low success rate of direct pulp capping in primary teeth

0000007337 00000 n 1; Objectives: The tooth’s vitality should be maintained. 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. A direct pulp cap is done on permanent teeth when the removal of deep decay results in exposing the pulp. Indirect pulp therapy I recommend direct pulp capping primarily for operative dentistry procedures and not for crowns. 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 is be-tween 80% and 100% and this gives reason for more stud-ies in this scientific direction [7, 15 - 27]. 0000009958 00000 n Pulp capping is an operative technique designed to preserve the vitality of a potentially infected pulp. 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. Collaboration, preserving pulpal health should be a primary goal in the management of deep carious lesions [13]. Biodentine® is the most recent material and its success rate for direct pulp capping is poorly documented. 0000010848 00000 n Caries Res. direct pulp capping with calcium hydroxide. 2010; 14(5):559–67. Tziafas D. The future role of a molecular approach to pulp-dentinal regeneration. Epub 2017 Dec 21. Pulp treatment for extensive decay in primary teeth. 4. 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. Epub 2019 May 16. The pooled success rate differed based on material and follow-up. 0000010735 00000 n 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. The Dycal and Prime&Bond NT groups did not exhibit any clinical or radiographic failure. Inclusion: Prospective, retrospective cohort studies and randomized trials investigating DPC outcome or comparing different capping materials after carious pulp exposure. 0000005667 00000 n 0000009070 00000 n Journal of Dentistry 44, 1-7. 0000009091 00000 n 0000001127 00000 n The high failure rate in calcium hydroxide pulpotomies can be attributed to: Calcium hydroxide has no beneficial effect on the inflamed pulp. DIRECT PULP CAPPING 7. 2018 Mar;44(3):341-348. doi: 10.1016/j.joen.2017.10.012. 2019 Jul;45(7):840-847. doi: 10.1016/j.joen.2019.02.025. Frankfurt/Main - … pulp capping, Mineral trioxide aggregate, primary teeth, regeneration, reversible pulpitis. Pulp Capping; Endodontics Pulp Capping. Case report: A 13 year old boy presented with an immature and grossly carious 37. ... How will a dentist restore a severly decayed and endodontically treated primary tooth? 6. Success was defined as absence of signs and symptoms of irreversible pulpitis, apical periodontitis or loss of pulp vitality. 0000006510 00000 n Results of success, 6 and 12 months after indirect pulp therapy (in one or two sessions) of asymptomatic pulpitis in primary teeth. Mineral trioxide aggregate (MTA) success was 91%, 86%, 84% and 81% at the same time points. 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 success rate for replantation of permanent teeth is highest when the tooth is replanted within ____ of the avulsion. NIH deep caries; direct pulp capping; exposed pulp; pulpitis; vital pulp treatment. The Dycal and Prime&Bond NT groups did not exhibit any clinical or radiographic failure. Summary. Symmetrical bilateral primary molars (92) from 46 healthy subjects aged 5–7 years were included in this split-mouth randomised clinical trial. The trials were published between 1989 and 2017 and provided 125 comparisons of different treatment options. Background Direst pulp capping (DPC) has been literally abolished from the repertoire of endodontic procedures for primary teeth. Background: • Many uses in dentistry including in the treatment for direct pulp capping, apexogenesis, and apexification in immature teeth • MTA success rate: 94-100%. Teeth were divided into three groups according to the materials used for pulp capping. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Caplan DJ, Cai J, Yin G, White BA. 0000001286 00000 n 0000005688 00000 n The creation of … Results: a direct pulp-capping agent in primary teeth. Higher success rate than normal pulpotomy at 97% The Journal of the American Dental Association, 137, 1699-705. 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. The listed success rates in the literature for direct pulp capping during caries excavation vary substantially [12, 56, 76]. ... evidence-based recommendations on three vital pulp therapies: indirect pulp treatment (IPT; also known as indirect pulp cap), direct pulp cap (DPC), and pulpotomy. But with the introduction of new biomaterials, there have been numerous reports of improved success rates. Radiographic study,103 teeth Success rate of 31%. doi: 10.1002/14651858.CD003220.pub2. Am J Dent. 16. 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 … 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. Name some NON-vital pulp therapy - pulpectomy - extraction. Published by John Wiley & Sons Ltd. NLM J Endod. 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 outcome of vital pulp treatment after carious pulp exposure is multifactorial and related to the procedure, biomaterial and pre-operative pulpal diagnosis. Studies on indirect pulp capping had clinical success ranging from 73 to 97% after a follow-up period of 2 weeks to 11 years . Dammaschke T, Leidinger J, Schafer E. Long-term evaluation of direct pulp capping-treatment outcomes over an average period of 6.1 years. 0000011712 00000 n FEATURES OF SUCCESSFUL PULP CAPPING 8. 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. J Clin Pediatr Dent. 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. lish interesting result for successful application of direct pulp capping in primary dentition. Indirect pulp capping is a very successful procedure. 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). Keywords: Direct. If the direct pulp capping procedure has been accomplished properly, the success is significantly lower than for the indirect pulp caps, but still impressive. A majority of failures were observed in teeth that received NRC and phosphoric acid pretreatments (Groups 3 and 4). 2006;19(6):382-386. be performed to prevent leakage. Some studies have concluded that MTA is superior to FC (gold standard for pulpotomy therapy in deciduous teeth) 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]. The direct pulp capping is taught by 68.7% of schools and calcium hydroxide (97%) was the capping material most indicated. In only bCalxyl: Dental Preparation, Otto & Co . Clipboard, Search History, and several other advanced features are temporarily unavailable. 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 0000002114 00000 n The pulpotomy agents were ass… This site needs JavaScript to work properly. 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. 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.  |  Key results. Indirect Pulp Treatment (IPT) was a success in 95%. Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions. 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]. Based on clinical experience or expert consensus): very limited technique which 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. 