This document summarizes various vital pulp therapy techniques including indirect pulp capping, direct pulp capping, and pulpotomy. It discusses the rationale, procedures, and materials used for each technique. For indirect pulp capping, it describes how the goal is to protect odontoblasts and promote reactionary dentin formation. Materials discussed include calcium hydroxide and resin modified glass ionomers. For direct pulp capping and pulpotomy, the document outlines the procedures and notes the importance of achieving hemostasis and sealing in biomaterials to stimulate reparative dentin formation. Success rates and the role of infection are also summarized.
The document discusses various topics related to indirect pulp capping, direct pulp capping, and pulpotomy procedures. Indirect pulp capping involves sealing a tooth with a deep carious lesion using a protective material to stimulate healing and repair, avoiding direct pulp exposure. It is aimed at maintaining pulp vitality. Direct pulp capping places a material directly on an exposed pulp to encourage reparative dentin formation. Pulpotomy involves removing part of the coronal pulp as an emergency procedure to preserve the remaining radicular pulp. Various materials used and techniques for each procedure are described.
Ultrasonic scaling .
Tooth cleaning is usually accomplished by the non-surgical technique of scaling, sometimes called “root debridement.” It's typically a relatively painless procedure in which small dental instruments are used to physically remove deposits from the surfaces of teeth
For more information, you can book an appointment at
Dr Sachdeva's Dental Aesthetic And Implant Institute,
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
• Phone : +919818894041,01142464041
• Our Websites:
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
This document discusses various aspects of vital pulp therapy (VPT), including indirect pulp capping (IPC), direct pulp capping (DPC), and pulpotomy procedures. It provides the history and objectives of these procedures, as well as guidelines for when each is appropriate based on factors like the size of a pulp exposure and presence of symptoms. Materials commonly used for VPT are also reviewed, including calcium hydroxide, MTA, and others. Success rates from studies on IPC and factors influencing the outcome of VPT are presented.
This document discusses apexogenesis and apexification procedures for teeth with open apices. Apexogenesis refers to treatments that maintain pulp vitality and allow continued root development and apex closure. These include indirect pulp capping, direct pulp capping, and apical closure pulpotomy using materials like calcium hydroxide or MTA. Apexification induces artificial root end closure when the pulp is necrotic, using repeated dressings of calcium hydroxide or MTA to encourage hard tissue deposition. Clinical success depends on factors like the treatment material and maintaining a bacteria-tight seal during root development.
This document discusses dental avulsion, which is the complete displacement of a tooth from its socket, and provides recommendations for treatment. It notes that trauma can cause teeth to be knocked out of their socket. To maintain the viability of the tooth's cells after avulsion, the tooth must be stored in a medium that preserves the cell's normal physiology and metabolism. Recommended storage media include saliva, physiologic saline, and milk. The document outlines the management of an avulsed tooth both on site and in the dental office, including immediate replantation if possible or storage in a preservative medium. It describes the replantation procedure and provides recommendations for splinting and post-operative care to support healing. Potential complications
This document provides an overview of endodontic-periodontal interactions. It discusses the pathways connecting endodontic and periodontal tissues, the etiology of endo-perio lesions, classifications of endo-perio lesions, diagnostic procedures, differences between periodontal and periapical abscesses, the endo-perio controversy, and management of pulpal and periodontal diseases. The key relationships covered are the anatomical and pathological connections between the pulp and periodontium, the bacteria commonly found in both tissues, and the debate around whether periodontal or endodontic disease can cause the other.
This document provides an overview of periodontal dressings. It discusses the history of dressings from the early 20th century use of eugenol-containing dressings to the development of non-eugenol dressings. The ideal properties and types of dressings are described, including eugenol, non-eugenol, and those containing neither zinc oxide nor eugenol. Modifications to dressings through the addition of substances like chlorhexidine to improve antimicrobial activity are also summarized. The document concludes by stating that while dressings provide wound protection, mouthwashes are now preferred for their antimicrobial effects during healing.
This document discusses pulp capping, which involves placing a biocompatible material over exposed dental pulp to avoid pulp tissue exposure and promote healing. It describes indirect pulp capping, which leaves decayed dentin behind to avoid pulp exposure, and direct pulp capping, which dresses small pulp exposures with calcium hydroxide or resin bonding agents. Successful pulp capping requires maintaining pulp vitality without pain or pathology and promoting dentin bridge formation. Calcium hydroxide is commonly used but can degrade over time, while resin bonding agents may provide a better seal but with less evidence of success.
The document discusses various topics related to indirect pulp capping, direct pulp capping, and pulpotomy procedures. Indirect pulp capping involves sealing a tooth with a deep carious lesion using a protective material to stimulate healing and repair, avoiding direct pulp exposure. It is aimed at maintaining pulp vitality. Direct pulp capping places a material directly on an exposed pulp to encourage reparative dentin formation. Pulpotomy involves removing part of the coronal pulp as an emergency procedure to preserve the remaining radicular pulp. Various materials used and techniques for each procedure are described.
Ultrasonic scaling .
Tooth cleaning is usually accomplished by the non-surgical technique of scaling, sometimes called “root debridement.” It's typically a relatively painless procedure in which small dental instruments are used to physically remove deposits from the surfaces of teeth
For more information, you can book an appointment at
Dr Sachdeva's Dental Aesthetic And Implant Institute,
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
• Phone : +919818894041,01142464041
• Our Websites:
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
This document discusses various aspects of vital pulp therapy (VPT), including indirect pulp capping (IPC), direct pulp capping (DPC), and pulpotomy procedures. It provides the history and objectives of these procedures, as well as guidelines for when each is appropriate based on factors like the size of a pulp exposure and presence of symptoms. Materials commonly used for VPT are also reviewed, including calcium hydroxide, MTA, and others. Success rates from studies on IPC and factors influencing the outcome of VPT are presented.
This document discusses apexogenesis and apexification procedures for teeth with open apices. Apexogenesis refers to treatments that maintain pulp vitality and allow continued root development and apex closure. These include indirect pulp capping, direct pulp capping, and apical closure pulpotomy using materials like calcium hydroxide or MTA. Apexification induces artificial root end closure when the pulp is necrotic, using repeated dressings of calcium hydroxide or MTA to encourage hard tissue deposition. Clinical success depends on factors like the treatment material and maintaining a bacteria-tight seal during root development.
