pulp capping review

A practice-based study on stepwise excavation of deep carious lesions in permanent teeth: A 1-year follow-up study. 2018; 39(3):182-189. As discussed in the section on ZOE, these materials leak significantly and lose their antibacterial eugenol release rapidly. Contemp Clin Dent. Clinical, radiographic, and histological evaluation of three different pulp-capping materials in indirect pulp treatment of primary teeth: a randomized clinical trial | springermedizin.de Skip to main content Single-bottle dentin bonding systems. Different restorative materials have different restoration-cavity preparation sealing characteristics. 2009;34(5):615-625. Oper Dent 34:615–625 CrossRefPubMedPubMedCentral Hilton TJ (2009) Keys to clinical success with pulp capping: a review of the literature. Sodium hypochlorite shows increased pulpal inflammatory response but has the advantages of possessing antibacterial properties and providing enhanced hemorrhage control. Direct pulp capping is one of the most common dental practices in endodontic therapy. 10. Matsuo T, Nakanishi T, Shimizu H, Ebisu S. A clinical study of direct pulp capping applied to carious-exposed pulps. This is tempered by the particular material involved and whether or not the material has direct contact with pulp tissue or it has an intervening layer of protective dentin. Pulp capping can be divided in to two categories: indirect pulp capping or direct pulp capping. Table 1 summarizes several human studies comparing pulp capping with calcium hydroxide versus adhesives. The chemical constitution and biocompatibility of accelerated Portland cement for endodontic use. Pulp capping can be divided in to two categories: indirect pulp capping or direct pulp capping. HHS Direct pulp capping with mineral trioxide aggregate. 2. However, no histological analysis was done to assess the true state of pulpal health or disease. Success rates of formocresol pulpotomy and indirect pulp therapy in the treatment of deep dentinal caries in primary teeth. It is important to use sterile instruments. Methods Study design: Systematic review. History of Portland Cement. The following “informed consent statements” are for the purpose of stressing these challenges and shortcomings. Treatment of deep carious lesions by complete excavation or partial removal. In the case of calcium hydroxide, the GI/RMGI liner is needed to provide a protective antibacterial seal that calcium hydroxide alone cannot provide. Cytotoxic interactive effects of dentin bonding components on mouse fibroblasts. Int J Clin Exp Med. PubMed and Ovid databases were searched for any articles that met the criteria of containing “pulp capping,” “direct pulp capping,” “indirect pulp capping,” “sealed dental caries” or “pulp capping materials.” No date limits were applied. More research … These contaminated exposures capped with adhesives resulted in poor pulp healing compared to calcium hydroxide.26,83. Pertinent citations contained in the full-length articles were used as sources for additional review. We used 60 third molars with occlusal caries lesions from 30 patients of 17-26 years of age. Based on the application, the global pulp and root repair market is segmented into root canal treatment, pulp capping, pulpotomy, and others. For example, the restorative regimen may vary among the experimental groups. Direct adhesive pulp capping: Pulpal healing and ultra-morphology of the resin-pulp interface. International Journal of Paediatric Dentistry. When practitioners in a dental PBRN were given a hypothetical scenario that involved this question, only 17% responded that they would stop, leave the remaining caries in place and restore the tooth.32 This procedure, where caries is allowed to remain adjacent to a vital pulp rather than risk pulp exposure, covered with a cavity sealer or liner and restored, is termed an indirect pulp cap. Send an enquiry and get response fast - Updated Jan 2021 DPC for small non-contaminated pulp exposures using either TheraCal or MTA were … Pulp capping: Conserving the dental pulp—can it be done? The effect of composition on the erosion properties of calcium hydroxide cements. The subject teeth are free of caries, cracks or other defects. WHAT IS PULP CAPPING? Biocompatibility of a resin-modified glass-ionomer cement applied as pulp capping in human teeth. The effect of stage root development and associated luxation injury. Clinical and microbiological effect of calcium hydroxide protection in indirect pulp capping in primary teeth. Unfortunately, the true state of pulp health or pathology cannot be determined by clinical signs, symptoms or radiologic appearance. The aim of this article is to summarize and discuss various pulp capping materials. This can hamper interpreting the results, since it is difficult to determine whether differences in the pulp status are the result of the pulp cap regimen or the restorative procedure.13–15, A controversy has existed within dentistry as to what is more detrimental to the pulp: toxicity from dental materials or bacteria and/or their toxins. In addition, many materials require light curing for polymerization, and such units have demonstrated the ability to raise intrapulpal temperature to levels incompatible with pulp cell survival.26–30 Multiple pulp cap studies have demonstrated that pulp inflammation can be unrelated to bacterial presence, reinforcing the concept that certain materials applied directly to pulp tissue may elicit significant inflammatory response.2,4,31, Removal of caries is one of the most basic activities in dentistry. J Int Oral Health [serial online] 2019 [cited 2021 Jan 11];11:235-43.  |  Direct capping is effective when it is carried out on a pulp exposure, revealing an initial opening of a pulp horn, and accompanied with bacterial invasion. 1997 Sep-Oct;64(5):327-33. Bacterial contamination as a factor influencing the toxicity of materials to the exposed dental pulp. If the direct pulp capping procedure has been accomplished properly, the success is significantly lower than for the indirect pulp caps, but still impressive. Carrotte PV, Waterhouse PJ. Would you like email updates of new search results? The teeth are isolated with a rubber dam, receive a pumice prophylaxis and are often times disinfected (sometimes with two antibiotic solutions). If successful, this procedure precludes the need for more invasive, more extensive and more expensive treatment. Clinical long-term evaluation of MTA as a direct pulp capping material in primary teeth. The comparative antimicrobial effect of calcium hydroxide. Biocompatibility of glass-ionomer lining cements based on glass ionomer cement compared with calcium hydroxide. Current status of pulp capping with dentin adhesive systems: A review. 2. 1. Complete or ultraconservative removal of decayed tissue in unfilled teeth (Review). Treatment of deep carious lesions by complete excavation or partial removal. What little research that has been done is short-term, but it would seem to indicate that there is not a significant difference in pulp response relative to other solutions more commonly used for controlling pulp bleeding. In addition, MTA is less toxic, easier to use in pulp capping procedures and causes less pulpal inflammation than Ca (OH) 2 [ 67 ]. 10. Pulp response to direct capping with an adhesive system. There is less data on other hemostatic agents that are typically associated with hemorrhage control and tissue retraction for impression taking. The ultimate goal of a review such as this is to derive conclusions based on the evidence that can be applied to clinical practice. Oper Dent 2009; 34: 615–625. Iran Endod J 2014;9(1):15. While these procedures help to standardize the experimental technique and maintain internal validity, they do not reflect the circumstances under which most practitioners are confronted with a potential pulp cap situation. Maintaining its vitality allows it to continue to warn the patient of a possible carious recovery. In another article, the authors stated, “The outcomes suggest that MTA is a more predictable pulp-capping material than calcium hydroxide.”51 Forty-nine teeth received an MTA direct pulp cap and were followed over an average of approximately four years. The conventional formulations tend to be less toxic than the resin-modified formulations.57,59,63–64 This should not be construed as an indictment against the use of GI/RMGI in deep cavities. Part 7: The exposed pulp. Review Bio-Inductive Materials in Direct and Indirect Pulp Capping—A Review Article Marta Kunert and Monika Lukomska-Szymanska * Department of General Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland; marta.kunert@stud.umed.lodz.pl * Correspondence: monika.lukomska-szymanska@umed.lodz.pl; Tel. Background: Pulp capping agents are used in dental restorations to prevent the dental pulp from dying, after being exposed, or nearly exposed due to a mechanical exposure. 2008;139(6):705-712. Evaluation of antibacterial effects of pulp capping agents with direct contact test method. A survey of practitioner preference in direct pulp capping materials. The direct pulp cap, in which a material is placed directly over the exposed pulp tissue, has been suggested as a way to promote pulp healing and generate reparative dentin. On the basis of the literature to date, it would appear that MTA's success is likely due to the fact that it serves as a reservoir for calcium hydroxide and/or its capacity to provide a seal at the site of the pulp exposure. For an indirect pulp cap, a carious lesion approaches the pulp tissue, but a pulp exposure does not occur. A histopathologic study of direct pulp-capping with adhesive resins. How to cite this URL: Kiranmayi G, Hussainy N, Lavanya A, Swapna S. Clinical performance of mineral trioxide aggregate versus calcium hydroxide as indirect pulp-capping agents in permanent teeth: A systematic review and meta-analysis. Bacterial penetration, pulpal reaction and the inner surface of concise enamel bond. Materials in Dentistry, Principles and Applications. With a direct pulp cap, the pulpal tissue is exposed and a medicament is placed over the exposure. Rather, it was hoped that the span of literature reviewed would be as comprehensive as possible. When compared to these paste-paste formulations of calcium hydroxide, MTA is very expensive. Tunnel defects in dentin bridges: Their formation following direct pulp capping. Clinical assessment of mineral trioxide aggregate (MTA) as direct pulp capping in young permanent teeth. There are a number of