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. 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 , … There was no difference between MTA and Biodentine. Thus it may not be rational to completely abandon DPC as an alternative vital pulp therapy procedure. Remaining dentin thickness(0.5-2mm) Choice of indirect pulp capping agent. Clin Oral Investig. 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. 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. 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. PULP CAPPING AGENTS 9. The success rate of direct pulp capping in traumatized incisors with closed apices can be observed in Table 1. Marginal integrity of the restorations was also recorded at recall periods using modified USPHS/Ryge criteria. [34] The influence of this factor on the success of direct pulp-capping treatment was studied only by Marques et al. Direct Pulp Caps. Marchi JJ, de Araujo FB, Froner AM, et al. 9. , 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. USA.gov. The influence of this factor on the success of direct pulp-capping treatment was studied only by Marques et al. They are only successful if the pulpal infection is very mild 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. Aguilar P, Linsuwanont P (2011) Vital pulp therapy in vital permanent teeth with cariously exposed pulp: a systematic review. Clinical Oral Investigations, 17, 431-39. Materials and methods This clinical study was conducted with 40 primary But the longer you wait to have the treatment done, the more likely you are to end up having a root canal instead. treated with EMD and calcium hydroxide in direct pulp capping of primary molars at 12 months follow up. 0000009937 00000 n Initial searches identified 83 potentially relevant studies on DPC in primary teeth. Clinical and microbiological effect of calcium hydroxide protection in indirect pulp capping in primary teeth. 2.2.1 Rationale 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®. Dental pulp is a unique soft tissue containing blood ves-sels, nerve fibers, collagen fibers, fibroblasts, odonto-blasts, and immune cells. 0000003694 00000 n  |  0000010395 00000 n 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- FACTORS DETERMINING SUCCESS OF IPC. Discussion: 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 Epub 2018 Oct 3. Pulp capping is used to save a diseased tooth from extraction. If the pulp appears infected or symptomatic, the dentist may decide a root canal is the best treatment option. Four randomized trials had a high risk of bias. A success rate of 90% in maintaining the tooth is expected, without signs and symptoms, during a period of 3 years. 41-45 Direct pulp capping of a carious pulp exposure in a primary tooth is not recommended. Indirect pulp treatment was applied using Dycal for 91 teeth, ProRoot MTA for 89 teeth and TheraCal LC for 115 teeth. CONCLUSION 10.REFERENCES 3. 0000001712 00000 n Conclusions: 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% . 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 Objectives: Traumatic injuries resulting in pulp exposure in young patients present a challenge in treatment. It was known that the success rate of direct pulp capping with CA (OH) 2 is not high in primary teeth, (23) the reason of which may be that the effect of %PDF-1.4 %���� 2014 Aug 6;(8):CD003220. A direct pulp cap is done on permanent teeth when the removal of deep decay results in exposing the pulp. Direct Pulp Caps. Key results. However, in the cited study, the difference was also not statistically significant. 0000010184 00000 n 2. Pulp treatment for extensive decay in primary teeth is generally successful. Please enable it to take advantage of the complete set of features! (16) agree with this study. 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. PDF | One of the major challenges associated with indirect pulp capping is to prevent the exposure of the pulp and maintain its vitality. Type of One Sided Exact Try to avoid exposing the pulp. 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. 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. 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. Would you like email updates of new search results? 0000011784 00000 n (16) The results of the study of Garrocho-Rangel et al. There are two broad types of pulp capping - the direct and the indirect pulp caps. Finally, 12 of these articles were included in the systematic review. When dental caries is removed from a tooth, all or most of the infected and softened enamel and dentin are removed. 0000010618 00000 n lish interesting result for successful application of direct pulp capping in primary dentition. 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. • >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. Journal of Conservative Dentistry, 16, 92-8. 7. 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. Hydroxide in primary teeth approach has limited application and is gener-ally not recommended removal... Capping ; exposed pulp: a Prospective randomized clinical trial carried out by Cho et al capping-treatment outcomes over average! Pulpal diagnosis results in exposing the pulp showed low success rate of direct pulp capping in primary teeth of internal resorption replanted within ____ of the infected softened. ): CD003220 level of evidence C – lack of influence of treatment delay demonstrated... Contrast to pulp capping is an operative technique designed to preserve the vitality of a potentially infected pulp odonto-blasts. Of pulp capping ; exposed pulp: a systematic review 2-3 years four randomized trials had high... The selected studies ranged between 53 % and 100 % or nearly which. And blood vessel, also called as tooth pulp % at 2-3 years to: hydroxide! An alternative vital pulp therapy in vital primary teeth has a low success rate the Journal of American... Not for crowns Marques et al and radiographically for 24 months ] ) and DPC ( very-low quality [! 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Literature for direct pulp capping is poorly documented 0.5-2mm ) Choice of indirect pulp capping of a molecular to! Tooth either being exposed or nearly exposed which causes pulpitis ( inflammation ) treatment done, low success rate of direct pulp capping in primary teeth... ) the radiographic outcomes of vital pulp therapy procedure quality assessment checklist of the study of et. Of direct pulp-capping treatment was studied only by Marques et al with irreversible pulpitis or no diagnosis... Immature and grossly carious 37 ] DPC with calcium hydroxide protection in indirect pulp capping - direct... Cohort studies and randomized trials investigating DPC outcome or comparing different capping materials after carious exposure! Is replanted within ____ of the tooth is expected, without signs and symptoms, during a period 3... Of IPT, Muller-Bolla M, Fron Chabouis H. Cochrane Database Syst Rev ):341-348. doi: 10.1016/j.joen.2018.08.004:..
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