This document discusses dental avulsion, which is the complete displacement of a tooth from its socket, and provides recommendations for treatment. It notes that trauma can cause teeth to be knocked out of their socket. To maintain the viability of the tooth's cells after avulsion, the tooth must be stored in a medium that preserves the cell's normal physiology and metabolism. Recommended storage media include saliva, physiologic saline, and milk. The document outlines the management of an avulsed tooth both on site and in the dental office, including immediate replantation if possible or storage in a preservative medium. It describes the replantation procedure and provides recommendations for splinting and post-operative care to support healing. Potential complications
This document provides an overview of endodontic-periodontal interactions. It discusses the pathways connecting endodontic and periodontal tissues, the etiology of endo-perio lesions, classifications of endo-perio lesions, diagnostic procedures, differences between periodontal and periapical abscesses, the endo-perio controversy, and management of pulpal and periodontal diseases. The key relationships covered are the anatomical and pathological connections between the pulp and periodontium, the bacteria commonly found in both tissues, and the debate around whether periodontal or endodontic disease can cause the other.
This document provides an overview of periodontal dressings. It discusses the history of dressings from the early 20th century use of eugenol-containing dressings to the development of non-eugenol dressings. The ideal properties and types of dressings are described, including eugenol, non-eugenol, and those containing neither zinc oxide nor eugenol. Modifications to dressings through the addition of substances like chlorhexidine to improve antimicrobial activity are also summarized. The document concludes by stating that while dressings provide wound protection, mouthwashes are now preferred for their antimicrobial effects during healing.
This document discusses pulp capping, which involves placing a biocompatible material over exposed dental pulp to avoid pulp tissue exposure and promote healing. It describes indirect pulp capping, which leaves decayed dentin behind to avoid pulp exposure, and direct pulp capping, which dresses small pulp exposures with calcium hydroxide or resin bonding agents. Successful pulp capping requires maintaining pulp vitality without pain or pathology and promoting dentin bridge formation. Calcium hydroxide is commonly used but can degrade over time, while resin bonding agents may provide a better seal but with less evidence of success.
This document provides an overview of over dentures, including:
- Definitions of over dentures and the advantages of using them to preserve remaining teeth and bone.
- Classifications of over dentures based on the type of support (tooth, implant, or mixed) and the timing of placement.
- Common attachment types used for retention, including studs, bars, and magnets attached to teeth or implants.
- The minimum number of implants needed for fully implant supported maxillary and mandibular over dentures.
Restoration of endodontically treated teethNivedha Tina
This document discusses various methods for restoring endodontically treated teeth. It covers the history of restoring pulpless teeth dating back to 1747. Key factors in selecting a restorative approach include the amount of residual root and crown structure remaining as well as the tooth's function and position. Methods discussed include direct composite restorations, indirect restorations, fiber posts, cast posts, and full crowns. The document also addresses the vulnerability of root filled teeth to fracture and emphasizes the importance of preserving tooth structure.
Restoration of endodontically treated teethAnish Amin
Restoration of endodontically treated teeth often requires posts and cores to provide adequate retention and resistance for weakened teeth. Key principles for posts and cores include preserving tooth structure, maximizing retention through post length and design, and providing resistance through features like ferrules. Posts and cores are indicated when there is significant loss of coronal tooth structure and the risk of fracture is high. The amount of remaining tooth structure, presence of a ferrule, and post length and design all influence the success of a post and core restoration.
The document discusses endodontic surgery, including:
- Indications for endodontic surgery when non-surgical retreatment has failed or is not feasible.
- Classification, armamentarium, treatment planning considerations, and stages of surgical endodontics including flap design, osteotomy, periradicular curettage, root-end resection, and root-end preparation and filling.
- Key aspects are proper anesthesia, hemostasis, management of soft and hard tissues to access the surgical site and root structure for periradicular procedures.
This document provides an overview of dentin bonding agents. It discusses the history and development of bonding agents from the 1950s to present. Key topics covered include the bonding mechanism, ideal requirements, microstructure of dentin, smear layer, etching of enamel and dentin, hybridization, reverse hybrid layer, wet vs dry bonding, and classifications of dentin bonding agents. The document aims to describe the important concepts and advances in dentin bonding for adhesive dentistry.
Apexification is a technique used to induce formation of a calcified barrier at the apex of a tooth with incomplete root development and non-vital pulp. It involves removal of pulp tissue, placement of calcium hydroxide or mineral trioxide aggregate (MTA) in the root canal to stimulate apical closure, and subsequent filling of the canal. The steps are accessing the canal, determining root length, cleaning and shaping, placing calcium hydroxide or MTA, and filling the canal once closure is achieved, usually within 6 months. Apexification aims to enable conventional root canal treatment in teeth that would otherwise be non-restorable due to open apices.
Design of a fixed Partial Denture (with Abutment Tooth Preparation)Taseef Hasan Farook
A simplified take on the steps to designing a Fixed partial denture. This presentation also includes an overview of abutment preparation, associated finishes and methods of impression taking prior to the designing of the prosthesis itself
1. The functionally generated pathway technique involves recording the paths of tooth movement during excursive jaw motions using wax or other materials.
2. This recording is used to develop the occlusal morphology for dental restorations like crowns, ensuring optimal occlusion during all jaw motions.
3. Studies have found that the functionally generated pathway technique results in restorations with better functional articulation compared to conventional single casting techniques, with less adjustment needed and higher patient satisfaction.
This document discusses the use of radiography in endodontics. It begins with a brief history of dental radiography and then covers topics like how to obtain good radiographs, relevant findings for endodontists, different types of radiographs used, and techniques for intraoral periapical radiographs. The document emphasizes the importance of radiographs for diagnosing issues, determining working lengths, evaluating treatment outcomes, and providing follow-up assessments. Both advantages and disadvantages of radiographs are outlined. Various anatomical landmarks are also identified on sample radiographs.
Gutta percha and sealers are the most commonly used materials for root canal obturation. Gutta percha exists in alpha, beta, and gamma forms with different properties and is made of gutta-percha polymer, zinc oxide, and waxes or resins. It has advantages like biocompatibility and ability to adapt to canal irregularities but lacks rigidity and adhesive properties. Sealers are used to adhere gutta percha to canal walls and come in various formulations like zinc oxide-eugenol, resin, and glass ionomer based. An ideal sealer makes a hermetic seal, is biocompatible, and insoluble in tissue fluids.
