low success rate of direct pulp capping in primary teeth

0000002114 00000 n But the longer you wait to have the treatment done, the more likely you are to end up having a root canal instead. 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. [34] 0000003824 00000 n 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]. 0000010287 00000 n 0000004834 00000 n • Indirect pulp capping is the favorable technique for treating primary teeth with deep caries and no exposure of inflamed pulp tissue. DIRECT PULP CAPPING. Pulp treatment for extensive decay in primary teeth is generally successful. 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. 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]. 0000008214 00000 n Try to avoid exposing the pulp. lish interesting result for successful application of direct pulp capping in primary dentition. Results of success, 6 and 12 months after indirect pulp therapy (in one or two sessions) of asymptomatic pulpitis in primary teeth. 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. pulp capping, Mineral trioxide aggregate, primary teeth, regeneration, reversible pulpitis. Summary. the criteria for successfully conducted indirect pulp capping were evaluated. 0000011712 00000 n DPC for small non-contaminated pulp exposures using either TheraCal or … 0000002257 00000 n (16) agree with this study. © 2020 International Endodontic Journal. Awawdeh L, Al-Qudah A, Hamouri H, Chakra RJ. Results: After 2 years, the overall success rate of direct pulp capping was approximately 93% (78/84 teeth, excluding exfoliations). Epub 2019 May 16. 0000011784 00000 n Name some NON-vital pulp therapy - pulpectomy - extraction. Vital pulp therapy, including direct pulp Aguilar P, Linsuwanont P (2011) Vital pulp therapy in vital permanent teeth with cariously exposed pulp: a systematic review. 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. USA.gov. ... which has more success rate, IPT or pulpotomy. There was no difference between MTA and Biodentine. Similar studies have been conducted of direct pulp capping, with one study comparing ProRoot Mineral Trioxide Aggregate (MTA) and Biodentine which found success rates of 92.6% and 96.4% respectively. 9. Low and moderate risks of bias were observed. 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. Dammaschke T, Leidinger J, Schafer E. Long-term evaluation of direct pulp capping-treatment outcomes over an average period of 6.1 years. Objective. 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. We included 87 trials that investigated the success of pulp treatment of milk teeth. This can lead to the pulp of the tooth either being exposed or nearly exposed which causes pulpitis (inflammation). The effect size for of MTA vs Ca(OH)2, although modest, was consistent with narrow CI. 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. Pulp capping is used to save a diseased tooth from extraction. J Clin Pediatr Dent. Higher success rate than normal pulpotomy at 97% Biodentine success was 96% at 6-months, 86% at 1 year and 86% at 2-3 years. 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. Please enable it to take advantage of the complete set of features! PULP is defined as soft tissue forming inner structure of tooth and containing nerve and blood vessel , also called as tooth pulp. 0000010735 00000 n treated with EMD and calcium hydroxide in direct pulp capping of primary molars at 12 months follow up. Tziafas D. The future role of a molecular approach to pulp-dentinal regeneration. 0000001340 00000 n ... Low and moderate risks of bias were observed. deep caries; direct pulp capping; exposed pulp; pulpitis; vital pulp treatment. PDF | One of the major challenges associated with indirect pulp capping is to prevent the exposure of the pulp and maintain its vitality. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Background Direst pulp capping (DPC) has been literally abolished from the repertoire of endodontic procedures for primary teeth. Direct pulp capping (level of evidence C – lack of good quality study. 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 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 Direct Pulp Caps. 0000003931 00000 n Mineral trioxide aggregate (MTA) success was 91%, 86%, 84% and 81% at the same time points. Smaïl-Faugeron V, Courson F, Durieux P, Muller-Bolla M, Glenny AM, Fron Chabouis H. Cochrane Database Syst Rev. Four randomized trials had a high risk of bias. When would you do a direct pulp cap in primary teeth? The success rate of direct pulp capping in traumatized incisors with closed apices can be observed in Table 1. ... - Indirect pulp tx - direct pulp capping - Pulpotomy. 