Knowledge and Utilization of Direct Pulp Capping Procedures Among Dentists
Abstract
Direct pulp capping (DPC) is a procedure in which a medicated dental material is placed on a pulp exposure during the excavation of caries. The main advantage of this procedure is to avoid performing more invasive procedures such as endodontic therapy or extraction, and to preserve tooth vitality. However, it has been a controversial subject when performed on adult patients with many clinicians favoring endodontic therapy as the most predictable treatment for permanent teeth. (1,2) Calcium hydroxide (CaOH) was first used in 1930 and shown to be successful for maintaining the vitality of the pulp after a pulp exposure. (3) The first clinical study evaluating CaOH for DPC was conducted in 1963using primary teeth with a reported 85% pulpal survival rate. (4) Since then, CaOH has become the gold standard for DPC as it can induce teeth to create a protective dentinal bridge while healing from a carious pulp exposure. (5) However, a poor long-term success was noted in a evaluating the 5- and 10-year pulpal survival rates of DPC using CaOH with pulpal survival rates of 37% and 13% respectively. (6)The reasons for these failures may be due to the inability to create a long-term seal against bacteria, dissolution of the material over time, and an inability to induce a firm dentinal bridge. (7, 8, 9) There is a growing consensus that using CaOH for DPC after a carious pulp exposure is no longer preferred when compared to non-surgical root canal therapy (NSRCT), which demonstrates 10-year tooth survival rates of 74% (10). However, a tooth requires a full cuspal coverage restoration after NSRCT in order to prevent microleakage and fracture with additional treatment time and cost. (11) Furthermore, compared to avital tooth, an endodontically treated tooth is two to three times more likely to fail due to a higher risk of fracture. (12)
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 05, 2020
- Accession Number
- AD1182672
Entities
People
- Wing T. Chan
Organizations
- Uniformed Services University of the Health Sciences