Long-term prognosis of crown-fractured permanent incisors. There are a number of materials-related sequela associated with direct pulpal contact with certain materials, including cytotoxicity and immunosuppression. Compend Contin Educ Dent. Clinical and radiographic evaluation of adhesive pulp capping in primary molars following hemostasis with 1.25% sodium hypochlorite: 2-year results. DOI: 10.1002/14651858.CD004484 pub 2, The Cochrane Database of Systematic Reviews Issue 2.  |  Vital pulp therapy has been known as one of the treatment options to preserve pulp after being exposed by trauma or caries. For example, the restorative regimen may vary among the experimental groups. Colon P, Lasfargues JJ, Bonte E, Opsahl Vital S, Decup F. et al. The teeth are isolated with a rubber dam, receive a pumice prophylaxis and are often times disinfected (sometimes with two antibiotic solutions). 29. Calcium hydroxide possesses antibacterial properties, and this can minimize or eliminate bacterial penetration to the pulp.88 Traditionally, it has been believed that calcium hydroxide's high pH causes irritation of the pulp tissue, which stimulates repair via some unknown mechanism.96 In recent years, this “unknown mechanism” may have been explained by the release of bioactive molecules. Treatment of deep carious lesions by complete excavation or partial removal. The first reaction will destroy pulp cells, and the latter will reduce the ability of the pulp to respond to a bacterial invasion. A Comparison of Human Study Outcomes of Direct Pulp Capping Comparing Calcium Hydroxide to Adhesive Systems, There are several possible explanations for these poor outcomes in human studies. In the case of MTA, the GI/RMGI liner is needed to protect the MTA during restoration placement due to the prolonged setting time. Biocompatibility of resin-based materials used as pulp-capping agents. Unfortunately, the true state of pulp health or pathology cannot be determined by clinical signs, symptoms or radiologic appearance. State oi the pulp In 1959, Shroff (7) published an article "to show that the pulp normally possesses the power of heal-ing its exposed surface by the production of a calci- The comparative antimicrobial effect of calcium hydroxide. Calcium hydroxide has excellent antibacterial properties.88 One study found a 100% reduction in microorganisms associated with pulp infections after one-hour contact with calcium hydroxide.89 Most importantly, calcium hydroxide has a long-term track record of clinical success as a direct pulp-capping agent in periods of up to 10 years,46,84,90 although reduced success rates have been found in studies in which dental students were the operators.6,25,44–45, Calcium hydroxide has some disadvantages as well. Alex, G. “Direct and indirect pulp capping: A brief history, innovations, and clinical case report.” Compendium. [Article in English, Hebrew] Littman H. Pulp exposure remains a source of great frustration to the dental practitioner, because the outcome of any pulp capping procedure is marked with uncertainty. In addition, calcium hydroxide has demonstrated clinical success even when done under less-than-ideal circumstances. It must also be kept in mind that most studies that include histological analysis are of quite a short duration, typically two to four months.3–4,6–9, Much research on pulp capping has been accomplished in animals, from lower species, such as mice and dogs, to primates. Comparison of the physical and mechanical properties of MTA and Portland cement. Clinical, radiographic and histological analysis of the effects of mineral trioxide aggregate used in direct pulp capping and pulpotomies of primary teeth. Cytotoxic interactive effects of dentin bonding components on mouse fibroblasts. Bacterial contamination as a factor influencing the toxicity of materials to the exposed dental pulp. Follow-up examinations revealed that treatment was successful in preserving pulpal vitality and continued development of the tooth. Yalcin M, Arslan U, Dundaar A. Replacement of a fractured incisor fragment over pulp exposure: A long-term case report. Pulp capping: Conserving the dental pulp—can it be done? Pulp capping can be divided in to two categories: indirect pulp capping or direct pulp capping. Treatment of deep carious lesions by complete excavation or partial removal. Even though MTA seals better than calcium hydroxide, it should be kept in mind that a glass ionomer (GI) or resin-modified glass ionomer (RMGI) will be needed as a liner over either pulp cap material. Journal of Esthetic Restorative Dentistry. Control hemorrhage with water, saline or sodium hypochlorite. There are fewer studies that note observing tunnel defects and more studies that do not observe tunnel defects.2–3,6,9,84, Calcium hydroxide is believed to effect pulp repair by one or more of several mechanisms of action. Educational video for dental students and dentists on the Direct Pulp Capping procedure. The chances for tooth survival are excellent if the tooth is asymptomatic and well sealed, even if residual caries remains. [2] Ghoddusi J, Forghani M, et al. A review of 14 clinical studies, including over 2,300 cases of calcium hydroxide pulp capping, noted success rates of up to 90% when done by experienced clinicians.25 This review article highlighted two keys to calcium hydroxide direct pulp capping success: restricting pulp capping to asymptomatic teeth and providing a well-sealed restoration following the pulp cap. Of soluble plaque factors on inflammatory reactions in the full-length articles from peer-reviewed periodicals were obtained contact information and.... 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