The document discusses the classification and design principles of obturators for partially edentulous patients. It presents a 6-class classification system for maxillary defects based on the location and extent of the resection. The classes range from a midline defect (Class I) to a bilateral posterior defect (Class V). Design principles are provided for each class, focusing on support, retention, and stabilization. Support is primarily through rests on abutment teeth and palatal tissues. Retention uses direct and indirect retainers on abutment teeth. Stabilization incorporates guide planes and tripodal/quadrilateral designs when possible. The goal is to distribute forces optimally and minimize movement of the prosthesis.
This document discusses occlusal equilibration and selective grinding. It begins by defining the key characteristics of a stable occlusion and the signs of an unstable occlusion. It then outlines the principles, indications, goals and procedures for occlusal equilibration and selective grinding. Specific techniques are covered such as how to eliminate interferences in centric relation, achieve the centric contact position, and adjust for lateral and protrusive interferences. The document emphasizes developing simultaneous contacts between cusp tips and flat surfaces to achieve occlusal stability.
This document provides information on root canal obturation materials. It defines obturation as the three dimensional filling of the entire root canal system as close to the cementodentinal junction as possible. The objectives and ideal requirements of root canal filling materials are described. Materials are classified and various materials used for filling root canals are discussed, including gutta percha, resilon, silver points, and various cements. The properties, advantages, and disadvantages of gutta percha are summarized. Recent advances in materials like medicated gutta percha and resilon are also outlined.
pulpotomy procedures in primary dentitionParth Thakkar
A pulpotomy involves removing the inflamed coronal pulp while leaving the healthy radicular pulp intact. The aim is to relieve pain and allow for root development. Formocresol pulpotomy is commonly used and involves applying formocresol to the exposed pulp stump to fix tissues and eliminate microorganisms. It is performed using either a single-stage or two-stage technique. Other materials used include calcium hydroxide, glutaraldehyde and ferric sulfate. Success rates depend on strict case selection and technique.
this seminar is talking about one of the most important topics for any dentist in the world (pulp and periapical diseases)
i hope it will be helpful for you
The document discusses the treatment plan for periodontal therapy. It defines the treatment plan as the blueprint for case management that includes all procedures needed to establish and maintain oral health. The goals of treatment are to eliminate inflammation, correct conditions that cause it, and establish healthy gum contours. Treatment involves nonsurgical procedures, possible surgery, restorations, and a maintenance phase with periodic checkups. The treatment plan guides the phases of therapy and overall management of the patient's periodontal condition.
This document discusses vital pulp therapy, which aims to maintain pulp vitality when it is exposed. It describes different types of vital pulp therapy, including indirect pulp capping, direct pulp capping, pulpotomy, and apexification. Indirect pulp capping covers exposed dentin with a biocompatible material to stimulate tertiary dentin formation and prevent further exposure. Direct pulp capping places a protective material directly over an exposed pulp. Pulpotomy removes a portion of exposed pulp to preserve the remaining radicular pulp. Apexification induces a calcific barrier in a tooth with an open apex. Calcium hydroxide and MTA are commonly used capping agents, with MTA having advantages like better bi
The document discusses recent advances in prosthodontics presented by Dr. J. Koshy Joseph. It covers various topics including complete dentures, fixed partial dentures, removable partial dentures, maxillofacial prosthetics, implantology, materials and instrumentation. New techniques and materials discussed include the use of lasers in denture fabrication, CAD/CAM systems for complete dentures, magnets and denture liners in prosthodontics, and all-on implants. The document provides an overview of the latest developments across different areas of prosthodontics.
This document discusses ideal requirements, functions, and commonly used irrigating solutions and intracanal medicaments in endodontic treatment. Sodium hypochlorite and EDTA are the most commonly used irrigants due to their ability to dissolve tissue and remove smear layer. Chlorhexidine and hydrogen peroxide are also discussed. Intracanal medicaments mentioned include eugenol, phenol, camphorated monochlorophenol, formocresol, and calcium hydroxide which are used to disinfect canals and promote healing.
Conservative Management of Mature Permanent Teeth with Carious Pulp ExposureDR.AJAY BABU GUTTI M.D.S
1) The study evaluated the correlation between clinical diagnoses of normal/reversible pulpitis (savable pulp) vs irreversible pulpitis (nonsavable pulp) and histologic diagnoses.
2) Results found the clinical diagnosis of normal/reversible pulpitis matched the histologic diagnosis in 84% of teeth, suggesting clinical diagnoses can reliably determine whether the pulp is savable or nonsavable.
3) However, clinical pulp testing alone is not definitive, and an urgent need remains for more accurate diagnostic tools to determine pulpal status.
24th oct Pulp Therapy In Young Permanent Teeth.pptxismasajjad1
The document discusses various pulp therapy techniques for young permanent teeth including indirect pulp capping, direct pulp capping, Cvek pulpotomy, apexogenesis, apexification, and regenerative endodontics. Important factors to consider include assessing for signs of reversible pulpitis. Indirect pulp capping involves sealing a deep lesion near the pulp with a protective material while direct pulp capping places a material directly over an exposure site after controlling bleeding. Pulpotomy removes inflamed pulp from the crown while leaving healthy tissue in the root canals. Apexogenesis treats immature teeth to allow continued root development while apexification induces a barrier in nonvital open apices. Regenerative endodontics aims
This document provides an overview of over dentures, including:
- Definitions of over dentures and the advantages of using them to preserve remaining teeth and bone.
- Classifications of over dentures based on the type of support (tooth, implant, or mixed) and the timing of placement.
- Common attachment types used for retention, including studs, bars, and magnets attached to teeth or implants.
- The minimum number of implants needed for fully implant supported maxillary and mandibular over dentures.
Restoration of endodontically treated teethNivedha Tina
This document discusses various methods for restoring endodontically treated teeth. It covers the history of restoring pulpless teeth dating back to 1747. Key factors in selecting a restorative approach include the amount of residual root and crown structure remaining as well as the tooth's function and position. Methods discussed include direct composite restorations, indirect restorations, fiber posts, cast posts, and full crowns. The document also addresses the vulnerability of root filled teeth to fracture and emphasizes the importance of preserving tooth structure.