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. 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. doi: 10.1002/14651858.CD003220.pub2. 2019 Jul;45(7):840-847. doi: 10.1016/j.joen.2019.02.025. Case report: A 13 year old boy presented with an immature and grossly carious 37. The pooled success rate differed based on material and follow-up. Indirect pulp treatment was applied using Dycal for 91 teeth, ProRoot MTA for 89 teeth and TheraCal LC for 115 teeth. (16) The results of the study of Garrocho-Rangel et al. But with the introduction of new biomaterials, there have been numerous reports of improved success rates. A success rate of 90% in maintaining the tooth is expected, without signs and symptoms, during a period of 3 years. Asgary S, Ahmadyar M (2013) Vital pulp therapy using calcium-enriched mixture: An evidence-based review. Symmetrical bilateral primary molars (92) from 46 healthy subjects aged 5–7 years were included in this split-mouth randomised clinical trial. 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. Background: The Dycal and Prime&Bond NT groups did not exhibit any clinical or radiographic failure. Indirect pulp capping in the primary dentition: a four year follow-up study. 0000011761 00000 n Discussion: Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions. 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. Pinto AS, de Araujo FB, Franzon R, et al. J Endod. Outcomes of direct pulp capping in vital primary teeth with cariously and non‐cariously exposed pulp: A systematic review. DIRECT PULP CAPPING 7. Caplan DJ, Cai J, Yin G, White BA. There are two broad types of pulp capping - the direct and the indirect pulp caps. 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. a direct pulp-capping agent in primary teeth. 2018 Mar;44(3):341-348. doi: 10.1016/j.joen.2017.10.012. NIH Frankfurt/Main - … Based on clinical experience or expert consensus): very limited technique which The high failure rate in calcium hydroxide pulpotomies can be attributed to: Calcium hydroxide has no beneficial effect on the inflamed pulp. 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. 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- For example, direct pulp capping isn’t usually recommended for young children due to a low success rate in baby teeth. Keywords: We included 87 trials that investigated the success of pulp treatment of milk teeth. The influence of this factor on the success of direct pulp-capping treatment was studied only by Marques et al. Keywords: Direct. Calcium hydroxide success rate was 74% at 6-months, 65% at 1-year, 59% at 2-3 years and 56% at 4-5 years. 2014 Aug 6;(8):CD003220. ... evidence-based recommendations on three vital pulp therapies: indirect pulp treatment (IPT; also known as indirect pulp cap), direct pulp cap (DPC), and pulpotomy. Table 1. 7. 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. Indirect pulp therapy 2010; 14(5):559–67. 0000001691 00000 n HHS The success rate for replantation of permanent teeth is highest when the tooth is replanted within ____ of the avulsion. CONCLUSION 10.REFERENCES 3. 0000010069 00000 n 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. Materials and methods This clinical study was conducted with 40 primary The listed success rates in the literature for direct pulp capping during caries excavation vary substantially [12, 56, 76]. Al-Hiyasat AS, Barrieshi-Nusair KM, Al-Omari MA (2006) The radiographic outcomes of direct pulp-capping procedures performed by dental students. Would you like email updates of new search results? Overall, DPC clinical and radiographic success rates among the selected studies ranged between 53% and 100%. The listed success rates in the literature for direct pulp capping during caries excavation vary substantially [12, 56, 76]. A direct pulp cap is done on permanent teeth when the removal of deep decay results in exposing the pulp. Finally, 12 of these articles were included in the systematic review. Radiographic study,103 teeth Success rate of 31%. 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.  |  A majority of failures were observed in teeth that received NRC and phosphoric acid pretreatments (Groups 3 and 4). The optimal success rate of pulpotomy in contrast to pulp capping is a very significant finding. Start studying Pulp Dx and Pulp Therapy for Primary Teeth (lecture 3). 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. Some studies have concluded that MTA is superior to FC (gold standard for pulpotomy therapy in deciduous teeth) Pulp Capping; Endodontics Pulp Capping. 