Risk of bias assessed using Cochrane and modified Downs and Black quality assessment checklist. FACTORS DETERMINING SUCCESS OF IPC. 0000011712 00000 n Marginal integrity of the restorations was also recorded at recall periods using modified USPHS/Ryge criteria. This site needs JavaScript to work properly. 0000001127 00000 n © 2020 International Endodontic Journal. Background: Direst pulp capping (DPC) has been literally abolished from the repertoire of endodontic procedures for primary teeth. Finally, 12 of these articles were included in the systematic review. 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 Frankfurt/Main - … 0000010184 00000 n Outcomes of Vital Pulp Therapy Using Mineral Trioxide Aggregate or Biodentine: A Prospective Randomized Clinical Trial. ... not done if there is caries present as low success rate. %PDF-1.4 %���� ... How will a dentist restore a severly decayed and endodontically treated primary tooth? Caplan DJ, Cai J, Yin G, White BA. Smaïl-Faugeron V, Glenny AM, Courson F, Durieux P, Muller-Bolla M, Fron Chabouis H. Cochrane Database Syst Rev. Methods: 0000007337 00000 n Outcomes of direct pulp capping in vital primary teeth with cariously and non‐cariously exposed pulp: A systematic review. 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 lack of influence of treatment delay is demonstrated once more. PULP is defined as soft tissue forming inner structure of tooth and containing nerve and blood vessel , also called as tooth pulp. There are two broad types of pulp capping - the direct and the indirect pulp caps. Direct Pulp Caps. 0000002152 00000 n 0000010395 00000 n Background Direst pulp capping (DPC) has been literally abolished from the repertoire of endodontic procedures for primary teeth. We included 87 trials that investigated the success of pulp treatment of milk teeth. Direct Pulp Caps. 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. 2006;19(6):382-386. Try to avoid exposing the pulp. 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. However, in the cited study, the difference was also not statistically significant. Asgary S, Ahmadyar M (2013) Vital pulp therapy using calcium-enriched mixture: An evidence-based review.  |  6. The pooled success rate differed based on material and follow-up. 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. (16) agree with this study. 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.  |  Meta-analysis on combined clinical/radiographic outcome was performed using a random effect model. 0000010505 00000 n • Many uses in dentistry including in the treatment for direct pulp capping, apexogenesis, and apexification in immature teeth • MTA success rate: 94-100%. 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. Epub 2019 May 16. However, in the cited study, the difference was also not statistically significant. The effect size for of MTA vs Ca(OH)2, although modest, was consistent with narrow CI. 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 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. When dental caries is removed from a tooth, all or most of the infected and softened enamel and dentin are removed. Keywords: Objectives: 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. The high failure rate in calcium hydroxide pulpotomies can be attributed to: Calcium hydroxide has no beneficial effect on the inflamed pulp. Indirect pulp treatment was applied using Dycal for 91 teeth, ProRoot MTA for 89 teeth and TheraCal LC for 115 teeth. primary teeth with reversible pulp inflammation. Al-Hiyasat AS, Barrieshi-Nusair KM, Al-Omari MA (2006) The radiographic outcomes of direct pulp-capping procedures performed by dental students. The success rate of direct pulp capping in traumatized incisors with closed apices can be observed in Table 1. Results of success, 6 and 12 months after indirect pulp therapy (in one or two sessions) of asymptomatic pulpitis in primary teeth. 0000009937 00000 n Caries Res. DIRECT PULP CAPPING. Collaboration, preserving pulpal health should be a primary goal in the management of deep carious lesions [13]. 0000011784 00000 n 0000008214 00000 n 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 ]. A direct pulp cap is done on permanent teeth when the removal of deep decay results in exposing the pulp. Clinical and microbiological effect of calcium hydroxide protection in indirect pulp capping in primary teeth. 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. 1; Objectives: The tooth’s vitality should be maintained. The trials were published between 1989 and 2017 and provided 125 comparisons of different treatment options. Case report: A 13 year old boy presented with an immature and grossly carious 37. Please enable it to take advantage of the complete set of features! Overall, DPC clinical and radiographic success rates among the selected studies ranged between 53% and 100%. 0000001286 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 … deep caries; direct pulp capping; exposed pulp; pulpitis; vital pulp treatment. Calcium hydroxide liners increased the success rate of IPT. Some studies have concluded that MTA is superior to FC (gold standard for pulpotomy therapy in deciduous teeth) 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]. 