Restoration of endodontically treated teethAnish Amin
Restoration of endodontically treated teeth often requires posts and cores to provide adequate retention and resistance for weakened teeth. Key principles for posts and cores include preserving tooth structure, maximizing retention through post length and design, and providing resistance through features like ferrules. Posts and cores are indicated when there is significant loss of coronal tooth structure and the risk of fracture is high. The amount of remaining tooth structure, presence of a ferrule, and post length and design all influence the success of a post and core restoration.
The document discusses endodontic surgery, including:
- Indications for endodontic surgery when non-surgical retreatment has failed or is not feasible.
- Classification, armamentarium, treatment planning considerations, and stages of surgical endodontics including flap design, osteotomy, periradicular curettage, root-end resection, and root-end preparation and filling.
- Key aspects are proper anesthesia, hemostasis, management of soft and hard tissues to access the surgical site and root structure for periradicular procedures.
This document provides an overview of dentin bonding agents. It discusses the history and development of bonding agents from the 1950s to present. Key topics covered include the bonding mechanism, ideal requirements, microstructure of dentin, smear layer, etching of enamel and dentin, hybridization, reverse hybrid layer, wet vs dry bonding, and classifications of dentin bonding agents. The document aims to describe the important concepts and advances in dentin bonding for adhesive dentistry.
Apexification is a technique used to induce formation of a calcified barrier at the apex of a tooth with incomplete root development and non-vital pulp. It involves removal of pulp tissue, placement of calcium hydroxide or mineral trioxide aggregate (MTA) in the root canal to stimulate apical closure, and subsequent filling of the canal. The steps are accessing the canal, determining root length, cleaning and shaping, placing calcium hydroxide or MTA, and filling the canal once closure is achieved, usually within 6 months. Apexification aims to enable conventional root canal treatment in teeth that would otherwise be non-restorable due to open apices.
Design of a fixed Partial Denture (with Abutment Tooth Preparation)Taseef Hasan Farook
A simplified take on the steps to designing a Fixed partial denture. This presentation also includes an overview of abutment preparation, associated finishes and methods of impression taking prior to the designing of the prosthesis itself
1. The functionally generated pathway technique involves recording the paths of tooth movement during excursive jaw motions using wax or other materials.
2. This recording is used to develop the occlusal morphology for dental restorations like crowns, ensuring optimal occlusion during all jaw motions.
3. Studies have found that the functionally generated pathway technique results in restorations with better functional articulation compared to conventional single casting techniques, with less adjustment needed and higher patient satisfaction.
This document discusses the use of radiography in endodontics. It begins with a brief history of dental radiography and then covers topics like how to obtain good radiographs, relevant findings for endodontists, different types of radiographs used, and techniques for intraoral periapical radiographs. The document emphasizes the importance of radiographs for diagnosing issues, determining working lengths, evaluating treatment outcomes, and providing follow-up assessments. Both advantages and disadvantages of radiographs are outlined. Various anatomical landmarks are also identified on sample radiographs.
Gutta percha and sealers are the most commonly used materials for root canal obturation. Gutta percha exists in alpha, beta, and gamma forms with different properties and is made of gutta-percha polymer, zinc oxide, and waxes or resins. It has advantages like biocompatibility and ability to adapt to canal irregularities but lacks rigidity and adhesive properties. Sealers are used to adhere gutta percha to canal walls and come in various formulations like zinc oxide-eugenol, resin, and glass ionomer based. An ideal sealer makes a hermetic seal, is biocompatible, and insoluble in tissue fluids.
The document discusses the classification and design principles of obturators for partially edentulous patients. It presents a 6-class classification system for maxillary defects based on the location and extent of the resection. The classes range from a midline defect (Class I) to a bilateral posterior defect (Class V). Design principles are provided for each class, focusing on support, retention, and stabilization. Support is primarily through rests on abutment teeth and palatal tissues. Retention uses direct and indirect retainers on abutment teeth. Stabilization incorporates guide planes and tripodal/quadrilateral designs when possible. The goal is to distribute forces optimally and minimize movement of the prosthesis.
This document discusses occlusal equilibration and selective grinding. It begins by defining the key characteristics of a stable occlusion and the signs of an unstable occlusion. It then outlines the principles, indications, goals and procedures for occlusal equilibration and selective grinding. Specific techniques are covered such as how to eliminate interferences in centric relation, achieve the centric contact position, and adjust for lateral and protrusive interferences. The document emphasizes developing simultaneous contacts between cusp tips and flat surfaces to achieve occlusal stability.
This document provides information on root canal obturation materials. It defines obturation as the three dimensional filling of the entire root canal system as close to the cementodentinal junction as possible. The objectives and ideal requirements of root canal filling materials are described. Materials are classified and various materials used for filling root canals are discussed, including gutta percha, resilon, silver points, and various cements. The properties, advantages, and disadvantages of gutta percha are summarized. Recent advances in materials like medicated gutta percha and resilon are also outlined.
pulpotomy procedures in primary dentitionParth Thakkar
A pulpotomy involves removing the inflamed coronal pulp while leaving the healthy radicular pulp intact. The aim is to relieve pain and allow for root development. Formocresol pulpotomy is commonly used and involves applying formocresol to the exposed pulp stump to fix tissues and eliminate microorganisms. It is performed using either a single-stage or two-stage technique. Other materials used include calcium hydroxide, glutaraldehyde and ferric sulfate. Success rates depend on strict case selection and technique.
this seminar is talking about one of the most important topics for any dentist in the world (pulp and periapical diseases)
i hope it will be helpful for you
The document discusses the treatment plan for periodontal therapy. It defines the treatment plan as the blueprint for case management that includes all procedures needed to establish and maintain oral health. The goals of treatment are to eliminate inflammation, correct conditions that cause it, and establish healthy gum contours. Treatment involves nonsurgical procedures, possible surgery, restorations, and a maintenance phase with periodic checkups. The treatment plan guides the phases of therapy and overall management of the patient's periodontal condition.