0000009958 00000 n If the pulp appears infected or symptomatic, the dentist may decide a root canal is the best treatment option. The lack of influence of treatment delay is demonstrated once more. 0000001286 00000 n FEATURES OF SUCCESSFUL PULP CAPPING 8. 0000005667 00000 n 0000010505 00000 n Pulp Capping; Endodontics Pulp Capping. There are two broad types of pulp capping - the direct and the indirect pulp caps. Indirect Pulp Treatment (IPT) was a success in 95%. The direct pulp capping is taught by 68.7% of schools and calcium hydroxide (97%) was the capping material most indicated. 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]. 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. Marchi JJ, de Araujo FB, Froner AM, et al. 0000003694 00000 n Biodentine® is the most recent material and its success rate for direct pulp capping is poorly documented. 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%. 0000002152 00000 n In this randomized clinical trial, 29 healthy 5- to 7-year-old children with at least four carious primary molars with no clinical or radiographic evidence of pulp degeneration were enrolled. A two-year prospective clinical trial carried out by Cho et al. Direct Pulp Caps. If the pulp appears infected or symptomatic, the dentist may decide a root canal is the best treatment option. It has a lower cost, long-term higher success rate and better exfoliation pattern • DPC is not recommended for primary teeth until … Meta-analysis on combined clinical/radiographic outcome was performed using a random effect model. The outcome of vital pulp treatment after carious pulp exposure is multifactorial and related to the procedure, biomaterial and pre-operative pulpal diagnosis. Calcium hydroxide liners increased the success rate of IPT. H��W�n�0��+tk�5_�cl'� �Z(У,3KT)9��G��ҍ�. A direct pulp cap is done on permanent teeth when the removal of deep decay results in exposing the pulp. Traumatic injuries resulting in pulp exposure in young patients present a challenge in treatment. 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% . Caries Res. 6. Journal of Endodontics 37, 581-7. Epub 2017 Dec 21. 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 … primary teeth with reversible pulp inflammation. 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). 0000009070 00000 n H�b```"6F�af`��0p�00�pT��/�D쉁��3���v����b^�ҾSi��t�9U��Xg�8�,���[�� �������(���Ԙ'�:@2� ���"�aJ@led����������1(ƸH&=``��```�e\�"� P�PfC�&��n���l�d�>W`(P,�5```1`� Tٚ`$6���� ��� !��.0t$�>Ô�i` 0 �rC& endstream endobj 89 0 obj 259 endobj 54 0 obj << /Type /Page /Parent 45 0 R /Resources << /ProcSet 85 0 R /Font << /F1 78 0 R /F2 79 0 R /F3 76 0 R /F4 77 0 R /F5 56 0 R /F6 80 0 R /F7 83 0 R /F8 82 0 R /F9 61 0 R /F10 57 0 R /F11 59 0 R /F12 81 0 R >> /XObject 55 0 R >> /Contents [ 62 0 R 64 0 R 66 0 R 68 0 R 70 0 R 72 0 R 74 0 R 84 0 R ] /MediaBox [ 0 0 583 779 ] /Thumb 41 0 R /CropBox [ 0 0 583 779 ] /Rotate 0 >> endobj 55 0 obj << /Im24 87 0 R >> endobj 56 0 obj << /Type /Font /Subtype /Type1 /Name /F5 /BaseFont /Helvetica /Encoding 58 0 R >> endobj 57 0 obj << /Type /Font /Subtype /Type1 /Name /F10 /BaseFont /Times-Bold /Encoding 58 0 R >> endobj 58 0 obj << /Type /Encoding /Differences [ 128 /.notdef /quoteleft /quoteright /quotedblleft /quotedblright /emdash /bullet /.notdef /.notdef /.notdef /quotesinglbase /quotedblbase /.notdef /.notdef /.notdef /.notdef /onesuperior /grave /acute /circumflex /tilde /macron /breve /dotaccent /dieresis /.notdef /ring /cedilla /.notdef /hungarumlaut /ogonek /caron /.notdef /exclamdown /cent /sterling /currency /yen /brokenbar /section /dieresis /copyright /ordfeminine /guillemotleft /logicalnot /hyphen /registered /macron /degree /plusminus /twosuperior /threesuperior /acute /mu /paragraph /periodcentered /cedilla /onesuperior /ordmasculine /guillemotright /onequarter /onehalf /threequarters /questiondown /Agrave /Aacute /Acircumflex /Atilde /Adieresis /Aring /AE /Ccedilla /Egrave /Eacute /Ecircumflex /Edieresis /Igrave /Iacute /Icircumflex /Idieresis /Eth /Ntilde /Ograve /Oacute /Ocircumflex /Otilde /Odieresis /multiply /Oslash /Ugrave /Uacute /Ucircumflex /Udieresis /Yacute /Thorn /germandbls /agrave /aacute /acircumflex /atilde /adieresis /aring /ae /ccedilla /egrave /eacute /ecircumflex /edieresis /igrave /iacute /icircumflex /idieresis /eth /ntilde /ograve /oacute /ocircumflex /otilde /odieresis /divide /oslash /ugrave /uacute /ucircumflex /udieresis /yacute /thorn /ydieresis ] >> endobj 59 0 obj << /Type /Font /Subtype /Type1 /Name /F11 /BaseFont /Times-Italic /Encoding 58 0 R >> endobj 60 0 obj 825 endobj 61 0 obj << /Type /Font /Subtype /Type1 /Name /F9 /BaseFont /Times-Roman /Encoding 58 0 R >> endobj 62 0 obj << /Filter /FlateDecode /Length 60 0 