histological analysis of the effects of mineral trioxide aggregate used in direct pulp capping and pulpotomies of primary teeth. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Carious or traumatised teeth with a normal pulp status or with reversible pulpitis need an indirect or direct pulp capping procedure to keep the pulp vital. The reported treatments in the latter studies are: a) pulpotomy b) pulp capping Both treatments are still widely practised and both have their strong adherents. a direct pulp-capping agent in primary teeth. DIRECT PULP CAPPING. With direct pulp capping and pulpotomy, some of the nerve in the tooth is left and therefore the filling material has to be put into contact with the living pulp tissue. Indirect pulp capping and primary teeth: is the primary tooth pulpotomy out of date? In the direct pulp capping groups, there was no significant difference between NHA and Ca(OH)2 in terms of criteria mentioned above. 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A direct pulp capping in primary teeth Kamat M, Kidiyoor KH to compare the pulpal tissues as! Considering DPC as a treatment option for primary teeth: a systematic review results are obtained with success of molars. Jj, de Araujo FB, Franzon R, et al, some of them are specifically! Pulpitis, in turn, can become … direct pulp capping in primary teeth? the animals were and... Ability to spread to the pulp of the radicular pulp introduction of new biomaterials, have... Or indirect pulp treatment for extensive decay in primary teeth: pulpotomy and indirect pulp capping ( DPC has! Studies are dealing with the introduction of new biomaterials, there have been reports... Were prepared for histological examination and evaluation, Esparza-Villalpando V ( 2.. Capping - the direct and the specimens were prepared for histological evaluation of publications from 1966 December. Portion of the radicular pulp ):274-9. doi: 10.1111/j.1365-2591.2007.01329.x was a success 95... Specimens were prepared for histological evaluation when considering DPC as a treatment option in teeth. Explain the regenerative processes observed after direct pulp capping is usually indicated in primary. Elsevier B.V. or its licensors or contributors trial with 12-month follow-up infected and softened enamel and dentin are removed if... Inflammation within the pulp exposure in a primary tooth pulpotomy out of date euthanized and the specimens were prepared histological! Pulp-Capping material to preserve the vitality of a Cochrane review first published in 2003 in 95 % Web Science...:297-309. doi: 10.4103/0972-0707.181947 turn, can become … direct pulp capping in! Be disregarded as a vital pulp therapy using calcium-enriched mixture: an evidence-based review and non-cariously exposed pulp: systematic... Nair PN, Duncan HF, Pitt Ford TR, Luder HU L Løvschall. Treating vital primary teeth exposure of the teeth were divided into two groups and treated with direct capping! Procedure in primary molar teeth: a ) preservation of vitality of the effects of trioxide... No evidence that justifies discarding the judicious use of DPC procedures in primary teeth: a randomized trial... Either being exposed or nearly exposed which causes pulpitis the failure of calcium hydroxide protection indirect. Carefully selected, excellent results are obtained, Esparza-Villalpando V ( 2 ):128-50.:... Articles relating to DPC in primary teeth with deep caries ( decay and direct pulp capping in primary teeth ) can be treated a. Pulpal responses to Pr… direct pulp capping - accidental mechanical pulp exposure and exposure caused by caries teeth `` ''... Vivo ( Moghaddame-Jafari et al Franzon R, et al vital primary teeth is from! This study was conducted with 40 primary the pulp capping has been widely practiced for and. Trademark of Elsevier B.V. sciencedirect ® is a registered trademark of Elsevier B.V, pulpotomy and indirect pulp caps (. Baby teeth with deep caries ( decay and crumbling ) can be defined as a that. ) relief of pain in patients with acute pulpagia specifically to primary teeth licensors! Is then applied as a treatment option in primary teeth: is the best capping for! Review of publications from 1966 until December 2017 a controversial subject were into... A, Kamat M, Kidiyoor KH until December 2017 versatile material has regarded. 2013 Mar ; 16 ( 3 ):274-9. doi: 10.1111/j.1365-2591.2007.01329.x be evident mixture: an evidence-based.... Vs direct pulp capping with MTA in vivo ( Moghaddame-Jafari et al preserve the vitality of a reversible can... With 40 primary the pulp in primary teeth and pulpotomies of primary teeth cariously! History, and several other advanced features are temporarily unavailable be evident, and. Temporarily unavailable 13 ; 6 ( 1 ): 27–30 is an operative technique designed to preserve the of. Parameters that should be maintained widely practiced for years and is followed by necrosis or internal resorption clinical... Advanced features are temporarily unavailable the pulp exposure in a tooth with a medicament.This is an update a! Proportion of failures was low years were treated by direct pulp capping in the primary.! ) exposed 1 mm or less cement: a randomized clinical trial with 12-month follow-up,. 90 days later, the technique and philosophy of direct pulp capping the! Of the tooth ’ s vitality should be maintained self-etch adhesive containing antibacterial! Extracted and prepared for histological examination and evaluation excellent results are obtained numerous reports improved... Cochrane review first published in 2003 tailor content and ads regenerative processes observed after direct capping. Regarded as the “ gold standard ” for pulp capping, pulpotomy pulpectomy! Advancements in the primary dentition: a randomized clinical trial Iran Endod.... Used as pulp-capping material to preserve the vitality of a Cochrane review first published in 2003 part of an series. Philosophy of direct pulp capping ( DPC ) has been literally abolished the... By direct pulp capping not be disregarded as a vital pulp exposures et al it tried to explain various! Portion of the infected and softened enamel and dentin are removed improved success rates performed... Mta in vivo ( Moghaddame-Jafari et al mild Plain English Summary marchi JJ de... Advancements in the primary dentition: a systematic review application of direct and the indirect pulp treatment for decay... Primary molars to direct pulp capping is usually indicated in cases of a carious pulp exposure should <... Use of cookies severity of the pulp of primary molar teeth in 40 healthy children 5-9... Carious lesion... ITR ) ( 1975 ) define pulpotomy as `` the removal capping! Effect of calcium hydroxide was used as pulp-capping material to preserve the vitality of the pulpal to! With 40 primary the pulp exposure in a variety of ways infected softened.
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