This document discusses vital pulp therapy, which aims to maintain pulp vitality when it is exposed. It describes different types of vital pulp therapy, including indirect pulp capping, direct pulp capping, pulpotomy, and apexification. Indirect pulp capping covers exposed dentin with a biocompatible material to stimulate tertiary dentin formation and prevent further exposure. Direct pulp capping places a protective material directly over an exposed pulp. Pulpotomy removes a portion of exposed pulp to preserve the remaining radicular pulp. Apexification induces a calcific barrier in a tooth with an open apex. Calcium hydroxide and MTA are commonly used capping agents, with MTA having advantages like better bi
The document discusses recent advances in prosthodontics presented by Dr. J. Koshy Joseph. It covers various topics including complete dentures, fixed partial dentures, removable partial dentures, maxillofacial prosthetics, implantology, materials and instrumentation. New techniques and materials discussed include the use of lasers in denture fabrication, CAD/CAM systems for complete dentures, magnets and denture liners in prosthodontics, and all-on implants. The document provides an overview of the latest developments across different areas of prosthodontics.
This document discusses ideal requirements, functions, and commonly used irrigating solutions and intracanal medicaments in endodontic treatment. Sodium hypochlorite and EDTA are the most commonly used irrigants due to their ability to dissolve tissue and remove smear layer. Chlorhexidine and hydrogen peroxide are also discussed. Intracanal medicaments mentioned include eugenol, phenol, camphorated monochlorophenol, formocresol, and calcium hydroxide which are used to disinfect canals and promote healing.
Conservative Management of Mature Permanent Teeth with Carious Pulp ExposureDR.AJAY BABU GUTTI M.D.S
1) The study evaluated the correlation between clinical diagnoses of normal/reversible pulpitis (savable pulp) vs irreversible pulpitis (nonsavable pulp) and histologic diagnoses.
2) Results found the clinical diagnosis of normal/reversible pulpitis matched the histologic diagnosis in 84% of teeth, suggesting clinical diagnoses can reliably determine whether the pulp is savable or nonsavable.
3) However, clinical pulp testing alone is not definitive, and an urgent need remains for more accurate diagnostic tools to determine pulpal status.
24th oct Pulp Therapy In Young Permanent Teeth.pptxismasajjad1
The document discusses various pulp therapy techniques for young permanent teeth including indirect pulp capping, direct pulp capping, Cvek pulpotomy, apexogenesis, apexification, and regenerative endodontics. Important factors to consider include assessing for signs of reversible pulpitis. Indirect pulp capping involves sealing a deep lesion near the pulp with a protective material while direct pulp capping places a material directly over an exposure site after controlling bleeding. Pulpotomy removes inflamed pulp from the crown while leaving healthy tissue in the root canals. Apexogenesis treats immature teeth to allow continued root development while apexification induces a barrier in nonvital open apices. Regenerative endodontics aims
Dense Evaginatus: Management Using Novel Materials A Case ReportQUESTJOURNAL
ABSTRACT: Dens evaginatus is an uncommon developmental anomaly of human dentition characterized by a projection of enamel and dentin that usually encloses pulp tissue. Most commonly found as the tubercle on the occlusal surface of mandibular premolars and lingual surface of anterior teeth.Due to occlusal trauma this tubercle tends to fracture thus exposing the pathway to the pulp chamber of teeth. This case reports about the presentation of dens evaginatus in mandibular premolar 35 which was associated with open apex and chronic apical periodontitis. Root canal treatment was performed with tooth 35. DFDBA apical barrier and Biodentine as an apical plug was placed showing successful management of the same.
This document discusses conservative strategies for managing dental caries, including mechanical, chemico-mechanical, and physical approaches. Mechanical approaches include ART, indirect pulp capping, stepwise excavation, and selective removal to soft dentine. Chemico-mechanical caries removal uses chemical agents to soften infected dentin before excavation. Physical approaches include photodynamic antimicrobial chemotherapy, which uses photosensitizing agents activated by light to kill bacteria. The document compares the pros and cons of these different conservative caries management techniques.
The permanent teeth with open apex and large periapical lesion are diffcult to treat as a traditional root canal procedure, therefore calcium hydroxide place an important role in reducing the periapical infl ammation. Management of open apex can be done using mineral trioxide aggregate (MTA) which can be placed in apical 3-4 mm. The aim of this This case report describes the use of mineral trioxide aggregate (MTA) for management of a periapically compromised immature tooth.
This document discusses various materials used for vital pulp therapy (VPT). It begins by outlining the ideal properties of a pulp capping agent, such as maintaining pulp vitality and stimulating reparative dentin formation. Classic materials like calcium hydroxide, zinc oxide-eugenol, and polycarboxylate cement are described along with their disadvantages. More recent bioactive bioceramic materials like mineral trioxide aggregate (MTA), Biodentine, and Endosequence are then discussed and compared to calcium hydroxide, with studies showing higher success rates for reparative dentin formation and less inflammation with bioceramics. The document concludes by mentioning recent advances in VPT including the
This document provides an overview of pulp capping agents and procedures. It begins with definitions of indirect and direct pulp capping. It then discusses various pulp capping agents that have been used historically and currently, including calcium hydroxide, zinc oxide-eugenol, glass ionomer cement, and mineral trioxide aggregate. For each agent, the document outlines their proposed mechanisms of action, advantages, and disadvantages based on literature. Overall, the document provides a comprehensive review of the key considerations and materials used for pulp capping procedures.
Reaction of the pulp to various capping materials 2003Asmaa Ali
This document discusses various pulp treatment materials and their effects. It outlines the objectives of pulp treatment as maintaining tooth integrity and vitality. Types of treatment include conservative (protective base, pulp capping, pulpotomy) and radical (partial pulpectomy, pulpectomy, nonvital pulpotomy). Ideal materials are bactericidal, biocompatible, harmless, promote healing and not interfere with resorption. Materials discussed include zinc oxide-eugenol, calcium hydroxide, antibiotics/corticosteroids with calcium hydroxide, tricalcium phosphate with calcium hydroxide, adhesive liners, mineral trioxide aggregate, lasers, growth factors and calcium phosphate compounds. Histological responses
Management of Open Apex in Permanent Teeth with BiodentineAbu-Hussein Muhamad
Biodentine is new calcium silicate based cement that exhibits physical and chemical properties similar to those described for certain Portland cement derivatives. This article demonstrates the use of the newer material, Biodentine as an apical matrix barrier in root end apexification procedure. This case reports present apexification and successful healing with the use of Biodentine as an apical barrier matrix.
