indirect pulp capping success rate

J Endod. 16. This technique is used when most of the decay has been removed from a deep cavity, but some softened dentin and decay remains over the pulp chamber that if removed would expose the pulp and trigger irreversible pulpitis. [33] 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. [11][12] In one experiment conducted by Stuart et al. This is due to its superior properties of good biocompatibility and adhesive nature, providing coronal seal to prevent bacteria infiltration. In studies where dentists where were described the scenario of deep caries and given the option of removing all the affected dentin and exposing the pulp and doing a direct pulp cap, versus leaving some of the affected dentin and placing an indirect pulp cap, only 17% responded that they would stop and leave carious dentin behind. 2018; 39(3):182-189. If the indirect pulp capping procedure has been accomplished properly, there is an amazingly high success rate. 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]. When dental caries is removed from a tooth, all or most of the infected and softened enamel and dentin are removed. 12. This report included 22 operators and a total of 299 teeth. Conclusions Despite the success rate of indirect pulp Because of its many advantageous properties and long-standing success in clinical use, it has been used as a control material in multiple experiments with pulp capping agents over the years[17][18] and is considered the gold standard dental material for direct pulp capping to date. [5] [6] A temporary filling is used to keep the material in place, and about 6 months later, the cavity is re-opened and hopefully there is now enough sound dentin over the pulp (a "dentin bridge") that any residual softened dentin can be removed and a permanent filling can be placed. 10. These materials, protect the pulp from noxious agents (heat, cold, bacteria) and stimulate the cell-rich zone of the pulp to lay down a bridge of reparative dentin. But more recently mineral trioxide aggregate (MTA) used as a primary molar medicament for pulpotomies reported a 97% success rate. J Clin Pediatr 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. [3], Contraindication for Direct Pulp Capping:[4], In 1938, Bodecker introduced the Stepwise Caries Excavation (SWE) Technique for treatment of teeth with deep caries for preservation of Pulp vitality. After 6 months, this result is put into perspective [68]. MTA also comes in white and grey preparations[26] which may aid visual identification clinically. This is a step wise procedure and a long procedure which takes about 6 months or more to complete. Pulp capping material should provide a suitable condition to encourage regeneration of the dentin-pulp complex; be able to induce differentiation of odontoblastlike cells; and be antibacterial, biocompatible, and nontoxic 8 . [13][16] It is suggested that an adhesive coronal restoration be used above the CaOH lining to provide adequate coronal seal. Indirect pulp capping in the primary dentition: a four year follow-up study. Another study reported that the success rate of DPC with BD is 90.9% in patients younger than 40 and 73.8% in patients 40 or older [ 109 ]. Studies have demonstrated that it encourages bleeding due to its vasodilating properties hence impairing polymerisation of the material, affecting its ability to provide a coronal seal when used as a pulp capping agent. The tooth is then washed and dried, and the protective material placed, followed finally by a dental restoration which gives a bacteria-tight seal to prevent infection. A recent systematic review of vital pulp therapy in vital permanent teeth with cariously exposed pulps reviewed success rates of direct pulp capping.3 In this review the success rate of direct pulp capping was reported as >6 months-1 year, 87.5%; >1-2 … Tronstad L, Mjör IA. Results: After 48 months, Group-1 showed a success rate of 88.8% and Group-2 of 93%. It is only feasible if the exposure is made through non infected dentin and there is no recent history of spontaneous pain (i.e. Direct Pulp Caps. [3] Once the exposure is made, the tooth is isolated from saliva to prevent contamination by use of a dental dam, if it was not already in place. But success rates for pulpotomy decreases over time from 90% or more initially (6-12 months) to 70% or less after 3 years or more. RESULTS: The overall success rate was 100% in the absence of preoperative pain. [9], Calcium hydroxide (CaOH) is an organo-metallic cement that was introduced into dentistry in the early twentieth century[10] and there have since been many advantages to this material described in much of the available literature. The prognosis of pulp capping (both direct and indirect) varies with success rates ranging from 13 percent to 100 percent. Pediatr Dent. [19], Mineral trioxide aggregate (MTA) is a recent development of the 1990s[20] initially as a root canal sealer but has seen increased interest in its use as a direct pulp capping material. Clinically and radiographically, teeth treated with indirect pulp capping using MTA show higher success rates after 3 months compared to using a setting calcium salicylate cement (Dycal, Dentsply Sirona, Konstanz, Germany). However, calcium hydroxide and mineral trioxide aggregate (MTA) are the preferred material of choice in clinical practice due to their favourable outcome. Marchi JJ, de Araujo FB, Froner AM, et al. The teeth were observed up to 9 years with a first visit after 3 months followed by an annual routine visit. Only age had a significant effect on the pulpal survival rate: the success rate was 90.9% in patients younger than 40 years and 73.8% in patients 40 years or older (P = .0480). [31] A further study testing medical Portland cement, Mineral Trioxide Aggregate (MTA) and calcium hydroxide in indirect pulp treatment found varying success rates of 73%-93%. The non-randomised study found a statistically significant difference in favour of indirect pulp capping for clinical and radiological success at 3 years but with high overall risk of bias. If the pulp appears infected or symptomatic, the dentist may decide a root canal is the best treatment option. 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. [24] There is also less coronal microleakage of MTA in one experiment comparing it to amalgam[25] thus suggesting some tooth adhesion properties. [34] Calcium hydroxide has also been tested on its use in indirect pulp capping and was found to have a success rate of 77.6%, compared to a success rate of 85.9% for MTA in another study.[35]. At 6 months, the success rate was 89.6% with MTA, and remained steady at 73% with calcium hydroxide (P = 0.63). 9. 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