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The rationale for using calcium hydroxide should be reserved for iatrogenic exposures in asymptomatic teeth expected to exfoliate within a short period of time. 5% failure rate. Second, the sample size was calculated on the basis of 2 previous studies analyzing success rates after pulp capping using the 2 materials. Clinical assessments of the MTA versus calcium hydroxide for direct pulp capping suggested that MTA was superior to calcium hydroxide in direct pulp capping resulting in a lower failure rate (risk difference 0.1 [95% CI 0.04 to … Considering this, the findings of the present study must be viewed with caution. Calcium Hydroxide and mineral trioxide aggregate (MTA) have both been used. Statistically significant difference was found between the success rates of MTA and calcium hydroxide treated teeth that needed direct pulp capping (P=0.002). Two of the disadvantages of this form of treatment are infection of the pulp, either preoperatively or postoperatively due to a non-sterile procedure or bacterial leakage at the capping site. INTRODUCTION: Direct pulp capping is a treatment option for teeth with carious-exposed pulp. 16. It is recommended that teeth should be followed after direct pulp capping for longer times to evaluate the long-term success rate. So that is not to say Durelon wouldn’t work, but based on the literature calcium hydroxide might improve your success rates. The listed success rates in the literature for direct pulp capping during caries excavation vary substantially [12, 56, 76]. Direct pulp capping in primary teeth due to a carious exposure is not indicated but is used in permanent teeth. 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. Direct pulp capping Indirect pulp capping 15. The success rates of direct pulp-capping with calcium hydroxide decrease as follow-up periods increase. The procedure typically involves arresting any pulpal hemorrhage followed by covering and sealing exposed pulp tissue in some fashion to preserve its health, function, and viability. Clinical success rate of indirect pulp capping using both materials at 24 months was 72% (39/54). Being a large difference, it could have underestimated the sample size. • Haskell and colleagues: success rate of 87.2% after five years. Direct pulp capping (DPC) and calcium hydroxide has been widely used with high success rates in young permanent teeth, but the results in primary teeth are less satisfactory [3,4]. The purpose of this study was to compare the clinical and radiographic success rate of direct pulp capping (DPC) and partial pulpotomy (PP) treatment using MTA as pulp capping agent in treatment of primary teeth with pulp exposure after direct complete excavation. The most effective material was anything with calcium hydroxide in it. The frequency of pulp necrosis and infection was 10.1% (11/109) for partial pulpotomy and 9.8% (22/205) for coronal pulpotomy. 4 year old boy. Conclusions MTA-capped teeth demonstrated a slightly higher success rate than CH, revealing that it can be recommended as a reliable direct pulp-capping material. 1. Indirect pulp capping • procedure where the deepest layer of the remaining affected carious dentin is covered with layer of biocompatible material in order to prevent pulpal exposure and further trauma to pulp. Conclusion: The success rate of direct pulp capping was 92.2 percent with mechanical exposure and 33.3 percent with carious exposure. 2019 Jul;45(7):840-847. doi: 10.1016/j.joen.2019.02.025. Direct Pulp Cap The exposed pulp is directly covered. Because pulp capping studies have exhibited fluctuations in success rates according to different follow-up times, investigating the clinical pulpal survival rate and the potential factors contributing to the survival with respect to time is necessary. 16. ... Table 1: Criteria of selection in the modified technique of direct pulp capping . Results: The study involved 375 teeth treated with direct pulp capping, partial or coronal pulpotomy, and direct pulp capping retreated by pulpotomy (partial or coronal). • Fitzgerald and Heys: 79% success rate after one year. The teeth which met the criteria were treated following the steps shown in Table 2, after warning each patient of the possibility of having to have endodontic therapy in case of tooth pain or evidence of of infection. Objective : The main aim of this study is to determine the 3 months success rate (defined as clinical and radiographic successes together) of direct pulp capping realized with Biodentine®. Clinical success rate for Biodentine™ was 77.8% (21/27) and for Fuji IX™ 66.7% (18/27) at 24 months. C. 12 months after DPC. Conclusions: … The success rate of direct pulp capping was 59.3%, associated more with traumatic exposure than with carious exposure (75 % versus 29.03%, p˂0,001) and more with class I occlusal restorations (85.71%) than with proximal restorations (class II 59.09%, class III 66.67%, p=0,009). VIII- Prognosis of direct pulp capping: Success rates range from 13% to 98% in one to 10 years retrospective studies: • Armstrong and Hoffman: 97.8% success rate after 1.5 years. Remaining dentin thickness(0.5-2mm) Choice of indirect pulp capping agent. ... DPC: Direct pulp capping; CS: Calcium silicate-based cement; MTA: Mineral trioxide aggregate; CH: Calcium hydroxide Table 2 The search strategy used in PubMed (MedLine) No. Though CaOH cements are clinically effective, MTA cements are a superior choice for pulp capping as long as the high cost, challenging handling properties, long setting time, and discolouration potential are acceptable in the situation. Search terms No. Epub 2019 May 16. In cariously exposed pulps, the effectiveness of direct pulp cap varies. Under the premise of correct indication and technical implementation, direct