Overall, DPC clinical and radiographic success rates among the selected studies ranged between 53% and 100%. Remaining dentin thickness(0.5-2mm) Choice of indirect pulp capping agent. Calcium hydroxide liners increased the success rate of IPT. 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. 2018 May 31;5(5):CD003220. Clinical Oral Investigations, 17, 431-39. © 2020 International Endodontic Journal. Published by John Wiley & Sons Ltd. NLM 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]. 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. INTRODUCTION: This randomized clinical trial aimed to compare the success rate and postoperative pain of direct pulp capping (DPC) using calcium hydroxide (CH) and mineral trioxide aggregate (MTA) in teeth with carious pulp exposures and reversible pulpitis.METHODS: Sixty-four permanent teeth were randomly divided after caries excavation into 2 groups: CH and MTA (n = 32 in 2.2 Direct pulp capping This approach has limited application and is gener-ally not recommended for primary molars. Background: Direst pulp capping (DPC) has been literally abolished from the repertoire of endodontic procedures for primary teeth. The success rate is be-tween 80% and 100% and this gives reason for more stud-ies in this scientific direction [7, 15 - 27]. 2018 Mar;44(3):341-348. doi: 10.1016/j.joen.2017.10.012. (16) The results of the study of Garrocho-Rangel et al. 7. Patients included in this study will be recruited from routine dental patients attending conservative clinics in JUST Dental Teaching Centre. Overall, DPC clinical and radiographic success rates among the selected studies ranged between 53% and 100%. ... [5,6,7] DPC with calcium hydroxide in primary teeth has a low success rate. Journal of Conservative Dentistry, 16, 92-8. 0000004855 00000 n 4. 0000010505 00000 n The high failure rate in calcium hydroxide pulpotomies can be attributed to: Calcium hydroxide has no beneficial effect on the inflamed pulp. It has a lower cost, long-term higher success rate and better exfoliation pattern • DPC is not recommended for primary teeth until … The pooled success rate differed based on material and follow-up. Exclusion: Primary teeth, mechanical, traumatic or not specified pulp exposure, teeth with irreversible pulpitis or no pulpal diagnosis. 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. 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 ]. 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. 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. 0000010395 00000 n Asgary S, Ahmadyar M (2013) Vital pulp therapy using calcium-enriched mixture: An evidence-based review. The trials were published between 1989 and 2017 and provided 125 comparisons of different treatment options. PDF | One of the major challenges associated with indirect pulp capping is to prevent the exposure of the pulp and maintain its vitality. H��W�n�0��+tk�5_�cl'� �Z(У,3KT)9��G��ҍ�. Pulp Capping; Endodontics Pulp Capping. 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. The influence of this factor on the success of direct pulp-capping treatment was studied only by Marques et al. 0000003931 00000 n 51 0 obj << /Linearized 1 /O 54 /H [ 1340 372 ] /L 1602051 /E 92989 /N 5 /T 1600913 >> endobj xref 51 39 0000000016 00000 n When would you do a direct pulp cap in primary teeth? Results: 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. I recommend direct pulp capping primarily for operative dentistry procedures and not for crowns. There was no difference between MTA and Biodentine. The aim of this study was to evaluate the pulpal response of primary teeth after direct pulp capping (DPC) with two biocompatible materials namely mineral trioxide aggregate (MTA) and bioactive glass (BAG). 0000009958 00000 n 0000010735 00000 n Would you like email updates of new search results? , 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. 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. 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. Direct pulp capping (level of evidence C – lack of good quality study. direct pulp capping with calcium hydroxide. J Endod. This can lead to the pulp of the tooth either being exposed or nearly exposed which causes pulpitis (inflammation). 0000010618 00000 n However, in the cited study, the difference was also not statistically significant. Risk of bias assessed using Cochrane and modified Downs and Black quality assessment checklist. ... - Indirect pulp tx - direct pulp capping - Pulpotomy. Keywords: Pulp Capping; Endodontics Pulp Capping. Success was defined as absence of signs and symptoms of irreversible pulpitis, apical periodontitis or loss of pulp vitality. From a total of 38 pulp capped teeth 7(18.5%) became necrotic; among these, 5 were treated within 24 hours after the accident. Outcomes of Vital Pulp Therapy Using Mineral Trioxide Aggregate or Biodentine: A Prospective Randomized Clinical Trial. Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions. a direct pulp-capping agent in primary teeth. 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. Pulp capping is an operative technique designed to preserve the vitality of a potentially infected pulp. 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. 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. Caries Res. Please enable it to take advantage of the complete set of features! 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]. 0000009070 00000 n The effect size for of MTA vs Ca(OH)2, although modest, was consistent with narrow CI. 0000010848 00000 n 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. 0000006510 00000 n Four randomized trials had a high risk of bias. • Indirect pulp capping is the favorable technique for treating primary teeth with deep caries and no exposure of inflamed pulp tissue. radiographic criteria of success. Clipboard, Search History, and several other advanced features are temporarily unavailable. The listed success rates in the literature for direct pulp capping during caries excavation vary substantially [12, 56, 76]. 0000001286 00000 n Direct Pulp Caps. 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% . HHS 2004; 38(3):314–20. Methods: A success rate of 90% in maintaining the tooth is expected, without signs and symptoms, during a period of 3 years. 0000004834 00000 n Biodentine success was 96% at 6-months, 86% at 1 year and 86% at 2-3 years. (16) agree with this study. 0000001340 00000 n The creation of … 2.2.1 Rationale 6. 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. They are only successful if the pulpal infection is very mild ... low quality evidence [48 months]) and DPC (very-low quality evidence [24 months]). ... Low and moderate risks of bias were observed.  |  0000005667 00000 n Objectives: Indirect pulp capping in the primary dentition: a four year follow-up study. Key results. 0000011761 00000 n USA.gov. 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. A two-year prospective clinical trial carried out by Cho et al. FACTORS DETERMINING SUCCESS OF IPC. The aim of this paper is to present the approbated by us protocol for application of direct pulp capping … Pulp treatment for extensive decay in primary teeth is generally successful. However, in the cited study, the difference was also not statistically significant. The trials were published between 1989 and 2017 and provided 125 comparisons of different treatment options. Epub 2017 Dec 21. Awawdeh L, Al-Qudah A, Hamouri H, Chakra RJ. Traumatic injuries resulting in pulp exposure in young patients present a challenge in treatment. 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 is defined as soft tissue forming inner structure of tooth and containing nerve and blood vessel , also called as tooth pulp. 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. [34] 16. the criteria for successfully conducted indirect pulp capping were evaluated. 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%. Type of One Sided Exact 0000006531 00000 n In only bCalxyl: Dental Preparation, Otto & Co . Background Direst pulp capping (DPC) has been literally abolished from the repertoire of endodontic procedures for primary teeth. Teeth were divided into three groups according to the materials used for pulp capping. Collaboration, preserving pulpal health should be a primary goal in the management of deep carious lesions [13]. ... evidence-based recommendations on three vital pulp therapies: indirect pulp treatment (IPT; also known as indirect pulp cap), direct pulp cap (DPC), and pulpotomy. J Endod. 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. The success rate of direct pulp capping in traumatized incisors with closed apices can be observed in Table 1. Table 1. 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. • >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. %PDF-1.4 %���� Based on clinical experience or expert consensus): very limited technique which The Journal of the American Dental Association, 137, 1699-705. Studies on indirect pulp capping had clinical success ranging from 73 to 97% after a follow-up period of 2 weeks to 11 years . Results of success, 6 and 12 months after indirect pulp therapy (in one or two sessions) of asymptomatic pulpitis in primary teeth. Conclusions: FEATURES OF SUCCESSFUL PULP CAPPING 8. Biodentine® is the most recent material and its success rate for direct pulp capping is poorly documented. 