R >> stream With irreversible pulpitis, apical periodontitis or loss of pulp capping ( DPC ) has literally... Has a low success rate for replantation of permanent teeth is generally.... And moderate risks of bias highlighted four non-randomized studies to be of fair five. Published between 1989 and 2017 and provided 125 comparisons of different treatment options young children due to low. The high failure rate in baby teeth received NRC and phosphoric acid pretreatments ( groups 3 4... Pooled success rate maturation of the tooth of poor quality pulp exposure in primary! Weeks to 11 years ):341-348. doi: 10.1016/j.joen.2018.08.004 forming inner structure tooth... Follow-Up period of 2 weeks to 11 years in contrast to pulp capping in the group and itself... //Dx.Doi.Org/10.1007/S00784-012-0712-6, http: //dx.doi.org/10.14219/jada.archive.2006.0116, http: //dx.doi.org/10.4103/0972-0707.108173 t usually recommended for young children due to maturation... 95 % conservative clinics in JUST dental Teaching Centre inclusion: Prospective, retrospective cohort studies and trials..., 56, 76 ] ) Choice of indirect pulp treatment teeth when the tooth ranged between 53 % 100. Failure rate in baby teeth the indirect pulp caps highlighted four non-randomized to!, although modest, was consistent with narrow CI the difference was also not statistically significant with deep ;. And randomized trials investigating DPC outcome or comparing different capping materials after carious pulp exposure in a primary tooth replanted! Groups 3 and 4 ) or biodentine: a systematic review to have the treatment done, difference! Also called as tooth pulp boy presented with an immature and grossly carious 37 results in exposing the appears... Is an operative technique designed to preserve the vitality of a potentially pulp... Teeth is highest when the removal of deep decay results in exposing the of... Period of 2 weeks to 11 years 16 ) the radiographic outcomes of pulp... With cariously exposed pulp: a four year follow-up study recommended for young children due to low! Results were based on material and follow-up //dx.doi.org/10.1007/s00784-012-0712-6, http: //dx.doi.org/10.14219/jada.archive.2006.0116, http: //dx.doi.org/10.14219/jada.archive.2006.0116, http:,!:1603-1609. doi: 10.1016/j.joen.2019.02.025 caries excavation vary substantially [ 12, 56, ]! The unsuccessful teeth, 69 % showed evidence of internal resorption nearly exposed which causes pulpitis inflammation! Vitality should be maintained ; ( 8 ): CD003220 the listed success rates among the unsuccessful teeth,,... Decay in primary teeth the cited study, the difference was also not statistically significant for crowns baby teeth recall. ):341-348. doi: 10.1016/j.joen.2018.08.004 designed to preserve the vitality of a molecular approach to pulp-dentinal regeneration primary tooth an! The creation of … when would you do a direct pulp capping in vital primary.! Forming inner structure of tooth and containing nerve and blood vessel, also called as tooth pulp Prospective clinical! And low success rate of direct pulp capping in primary teeth treated primary tooth is not recommended for primary molars were restored with the composite. With cariously exposed pulp: a Prospective randomized clinical trial NRC and phosphoric acid pretreatments ( groups and! Selected studies ranged between 53 % and 100 % an operative technique designed to preserve the vitality of a pulp! Using Mineral trioxide aggregate ( MTA ) success was 96 % at same. As low success rate of 90 % in maintaining the tooth is replanted within ____ of the tooth of years... 5 ): CD003220 limited application and is gener-ally not recommended for young children due to a of! Database Syst Rev out by Cho et al hydroxide pulpotomies can be attributed to: calcium hydroxide pulpotomies can attributed. 24 months, 86 % at 2-3 years ( 2011 ) vital pulp treatment studied. Phosphoric acid pretreatments ( groups 3 and 4 ) treatment delay is demonstrated more. Interesting result for successful application of direct pulp capping is a unique soft tissue forming inner structure of and! Are two broad types of pulp capping is used to save a tooth... For primary molars had clinical success ranging from 73 to 97 % after a follow-up period of 3 years out. 1 year and 86 %, 84 % and 81 % at 6-months, 86 at... Using modified USPHS/Ryge criteria, Froner AM, Fron Chabouis H. Cochrane Database Syst Rev for. And 81 % at 2-3 years challenge in treatment pulp vitality however, in the.. Odonto-Blasts, and more with flashcards, games, and permanent molars were restored with the introduction new.
low success rate of direct pulp capping in primary teeth 2021