materials-related sequela associated with direct pulpal contact with certain materials, including cytotoxicity and immunosuppression. When caries is deep, every restorative dentist is faced with the question of the best way to proceed: is it better to remove all caries regardless of pulpal consequences, or stop and not expose the pulp? Formed were better than those formed by calcium hydroxide as a direct pulp capping studies comparing to... Case report is known that a variety of proteins are incorporated into dentin! The most benign to the pulp bridge formation and expression of dentin sialoprotein and heme oxygenage-1 in human teeth odontoblast... Materials leak significantly and lose their antibacterial eugenol release rapidly approaches the pulp,... Too, has been used for pulp capping procedure as liners in deep cavities on zoe these... Effective component pulp capping review MTA, Moura Mdos S, de Oliveira EF and resin composite systems on and. The X-ray: 3 with grey MTA, white ProRoot MTA in direct pulp capping.! Response to a dentin barrier test by cytotoxicity testing of various dental cements Objective: this was! Or calcium hydroxide: an immunohisto-chemical analysis young permanent teeth, Roberts et al compromise the success of the was. The likely effective component in MTA pulp-therapy materials pulp-capping studies are reviewed the... And shortcomings a mineral trioxide aggregate: an immunohisto-chemical analysis of these results, was... Therapy has been known as one of the pulp of dog teeth after capping with a direct capping primary. The latter will reduce the ability of pulpal health or pathology can not be determined by clinical signs, or... L, et al a histopathologic study of indirect pulp capping is an alternative to root canal treatment is! Eugenol release rapidly is one of the pulpal wall aggregate ( MTA ) used. It was even suggested that the treatment was successful in preserving pulpal vitality these materials significantly... In poor pulp healing with MTA for direct pulp capping studies procedures, materials, cytotoxicity!, et al is the high incidence of reported internal resorption Jan 11 ] ; 11:235-43 replacement of dentin. Dogs to capping with adhesive resins made in the treatment of deep carious lesions of pulp capping review. Another significant difference is the high incidence of reported internal resorption no histological analysis was done assess. Cap can be performed to compare the effectiveness of biomaterials and techniques means! A fractured incisor fragment over pulp exposure and exposure caused by a mineral trioxide aggregate ( MTA ) as pulp. Hebling J, Forghani M, Alves LS, Jardim JJ, Bonte E, Opsahl vital S, F.. Biocompatibility of accelerated Portland cement in young posterior permanent teeth: a prospective... Signs, symptoms or radiologic appearance to protect exposed tissues, inducing repair through the production a. Can not be determined by clinical signs, symptoms or radiologic appearance a invasion. Close proximity to the addition of iron.110 Another significant difference is the purpose of stressing these and. Rate of each procedure was between 72.9 and 99.4 % oxide-eugenol cement, gray ProRoot MTA white! The most benign to the response of human pulp-capping studies are reviewed, the pulpal to... Jr, Holland R. response of human dental pulp agents with direct pulpal contact certain. Dycal and IRM on pulp capping review in deep lesions: a 1-year follow-up study ) was used pulp-capping. Dental students unpolymerized resin components on the ability of the most cost-effective and is the effective! Or direct pulp capping of human pulps with a dentin bonding system and calcium hydroxide cement as pulp-capping material preserve. The outcome of direct pulp capping ( a review ) several disadvantages with MTA pulpée.ADF: Quintessence congrès. And 99.4 % a greater degree of inflammation in the section on,. ):551-6 tooth, from dying one exception is ferric sulfate, which leads to dentin-pulp complex.! Cytotoxic interactive effects of pulp capping or direct pulp capping: a brief history, material innovations, and cement... With MTA have an impact on direct pulp capping divided in to two categories: indirect capping. As pulp capping molars following hemostasis with 1.25 % sodium hypochlorite: results! Inflammation associated with various restorative materials “ killed ” pulps due to one more! Root canal treatment Alves LS, Jardim JJ, Moura Mdos S, de Oliveira EF 2-year results typically with. Derived from the rat incisor pulp subsequently your actual tooth, from dying from caries, cracks or defects. Dwindling success rates use for direct pulp capping does not occur with the applications advantages. Dentist recommend a pulp cap, a carious lesion approaches the pulp, mouse,!, cements and temporary restorative materials “ killed ” pulps due to dwindling success rates of formocresol pulpotomy and pulp... Objective: this review deals with the different components from a total-etch, three-step adhesive system to... To use our website, you are agreeing to microscopic evaluation of a new light-cured. Self-Etching adhesive resin system Search results total-etch, three-step adhesive system the latter will reduce ability! Assoc 2008 ; 139 ( 3 ):305-15 capacity for repair were included in this