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 , … • Many uses in dentistry including in the treatment for direct pulp capping, apexogenesis, and apexification in immature teeth • MTA success rate: 94-100%. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Key results. The influence of this factor on the success of direct pulp-capping treatment was studied only by Marques et al. 0000008235 00000 n 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. Keywords: Direct. 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. 0000009937 00000 n 2014 Aug 6;(8):CD003220. Journal of Dentistry 44, 1-7. The outcome of vital pulp treatment after carious pulp exposure is multifactorial and related to the procedure, biomaterial and pre-operative pulpal diagnosis. Vital pulp therapy, including direct pulp Indirect pulp capping is a very successful procedure. Al-Hiyasat AS, Barrieshi-Nusair KM, Al-Omari MA (2006) The radiographic outcomes of direct pulp-capping procedures performed by dental students. 41-45 Direct pulp capping of a carious pulp exposure in a primary tooth is not recommended. Tziafas D. The future role of a molecular approach to pulp-dentinal regeneration. 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. The listed success rates in the literature for direct pulp capping during caries excavation vary substantially [12, 56, 76]. Indirect pulp therapy They are only successful if the pulpal infection is very mild lish interesting result for successful application of direct pulp capping in primary dentition. This site needs JavaScript to work properly. 0000010069 00000 n The success rate is be-tween 80% and 100% and this gives reason for more stud-ies in this scientific direction [7, 15 - 27]. 0000010287 00000 n Am J Dent. Quality assessment highlighted four non-randomized studies to be of fair and five of poor quality. Pulp treatment for extensive decay in primary teeth is generally successful. Results: After 2 years, the overall success rate of direct pulp capping was approximately 93% (78/84 teeth, excluding exfoliations). A majority of failures were observed in teeth that received NRC and phosphoric acid pretreatments (Groups 3 and 4). Objective. 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. Among the unsuccessful teeth, 69% showed evidence of internal resorption. Dental pulp is a unique soft tissue containing blood ves-sels, nerve fibers, collagen fibers, fibroblasts, odonto-blasts, and immune cells. 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. 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. 9. 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- 8. J Clin Pediatr Dent. For example, direct pulp capping isn’t usually recommended for young children due to a low success rate in baby teeth. Smaïl-Faugeron V, Glenny AM, Courson F, Durieux P, Muller-Bolla M, Fron Chabouis H. Cochrane Database Syst Rev. Aguilar P, Linsuwanont P (2011) Vital pulp therapy in vital permanent teeth with cariously exposed pulp: a systematic review. Meta-analysis on combined clinical/radiographic outcome was performed using a random effect model. NIH A direct pulp cap is done on permanent teeth when the removal of deep decay results in exposing the pulp. But with the introduction of new biomaterials, there have been numerous reports of improved success rates. 2018 Nov;44(11):1603-1609. doi: 10.1016/j.joen.2018.08.004. 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/. ... which has more success rate, IPT or pulpotomy. These results were based on poor methodological quality studies. treated with EMD and calcium hydroxide in direct pulp capping of primary molars at 12 months follow up. But the longer you wait to have the treatment done, the more likely you are to end up having a root canal instead. Background: Pulp treatment for extensive decay in primary teeth. 2019 Jul;45(7):840-847. doi: 10.1016/j.joen.2019.02.025. 0000001127 00000 n 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]. 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Periodontitis or loss of pulp capping is the best treatment option pulp-dentinal regeneration ( 7 ) doi! This can lead to the pulp appears infected or symptomatic, the difference was not. I recommend direct pulp capping during caries excavation vary substantially [ 12, 56, 76.. Capping this approach has limited application and is gener-ally not recommended and provided 125 comparisons different! Http: //dx.doi.org/10.4103/0972-0707.108173 selected studies ranged between 53 % and 81 % at the same time.... Rate of pulpotomy in contrast to pulp capping in the primary dentition: 13! Clinically and radiographically for 24 months ] ) and DPC ( very-low quality evidence 24.