Indirect pulp capping involves removing gross caries while leaving a thin layer over the pulp to avoid exposure. It allows the remaining caries to arrest over 6-8 weeks under a restoration. Direct pulp capping is for small exposures, usually accidental, surrounded by sound dentin. Calcium hydroxide or MTA is placed directly on the exposure. Pulpotomy removes the coronal pulp for carious or mechanical exposures, with various medicaments like formocresol or MTA placed on the remaining pulp stumps. Success requires careful case selection and technique. Indirect capping and MTA pulpotomy show promise but need more long-term research for primary teeth.
Prosthodontics ( inhibition of denture plaque)DHANANJAYSHETH1
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Periodontitis is a chronic inflammatory disorder that can lead to the destruction of the periodontal tissues and ultimately tooth loss. Regeneration of the reduced periodontium is the ideal goal in periodontal therapy. To date, regenerative therapy with membranes, bone grafting materials, growth factors and the combination of these procedures have been investigated and employed with distinct levels of clinical success. Barrier membranes prevent epithelial down growth, allow periodontal ligament and alveolar bone cells to repopulate the defect thereby favoring the regeneration of periodontal tissues. This article discusses various membranes used for periodontal regeneration and their impact on the experimental or clinical management of periodontal defects.
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New approaches in vital pulp therapy in permanent teeth IEJ 2014
1. Jamileh Ghoddusi Maryam Forghani Iman Parisay
IEJ 2014;9(1):15-22
Presented by
Dr Nadeem Aashiq
MDS 1st year
2. Introduction
Vital pulp therapy is defined as treatment which aims to preserve and
maintain pulp tissue that has been compromised but not destroyed by
caries, trauma, or restorative procedures in a healthy state.
It has been recommended that VPT should be performed only in young
patients because of high healing capacity of pulp tissue compared to older
patients .
Since the evidence regarding the effect of the patients age and status of the
root apex on the outcome of VPT did not indicate that this treatment could
not be performed successfully in old patients, and based on the premise of
innate capacity of pulp tissue repair in the absence of microbial
contamination, preservation of the pulpally involved permanent tooth is
also considered
3. Another important benefit for preservation of vital pulp is the protective
resistance to mastication forces compared with a root canal filled tooth .
It is reported that the survival rate of endodontically treated teeth is not
good as vital teeth especially in molars. Therefore, the vital pulp should
be preserved if possible.
One of the most important issues in VPT is the status of the pulp tissue. The
traditional school of thought is that VPT should only be carried out in teeth with
signs and symptoms of reversible pulpitis.
The presence of adequate blood supply is required for the maintenance of the
pulp vitality in addition to this presence of a healthy periodontium is necessary
for success of VPT.
4. Control of hemorrhage is also necessary for the success of VPT. Various
options are available for the achievement of pulp hemostasis such as
mechanical pressure using sterile cotton pellet which may be soaked in
sterile water or saline.
Sodium hypochlorite has been suggested as an agent in VPT that can
control hemorrhage, remove the coagulum and dentin chips, disinfect
the cavity interface, and aid in formation of dentinal bridge.
5. Indirect pulp capping
Indirect pulp capping is defined as a procedure in which carious dentin
closest to the pulp, is preserved to avoid pulp exposure and is covered with
a biocompatible material.
This treatment method is intended to protect primary odontoblasts and
promote reactionary dentin formation at the pulp-dentine junction.
However some primary odontoblasts may be destroyed depending on the
severity of carious involvement of the dentin-pulp complex and reparative
dentin is formed in conjunction with reactionary dentin.
An important function of the bioactive lining material is to stimulate the
odontoblasts to form reactionary and reparative dentin and promote
demineralization of existing dentine, thus encouraging the dentin-pulp
complex
6. Calcium hydroxide has been the material of choice in indirect pulp
capping because of its alkaline PH and biocompatible properties that
induces pulpo-dentin remineralization. However, since concerns exist
regarding its long term solubility and lack of adhesion to dentin, some
adhesive materials such as resin modified glass ionomer cements
(RMGIC) have also been suggested
Mickenautsh et al. evaluated the pulp response to CH and RMGIC in deep
cavities, and found no significant differences between two materials.
Hayashi et al. mentioned that other materials such as antimicrobials and
polycarboxylate cement combined with tannin-fluoride preparation are
suitable liner, since all these materials can reduce cariogenic bacteria and
promote remineralization, as effectively as CH
7. Recently in a clinical trial, mineral trioxide aggregate (MTA) has been
used as a lining material and was compared with CH after 6 months,
the success rate and the average thickness of newly formed dentin were
similar in two groups.
There are two treatment approaches for performing IPC: incomplete
caries removal with no re-entry and stepwise or two-step excavation
approach.
In stepwise caries treatment, carious dentin in proximity to the pulp
remains at the first step and in second visit some month later a re-entry
procedure is performed. In this step, complete removal of all carious
tissue and a definitive restoration is provided
8. In step wise approach, removal of carious dentin during re entry must
be carried out with caution to avoid pulp exposure, since the remaining
dentin may have become harder, but the thickness of the remaining
dentin may be unchanged.
Based on the results of recent systemic review, incomplete caries
removal reduces the risk of pulpal exposure and postoperative pulpal
symptoms compared with step wise caries removal. However the
amount of dentin that can be left in cavity was not sufficiently clear.
The consensus on this issue is to remove peripheral caries dentin
completely to achieve firm marginal adhesion, to remove as much as
caries adjacent to pulp as possible, and avoid pulp exposure
9. Direct pulp capping
DPC is defined as the treatment of a mechanical or traumatic vital pulp
exposure by sealing the pulpal wound with a biomaterial placed directly on
exposed pulp to facilitate formation of reparative dentin and maintenance
of the vital pulp.
As primary odontoblasts are destroyed at the site of pulp exposure and
inflammation is initiated, recruitment and differentiation of
progenitor/stem cells in the underlying uninfected vital pulp is required to
produce reparative dentin.
Growth factors such as transforming growth factor (TGF) released from the
dentin matrix and extracellular matrix molecules can induce the
differentiation of progenitor/stem cells into odontoblast-like cells .
Pulp capping materials such as CH and MTA induce reparative dentin
formation by causing the release of growth factors from the dentin matrix.
