Direct Pulp Capping of Carious Primary Molars. A Specialty Practice Based Study (original) (raw)
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European Archives of Paediatric Dentistry, 2019
Aim: Aim of this randomised clinical trial was to compare the outcome of direct pulp capping (DPC) versus pulpotomy, both with MTA, for carious primary molars. Methods: Healthy, cooperative children aged 3-9 years with at least one deep carious primary molar requiring vital pulp therapy were included. Data on the primary outcome (all-cause failure) and secondary outcomes (clinical or radiographic failure) were collected blindly semi-annually for a minimum of 1 year up to 3 years and analysed with survival analysis and generalised linear regression at alpha = 5%. Results: A total of 74 children were randomly allocated on 1:1 basis to DPC (35 children; 40 teeth) or pulpotomy (39 children; 57 teeth). Survival from all-cause failure was 79.7% [95% confidence interval (CI) 69.3-86.9%] at 12 months and 66.0% (95% CI 53.4-76.0%) at 24 months which remained stable up to 36 months, with no differences between groups (P > 0.05). No significant difference was found in the survival rate of the two groups for all-cause [hazard ratio (HR) = 0.95; 95% CI 0.45-2.01; P = 0.88], clinical (HR = 0.74; 95% CI 0.0.19-2.92; P = 0.66), or radiographic failure (HR = 0.80; 95% CI 0.0.36-1.82; P = 0.60) throughout the 3-year follow-up. Regression analysis indicated that needing a second attempt for haemorrhage control was associated with higher clinical failure rate. All-case failure was significantly different for class II versus occlusal cavities and in the latter cavities pulpotomy performed better (P < 0.001). Conclusion: The results of the current trial indicate that both DPC and pulpotomy can be reliable options for the treatment of deep carious primary molars in cooperative children, in carefully selected cases.
Clinical and Experimental Dental Research, 2020
Objective: A retrospective study of the success rate of direct pulp capping (DPC) and indirect pulp capping (IPC) was carried out in children between 6-14 years-old, considering separately primary caries or caries affecting teeth with molar incisor hypomineralization (MIH). Material and methods: Data were collected in a dental public health service. Following the inclusion criteria, 232 treatments were analyzed. Success was defined by the presence of a functional tooth without clinical signs or symptoms of pulpal or periapical disease. The success rate was correlated to patient gender, the affected tooth and the indication of therapy using the chi-squared and Fisher exact test. The success time related to treatment type was evaluated through the Mann-Whitney test. Results: The IPC and DPC success rate was 99.4%, and 84.6%, respectively (p = .01). Success was significantly lower when caries affected teeth with MIH than when caries affected teeth without MIH (p = .01). The mean survival for DPC and IPC was 14.07 ± 1.30 and 15.98 ± 0.80 months, respectively (p = .07). Conclusions: When caries were located in teeth that were not affected by MIH, IPC was significantly more successful than DPC, but did not differ significantly when caries were placed in teeth with MIH.
Incomplete caries removal and indirect pulp capping in primary molars: a randomized controlled trial
American journal of dentistry
To compare the effect of incomplete caries removal (ICR) and indirect pulp capping (IPC) with calcium hydroxide (CH) or an inert material (wax) on color, consistency and contamination of the remaining dentin of primary molars. This double-blind, parallel-design, randomized controlled trial included 30 children presenting one primary molar with deep caries lesion. Children were randomly assigned after ICR to receive IPC with CH or wax. All teeth were then restored with resin composite. Baseline dentin color and consistency were evaluated after ICR, and dentin samples were collected for contamination analyses using scanning electron microscopy. After 3 months, restorations were removed and the three parameters were re-evaluated. In both groups, dentin became significantly darker after 3 months. No cases of yellow dentin were observed after 3 months with CH compared to 33.3% of the wax cases (P < 0.05). A statistically significant difference over time was observed only for CH regard...
Journal of Pharmaceutical Research International
Aim: To evaluate the clinical success of Calcium Hydroxide (CH), Mineral trioxide aggregate (MTA) and Biodentine as pulp capping materials for Direct pulp capping in carious molars. Materials and Methods: Thirty-six molars of thirty-six patients with deep caries lesions, diagnosed with reversible pulpitis were subjected to direct pulp capping treatment. They were randomly divided into three groups, Biodentine (12 teeth) or MTA group (12 teeth) or CH group (12teeth). Simple randomization of three was employed to allocate the treatment materials. Patients were recalled at one, three and six months to evaluate the clinical success of the treatment outcome. Results: In clinical trial/study, the pulp capping materials gave different success rate, 91.67% success in the Biodentine group, 75% success in the MTA group and 41.67% success in Calcium Hydroxide group. Conclusion: In our study the materials tested at 1 month, 3 month and 6-month follow-up, Calcium Silicate materials are better th...