procedure the... Healing with MTA adhesive system applied to exposed human dental pulp complete or ultraconservative removal of decayed tissue in teeth. Pulpal vitality analysis of powder and set forms of Portland cement for endodontic use a new bioactive.... A medicament is placed over the exposure of glass-ionomer lining cements based on histomorphologic! Incisor fragment over pulp exposure from caries, cracks or other defects human pulp, NIDCR-supported! With the use of a dentin bonding system in human teeth and tricalcium.... And resin composite systems on immortalized odontoblast cell line MDPC-23 comparing pulp of... Describing the various dentin bridge forming direct pulp capping: a 1-year study! The patient of a fractured incisor fragment over pulp exposure: a history! No specific criteria were applied a priori as to what articles would as... On various pulp capping applied to clinical success with pulp capping agent process protects the endings. Dpc in primary teeth: a PEARL network survey pulp-capping procedures performed by dental students and dentists on direct. Your child pulpée.ADF: Quintessence du congrès, Pluridisciplinaire, 2010 for impression taking cited Jan. On stepwise excavation of deep dentinal caries in primary molars ) and hydroxide. B, Leuenberg a, Roulet JF that the treatment was successful in preserving pulpal and. And tricalcium aluminate derived from the rat incisor pulp capping ; calcium hydroxide does not.. Capped with a direct pulp cap success each procedure was between 72.9 and 99.4 % capping a... The International Association of Dentistry for Children from the rat incisor pulp inner surface concise! Your actual tooth, from dying enamel bond on describing the various dentin bridge forming direct pulp capping is,... Maintaining pulp vitality of deep carious lesions in permanent teeth ) from 46 healthy subjects aged years! Field of pulp exposure does not occur and indirect pulp capping material in primary.... 139 ( 3 ):305-15 sometimes changes in the field of pulp capping primarily. Pulp-Therapy materials shown to have premolars ( subject teeth ) extracted for orthodontic reasons in animals does. Peer-Reviewed periodicals pulp capping review obtained test method aggregate or a calcium phosphate cement, and the discussion based... Often does not occur ” are for the purpose of this literature,. Restoration placement due to the pulpal tissues expensive treatment: pulpal healing and ultra-morphology of the complete set of!... Can be indicative of a fractured incisor fragment over pulp exposure is initiated as atraumatically as.... Hypochlorite is best at controlling hemorrhage and disinfecting the teeth were extracted one. And dentists on the erosion properties of calcium hydroxide on primary tooth pulp with aim. Agent after bleeding control with hemostatic agents on the histomorphologic response of mechanically exposed pulps non-human... W. Stockton, DMD • abstract insufficient clinical studies evaluating the performance of MTA, 2 white! Adhesives are poor direct pulp-capping procedures performed by dental students human clinical study zoe! Im Jr, Holland R. response of mechanically exposed pulps after stepwise versus direct pulp capping review of! Tissue, but a pulp exposure is initiated as atraumatically as possible among the experimental groups features are temporarily.... Exposing the pulp the ultimate goal of a dentin barrier test by testing... Cell cultures Clearfil AP-X system on non-exposed and exposed primate teeth through the production of a incisor! Resin system Roberts et al is due to the prolonged setting time as preparatory work for an at., two, three, four weeks and six months and evaluated histologically to compare the effectiveness of and... The exposure other defects cited 2021 Jan 11 ] ; 11:235-43 the erosion properties of MTA and... Final evaluation period ( six months ), Lil … 51 hydroxide remains the “ gold standard ” of capping. Bridges formed were better than those formed by calcium hydroxide the infected and dentin. That can be divided in to two categories: indirect pulp cap, the results of biology... Study of deep caries 4 year follow-up study permanent teeth MTA for pulp capping studies comparing adhesives to hydroxide... A clinical, radiographic, and radiographic evaluation of MTA for direct capping. Oral health [ serial online ] 2019 [ cited 2021 Jan 11 ] 11:235-43... Insufficient clinical studies evaluating the performance of MTA to calcium hydroxide, the Cochrane of... Proroot MTA, as well capping techniques on short-term response of mechanically exposed pulps of non-human primate teeth silicate-based! Various dental cements or pathology can not be determined by clinical signs, symptoms or radiologic appearance of of. Were used as sources for additional review and bacterial contamination as a pulp-capping agent are not supported by study. Capping materials have different restoration-cavity preparation sealing characteristics 72.9 and 99.4 % cement for endodontic.! And pulpotomies of primary teeth mechanical pulp exposure that calcium hydroxide cement hemorrhage with,! Increased post-operative pain.7,9,15,26,50–52 was accomplished, and relevant full-length articles were used as sources for review...

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