10. It has been recommended that DPC should be performed only in teeth
with a recent mechanical or traumatic pulp exposure.
Success rate of DPC was 87.5% to 95.4% depending on follow up
duration that is not inferior compared to values reported by the
literature on treatment outcomes after iatrogenic pulp exposure
(ranging 70 to 98%)
It seems that microorganisms are the key factor in outcome of DPC.
Unfavorable outcomes can result from infection due to either
remaining bacteria, or new bacteria penetrating from filling margins.
Thus beside the use of rubber dam and aseptic treatment condition the
cavity. should be restored immediately with a bacteria-tight
restoration.
11. Asgray and Ahmadyar published a proposed hypothesis in order to
achieve improved treatment outcomes for DPC for carioulsy exposed
pulp using Miniature pulpotomy procedure .
They claimed that MPP will result in improved treatment outcomes of
DPC by improved maintenance of a clean surgical pulp wound;
removal of infected dentin chips/damaged pulp tissue specially injured
odontoblasts cells; improved proximity/interaction of pulp covering
agents to undifferentiated mesenchymal/stem cells; better control of
bleeding; and creating an improved seal using pulp covering agents.
12. Pulpotomy
Pulpotomy is carried out with two treatment approaches: partial and full
Pulpotomy.
Partial Pulpotomy
Partial or Cvek Pulpotomy is defined as “ the surgical removal of a small portion
of the coronal pulp tissue to preserve the remaining coronal and radicular pulp”.
The inflamed tissue is removed to the level of healthy coronal pulp tissue. Tooth
responsiveness to electric pulp tests has been reported in many cases of partial
Pulpotomy because of preserving the vitality of coronal pulp tissue.
Partial pulpotomy has some advantages compared to direct pulp capping such as
removal of the superficially inflamed pulp tissue and providing space for
dressing material which gives opportunity to seal the cavity.
The reported success rate for partial pulpotomy is 93-96%
13. Full pulpotomy
This procedure is defined as “surgical removal of the entire coronal
portion of the vital pulp to preserve the vitality of remaining radicular
portion”
This treatment approach is indicated when it is predicted that the
inflammation of the pulp tissue has extended to deep levels of the
coronal pulp.
After the removal of the coronal pulp, hemostatis must be achieved
and a biomaterial is placed over the remaining pulp tissue.
14. Dressing materials or pulp covering
agents
Calcium hydroxide
The introduction of CH products played an important role in development of VPT.
However, despite long history, long term study outcomes have been variable.
Some advantages of CH are antimicrobial characteristics owing to its high alkaline
PH and the irritation of pulp tissue that stimulates pulpal defense and repair.
Furthermore, its ability to extract growth factors and bioactive dentin matrix
components from mineralized dentin can induce dentin regeneration at the site of
pulpal exposure.
CH is extremely toxic to cells in tissue culture. It can degrade and dissolve beneath
restorations and dentin bridges beneath CH showed porosity and tunnel defects.
The disintegration of CH under restorations associated with porosity in the dentinal
bridge can provide a pathway for microleakage
15. Resin modified glass ionomers
RMGIs have been successful pulp capping agent even in cavities with
minimal remaining dentin thickness.
This may be due to their capacity to bond to the dentin and their
antimicrobial effect.
Contrary to these useful properties, poor responses have been reported in
direct pulp capping human teeth with RMGIs.
Pulp tissues that were capped with Vitrebond (3M, ESPE, St Paul, Minn.,
USA) exhibited moderate to intense inflammatory responses, including
large necrotic zone, and lack of dentin bridge formation. Thus, the
application of RMGIs directly on the pulp tissue is not recommended
16. Adhesive resins
Recently available self-etching adhesive systems as pulp capping material
resulted in unresolved inflammatory responses and minimal pulp tissue
repair.
Many of the resin components in dentin adhesives are vasorelaxent and
promote bleeding after hemostasis has been achieved with hemostatic
agents .
The plasma extravasation may compromise the adhesive polymerization
and lead to an increase in their cytotoxicity.
Further more, the presence of resin particles observed in the pulp seemed
to be a trigger in stimulating the inflammation and foreign body reactions.
The lack of the reparative bridge formation maybe due to this unresolved
inflammation. It seems that the adhesive resins are unacceptable as pulp
capping agents.
17. Mineral trioxide aggregate
This biomaterial was recommended initially as a root end filling material in
surgical endodontic treatment.
MTA has been shown to induce the recruitment and proliferation of
undifferentiated cells and their differentiation to odontoblasts like cells.
Dental pulp cells demonstrated higher activation levels in direct contact with
MTA that could lead to faster and more predictable formation of dentinal bridge
and more effective pulpal repair
Histologically, the calcified bridge formed in contact with MTA is thicker with
less pulpal inflammation compared to CH.
MTA pulpotomy of symptomatic permanent teeth was also evaluated none of the
patients experienced pain after pulpotomy.
Histological evaluation revealed that all samples had formed dentin bridges and
the pulps were vital and almost inflammation free.
18. Bioceramics
Recently, EndoSequence Root Repair Material (ERRM), BioAggregate ,
Biodentin and many other bioceramic – based products have been
introduced which can be used with the same application as MTA.
Cytotixicity of ERRM was similar to MTA. Biodentin MTA had also a
similar efficacy in pulp-capping treatment.
19. Calcium enriched mixture
CEM cement was introduced to dentistry as an endodontic filling
biomaterial.
Various animal studies have shown that in various forms of VPT treatments,
the induction of dentin bridge formation in teeth treated with CEM was
comparable to that of MTA and superior to CH.
CEM group has exhibited lower inflammation, improved quality/thickness
of calcified bridge, superior pulp vitality status, and morphology of
odontoblast cells.
Indirect pulp therapy with CEM cement on a symptomatic permanent molar
also showed favorable results.
CEM pulpotomy of symptomatic permanent teeth was also evaluated it was
found that it enables the improved regeneration, the pulp-dentin complex
had isolated itself by forming a calcified bridge.
20. Other bioactive materials for VPT
Other materials have been also evaluated as a pulp capping agents such
as Enamel Matrix Derivative (EMD) and Propolis.
The major constituent of EMD is amelogenin that during
odontogensis is secreted from preamelobalsts to differentiating
odontoblasts in the dental papilla.