Nigerian Journal of Clinical Practice, 2021
Background and Aims: This study aimed to assess the outcomes of partial pulpotomy treatments using different biocompatible materials which were Biodentine®, mineral trioxide aggregate (MTA), and calcium hydroxide (CH) in cariously exposed pulp tissue in immature permanent molars. Materials and Methods: Fifty-four teeth of 50 patients, which had cariously pulp exposures were randomly divided into Biodentine®, MTA, and CH groups for partial pulpotomy treatments and finally restored with stainless steel crowns at the same appointment. Clinical and radiographical success was evaluated by the absence of any clinical and radiographical signs and symptoms for 12 months. Also, Image J was used for the quantitative assessment of length developments for mesial and distal roots. P value of less than 0.05 was considered statistically significant. Results: Partial pulpotomy treatments showed high overall success rate (87%). On the other hand, Biodentine and MTA showed higher success rates compared to CH without any statistical significance (P = 0.09). Besides, mesial and distal root lengths displayed a continuous and significant increase in each group at sixth month follow-up (P = 0.01; P = 0.03). Conclusions: Favorable results demonstrated that Biodentine, MTA, and CH might be recommended as suitable agents for partial pulpotomy treatment in cariously exposed immature molars with clinical diagnosis of normal pulp or reversible pulpitis.
Evaluation of Different Indirect Pulp Treatment Materials Used in Deep Carious Primary Molars
Al-Azhar Journal of Dentistry
Purpose: To evaluate the clinical and the radiographic outcomes of indirect pulp treatment (IPT) in primary molars using Calcium Hydroxide, Resin Modified Glass Ionomer and TheraCal LC. Subjects and Methods: Sample of 45 children aged from 4-8 years with deep carious one or more primary molars allocated randomly into 3 groups according to the capping material. Group I: Calcium Hydroxide (Dycal). Group II: Resin Modified Glass Ionomer (Vitrebond) and Group III: TheraCal LC. Teeth were treated then restored with EQUIA Forte HT in one visit and evaluated clinically and radiographically after three and six months. Results: The overall clinical and radiographic success rates were (88.2%) for Dycal group, (94.1%) for Vitrebond group and (100%) for TheraCal LC group. Results showed no statistically significant difference between groups in the overall clinical and radiographic success at 3 and 6 months. Conclusions: The indirect pulp treatment may be considered an appropriate procedure when applied on deeply carious primary teeth without irreversible pulpitis to achieve acceptable therapeutic results.
Iranian Endodontic Journal, 2013
The aim of this randomized controlled trial was to compare the radiographic and clinical success rates of direct pulp capping (DPC) using ProRoot mineral trioxide aggregate (MTA) or calcium enriched mixture (CEM). Methods and Materials: A total of 42 symptom-free carious vital primary molars (21 pairs) were selected in this split mouth trial and randomly pulpotomized in two experimental groups. Pinpoint pulp exposures were covered by the same blinded operator with MTA or CEM, and then restored by amalgam. Radiographic and clinical successes were evaluated at 20 month follow-up. Data were statistically analyzed using McNemar test. Results: Nineteen patients were available for 20month follow-up; only one failed tooth was extracted in the CEM group. All available teeth were symptom-free, however, the final evaluated success rate was 89% in CEM (CI 95%: 0.82-0.96) and 95% in MTA (CI 95%: 0.85-1) groups without statistical difference (P=0.360). Worst case scenario was applied for missing value analysis; assuming that the 2 lost cases in CEM group had failed and the only lost case in MTA group was due to treatment success, as a result the success of CEM and MTA were 81% (CI 95%: 0.72-0.90) and 95% (CI 95%:0.85-1), respectively, with no statistical difference (P=0.078). In the reverse scenario, the success of MTA and CEM were 86% (CI 95%: 0.78-0.94) and 90% (CI 95%: 0.82-0.98), respectively; again with no statistical difference (P=0.479). Conclusion: Effectiveness of MTA and CEM biomaterials for primary molars' DPC was similar; CEM can be a suitable alternative for MTA.
The Influence of Pulp Capping Procedures on the Long-Term Prognosis and Survival of Teeth
Journal of Healthcare Sciences, 2022
Pulp capping is a dental procedure to treat deep caries and preserve the vitality of affected teeth. It involves placing a biocompatible material directly on the exposed pulp (direct pulp capping) or using a medicated liner to protect the pulp (indirect pulp capping). The choice of biomaterials, such as calcium hydroxide or mineral trioxide aggregate (MTA), significantly impacts the success of pulp capping. Patient-related factors, including age, oral hygiene, and systemic health conditions, influence treatment outcomes. Younger patients generally have better results due to higher pulp vitality and regenerative capacity. Maintaining good oral hygiene and managing systemic health conditions are crucial for long-term success. Complications and treatment failure can occur in pulp capping, depending on factors like cavity size, infection, and initial pulp condition. Early detection and intervention are important to prevent further issues. Success in pulp capping is assessed based on factors like continuous root development, preserved pulp vitality, minimal inflammation, and formation of reparative dentin. Success rates may decrease over time, and further research is needed to understand why. Understanding procedural techniques, biomaterial selection, patient-related factors, and complications are vital for informed decision-making, optimizing outcomes, and increasing the longevity of pulp-capped teeth.