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. Clipboard, Search History, and several other advanced features are temporarily unavailable. Materials and methods This clinical study was conducted with 40 primary 0000008235 00000 n Marchi JJ, de Araujo FB, Froner AM, et al. PDF | One of the major challenges associated with indirect pulp capping is to prevent the exposure of the pulp and maintain its vitality. Indirect Pulp Treatment (IPT) was a success in 95%. Would you like email updates of new search results? If the pulp appears infected or symptomatic, the dentist may decide a root canal is the best treatment option. 2018 Nov;44(11):1603-1609. doi: 10.1016/j.joen.2018.08.004. 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 , … The trials were published between 1989 and 2017 and provided 125 comparisons of different treatment options. H��W�n�0��+tk�5_�cl'� �Z(У,3KT)9��G��ҍ�. 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/. ... low quality evidence [48 months]) and DPC (very-low quality evidence [24 months]). Overall, DPC clinical and radiographic success rates among the selected studies ranged between 53% and 100%. Epub 2018 Oct 3. Quality assessment highlighted four non-randomized studies to be of fair and five of poor quality. Remaining dentin thickness(0.5-2mm) Choice of indirect pulp capping agent. 0000004834 00000 n 0000003931 00000 n 0000010069 00000 n 0000005688 00000 n A direct pulp cap is done on permanent teeth when the removal of deep decay results in exposing the pulp. 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. Indirect pulp therapy Smaïl-Faugeron V, Courson F, Durieux P, Muller-Bolla M, Glenny AM, Fron Chabouis H. Cochrane Database Syst Rev. (16) The results of the study of Garrocho-Rangel et al. FEATURES OF SUCCESSFUL PULP CAPPING 8. USA.gov. The dental pulp occupies the center of each tooth and shapes itself to a maturation of the tooth . 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. 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. Journal of Conservative Dentistry, 16, 92-8. COVID-19 is an emerging, rapidly evolving situation. Type of One Sided Exact lish interesting result for successful application of direct pulp capping in primary dentition. Patients included in this study will be recruited from routine dental patients attending conservative clinics in JUST Dental Teaching Centre. 0000009070 00000 n 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). I recommend direct pulp capping primarily for operative dentistry procedures and not for crowns. 0000001712 00000 n Low and moderate risks of bias were observed. Key results. The optimal success rate of pulpotomy in contrast to pulp capping is a very significant finding. The aim of this paper is to present the approbated by us protocol for application of direct pulp capping … 9. The Journal of the American Dental Association, 137, 1699-705. ... Low and moderate risks of bias were observed. Pulp treatment for extensive decay in primary teeth is generally successful. 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. 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 16. The outcome of vital pulp treatment after carious pulp exposure is multifactorial and related to the procedure, biomaterial and pre-operative pulpal diagnosis. ... which has more success rate, IPT or pulpotomy. Success was defined as absence of signs and symptoms of irreversible pulpitis, apical periodontitis or loss of pulp vitality. 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. Pulp capping is used to save a diseased tooth from extraction. 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. 0000009091 00000 n 0000007358 00000 n The listed success rates in the literature for direct pulp capping during caries excavation vary substantially [12, 56, 76]. If the pulp appears infected or symptomatic, the dentist may decide a root canal is the best treatment option. 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. The pulpotomy agents were ass… , 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. 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. 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. be performed to prevent leakage. doi: 10.1002/14651858.CD003220.pub3. direct pulp capping with calcium hydroxide. Awawdeh L, Al-Qudah A, Hamouri H, Chakra RJ. • >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. Tziafas D. The future role of a molecular approach to pulp-dentinal regeneration. ... 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. 8. 0000003694 00000 n 0000005667 00000 n Results: After 2 years, the overall success rate of direct pulp capping was approximately 93% (78/84 teeth, excluding exfoliations). 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. 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. Indirect pulp capping in the primary dentition: a four year follow-up study. J Clin Pediatr Dent. 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. 2018 May 31;5(5):CD003220.  |  Dammaschke T, Leidinger J, Schafer E. Long-term evaluation of direct pulp capping-treatment outcomes over an average period of 6.1 years. HHS 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 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 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). The Dycal and Prime&Bond NT groups did not exhibit any clinical or radiographic failure. Conclusions: Am J Dent. 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]. Thus it may not be rational to completely abandon DPC as an alternative vital pulp therapy procedure. Loss of pulp capping ( level of evidence C – lack of influence of delay. 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