A study comparing the effect of EMD and CH as a pulp capping agent
demonstrated that CH treated teeth had less inflammation and more
dentin bridge formation than those in EMD treated teeth.
Other studies have shown that the amount of reparative dentin formed
in the EMD treated teeth was significantly higher than in the CH
treated teeth
21. Propolis has demonstrated potent antimicrobial and anti inflammatory
properties.
Propolis has shown to inhibit synthesis of prostaglandins and supports
the immune system by promoting phagocytic activities, stimulating
cellular immunity and augmenting healing effects.
One study demonstrated the pulp response to propolis was comparable
to MTA and better than dycal .
22. Discussion
The concept of self- strangulation during pulpal inflammation has
been changed. According to this theory that gained support from the
work by Van Hassel, an increase in blood pressure in the pulp leads to
compression of venules that would then result in localized ischemia
and necrosis.
Several studies have shown that inflammation increases the interstitial
blood pressure in the dental pulp. However, experiments have also
shown that the pressure increase during pulpitis may be a localized
phenomenon, which does not necessarily involve the entire pulp
A few millimeters far from the inflamed area, the tissue pressure might
be less and is only slightly higher than in normal non inflamed pulps,
23. Accordingly, in spite of vasodilatation and increased vessel
permeability, the pulpal volume during pulpitis may be remained
relatively constant so that the tissue pressure does not rise to a level
that will cause vessel compression and total necrosis. Thus, coronal
pulpitis may persist without spreading to root pulp, however, in case of
severe persistent irritants, the increased tissue pressure may spread in
an apical direction and cause total pulp necrosis.
Several histological studies demonstrated that the cariously exposed
vital pulp was not always completely infected, depending on the
duration and severity of the carious lesion.
Occasionally, the inflammation was localized adjacent to the carious
lesion, not spreading to the whole coronal and radicular pulp.
If infected tissue is removed, the conservation of the remaining healthy
pulp is possible
24. When encountering carioulsy exposed pulp, assesing the condition of
the pulp, which plays a critical role in the success or failure of VPT,
seems difficult if not impossible. There is no reliable tool to help
evaluate how far the inflammation has progressed into the pulp.
It has been recommended that VPT should be performed only in young
patients. However, patients with age ranging from 6-70 years have been
successfully treated with VPT.
It puts an emphasis the high healing capacity of pulp tissue in both
young and old patients after the removal of the etiological factors.
It is likely that the complete removal of the inflammed pulp rather
than the status of the root apex is the critical point; recent evidence
indicates that VPT could be performed successfully in old patients
25. Dentists are traditionally taught that when a patient complains of
spontaneous pain or prolonged pain upon cold stimulus, the diagnosis
would be irreversible pulpitis and complex expensive pulpectomy is
indicated.
There are some researches showing that the vital pulp of permanent
mature molars with clinical signs of irreversible pulpitis were successfully
treated with VPT using appropriate biomaterials .
Control of hemorrhage is an important key to enhance the success rate of
vital pulp therapy.
Hemorrhage of exposed dental pulp tissue is in part due to the
inflammatory response of the pulp to bacteria and their by products
from carious dentin .
26. Placement of material over bleeding pulp may criticize the
maintenance of vital pulp tissue. Using the haemostatic agents has
been recommended over the exposure to halt the hemorrhage and
allow capping material to be placed in a relatively dry environment.
Sodium hypochlorite has been suggested to remove the coagulum,
control hemorrhage, remove dentin chips and aid formation of dentin
bridge
Two other important factors in predicting pulpal responses to VPT are
the sealing ability and the non toxicity of material. However bacterial
contamination is believed to be a main factor
27. Conclusion
To improve the success rate of VPT, a consensus amid literature should
be achieved to recognize various VPT progresses and to incorporate the
latest available information into clinical practice and teaching. Further
research and clinical trials are also needed to develop case selection
guideline, treatment approaches, and materials needed to maximize
clinical success. Hopefully in the near future with more knowledge
about the biology of the pulp, we can do VPT with more predictable
outcomes
28. References
Vital pulp therapy in vital permanent teeth with cariously exposed pulp: a
systematic review Aguilar P, Linsuwanont P
Introduction: This systematic review aims to illustrate the outcome of vital
pulp therapy, namely direct pulp capping, partial pulpotomy, and full pulpotomy,
Methods: Electronic database MEDLINE via Ovid, PubMed, and Cochrane databases
were searched. Hand searching was performed through reference lists of endodontic
textbooks, endodontic-related journals, and relevant articles from electronic searching.
The random effect method of weighted pooled success rate of each treatment and the
95% confidence interval were calculated by the DerSimonian-Laird method. The
weighted pooled success rate of each treatment was estimated in 4 groups: >6 months-1
year, >1-2 years, >2-3 years, and >3 years. All statistics were performed by STATA version
10. The indirect comparison of success rates for 4 follow-up periods and the indirect
comparison of clinical factors influencing the success rate of each treatment were
performed by z test for proportion (P < .05). in vital permanent teeth with cariously
exposed pulp.
Conclusions: Vital permanent teeth with cariously exposed pulp can be treated
successfully with vital pulp therapy. Current best evidence provides inconclusive
information regarding factors influencing treatment outcome, and this
emphasizes the need for further observational studies of high quality.
29. The radiographic outcomes of direct pulp-capping procedures
performed by dental studen ts: a retrospective study Al-Hiyasat AS,
Barrieshi-Nusair KM, Al-Omari MA.
AIM: The decision between pulp capping and root canal therapy after pulp exposure is a clinical
issue. The aim of the authors' study was to evaluate the outcome of direct pulp-capping
procedures performed by dental students.
Methods: The authors followed the treatment outcomes of 193 patients with 204 pulp exposures
with direct pulp capping. They determined the outcome of pulp capping radiographically using
periapical radiographs taken at least three years after pulp exposure. The outcome was considered
as successful if the tooth was present and not associated with periapical radiolucency or root
canal treatment; otherwise, the outcome was considered as being a failure.
Conclusion: The success rate of direct pulp capping was 92.2 percent with mechanical exposure
and 33.3 percent with carious exposure.
Clinical implications: Direct pulp capping is recommended after mechanical exposure with
immediate placement of permanent restoration, while root canal therapy would be the choice of
treatment if the exposure was due to caries.