pulp capping using calcium hydroxide can reach success rates of nearly 60 % after 10 years [76, 110]. doi: 10.1016/j.adaj.2018.01.040. Clinical Relevance. FACTORS DETERMINING SUCCESS OF IPC. A. Radiograph taken before treatment showing deep carious lesion (teeth 54) and normal periapical conditions. B: Six months after direct pulp treatment using MTA.No visible calcified tissue formation (arrow). Direct pulp capping with Biodentine seems to have an acceptable success rate after 1 to 1.5 years. Only one study conducted by Leye Benoist et al. increased the success rate of IPT. MTA is increasingly being seen as the material of choice. METHODS: The sample of this retrospective study was constituted for 133 teeth treated in a Private clinic in Joinvile, Brazil, by one experienced dentist between 2007 and 2012. The tooth/teeth in question are examined and a decision is made to do direct or indirect pulp capping based on the condition of the tooth. success rate of DPC to pulp-exposed human permanent teeth? The purpose of this study was to compare the clinical and radiographic success rate of direct pulp capping (DPC) and partial pulpotomy (PP) treatment using MTA as pulp capping agent in treatment of primary teeth with pulp exposure after direct complete excavation. Conclusions. Third, a follow-up period of 1 year is short for the evaluation of long-term success of DPC … direct pulp capping is controversially dis-cussed in the literature,and the described success rates fluctuate between 40% and 94%,13–15 the aim of this retrospective study was to evaluate the long-term success of direct capping with a calcium hydroxide based material in permanent teeth. 2018 Jul;149(7):e106. This study aimed to evaluate the influence of preoperative pain in the success rate of indirect pulp capping. proves the efficacy of MTA in IPC procedure with a significant barrier formation when followed up till 6 months interval. DIRECT PULP CAPPING. If the pulp becomes exposed while removing soft infected dentine, the chances are that the pulp will be infected also, and a direct pulp cap will fail (that is, an irreversible pulpitis will develop). MTA proved better than CH in terms of both success rate and pain intensity. Data from retrospective studies have shown success rate, ranged between 30% and 85%., In our research, similar findings were found, when MTA placed as a direct pulp capping material in cariously exposed mature permanent teeth it was effective in 87.06% (74/85). (grossman) • without signs or symptoms of pulp degeneration. Authors Komal Suhag 1 , Jigyasa Duhan 2 , Sanjay … Although the success rate of pulp capping varies from case to case, the success rate is much lower than the success rate of root canals. If a pulp cap fails, as approximately 40 percent of them do, the tooth will require a root canal or extraction. The keys when doing a direct pulp cap are hemmorhage control and an absolute moisture seal, and the existing bacterial contamination and inflammation in the pulp before the procedure. Direct pulp capping is used when the pulp is visibly exposed (vital pulp exposure) due to caries, trauma, or iatrogenic insult such as accidental exposure during tooth preparation or caries removal. A recent systematic review of vital pulp therapy in vital permanent teeth with cariously exposed pulps reviewed success rates of direct pulp capping.3 In this review the success rate of direct pulp capping was reported as >6 months-1 year, 87.5%; >1-2 years, 95.4%; >2-3 years, 87.7% and >3 years, 72.9%. R. Kabaktchieva, N. Gateva. Defined as a procedure in which the exposed vital pulp is covered with a protective dressing or base placed directly over the site of exposure in an attempt to preserve the pulp vitality. Laser light cavity preparation resulted in a mean 88% success rate in 3 articles. Biodentine® is the most recent material and its success rate for direct pulp capping is poorly documented. Rates are more than 90% after 1 to 2 years and drop from 82% to 37% after 2 to 5 years48), or to 80%, 68% and 59% after 1, 5 and 9 years, respectively49). Aguilar and Linsuwanont [ 36 ] calculated the pooled success rates of 996 teeth after direct pulp capping, finding 87.5% success at 6 months to 1 year, 95.4% success at 1–2 years, 87.7% success at 2–3 years, and 72.9% success after 3 years. Epub 2018 Mar 20. Success of Direct Pulp Capping and Partial Pulpotomy of Primary Teeth using MTA. Direct pulp capping, where a medicament is placed over exposed dental pulp in order to maintain pulp vitality has success rates reported of between 13-95%. In case of direct pulp capping, the procedure is carried out in a single sitting with follow up appointments to determine the success of the procedure. There was no difference between partial and coronal pulpotomy (P=.673). No significant difference p = 0.07) was found in the success rate at 24 months between the two materials. J Am Dent Assoc. Success in direct pulp capping has been established with MTA; however, the success in IPT has not been reported yet. Figure 1: G.St. Appropriate definitions, history and success rates of direct pulp capping procedures are reviewed. Results: An apparent success rate of 48.5% was obtained versus a 51. Success of Direct Pulp Capping Using Mineral Trioxide Aggregate and Calcium Hydroxide in Mature Permanent Molars with Pulps Exposed during Carious Tissue Removal: 1-year Follow-up J Endod. The other aims are to determine the factors which have an influence over the success or … stimulate pulpal defenses.6-8 Success rates with direct pulp capping in a carious field have varied depending on the technique and materials. This works best when the exposure is not infected - for example a traumatic exposure caused by slipping with the drill. 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