Pulp capping direct

Alternatively the pulp may be saved by the process of pulp capping. This involves placing some sort of material over the pulp to protect it and maintain its viability so that more extreme treatment (extraction or endodontic therapy) can be avoided [1]. Two possible approaches are available, namely direct pulp capping, in which a bioactive material is placed directly over the exposed pulp, and indirect pulp capping, in which a cavity liner or sealant material is placed over a residual thin layer of dentine, which may be sound or carious. In the latter approach, the pulp has not been exposed, but it is at risk of becoming so either by the progress of the residual caries or by the process of tooth preparation. 

Direct pulp capping involves placing a pulp capping material directly over the exposed pulp with the aim of promoting pulp healing and the generation of reparative dentine [1], When this procedure is applied successfully, it eliminates the need for alternative, more invasive treatments. 

There is evidence that the pulp is more likely to survive if exposure occurs by accident during tooth preparation rather than due to the progression of caries [11,12], This is because caries penetration is inevitably associated with bacterial invasion, and therefore results in infection and inflammation of the pulp [10], By contrast, exposure due to a mechanical misadventure during tooth preparation does not necessarily result in bacterial invasion. Consequently, the exposed pulp does not become infected or inflamed. As a result, teeth repaired by direct pulp capping following this type of exposure are generally better able to survive with their pulp intact than those whose pulps become exposed due to advancing caries [11]. 

I. Baume, J. Holz, Long-term clinical assessment of direct pulp capping, Int. Dent. J. 31 (1981)251-260. 

A. Al-Hiyasat, K. Bairieshi-Nusair, M. Al-Mari, The radiographic outcomes of direct pulp-capping procedures performed by dental students, J. Am. Dent. Assoc. 137 (2006) 1699-1705. 

T. Matsuo, T. Nakanshi, H. Shuimizu, S. Ebisu, A clinical study of direct pulp capping applied to carious-exposed pulps, J. Endod. 22 (1996) 551-556. 

H. Stanley, Criteria for standardizing and increasing credibility of direct pulp capping studies. Am. J. Dent. 11 (Spec. No.) (1998) S17-S34. 

G. Bogen, J.S. Kim, L.K. Bakland, Direct pulp capping with mineral trioxide aggregate, an observational study, J. Am. Dent. Assoc. 139 (2008) 305-315. 

Y. Kitasako, S. Shibata, J. Tagami, Migration and particle clearance from hard-setting Ca(OH)j and self-etching adhesive resin following direct pulp capping. Am. J. Dent. 19 (2006) 370-375. 

J. Mente, B. Geletneky, M. Ohle, M.J. Koch, P.G.F. Ding, D. Wolff, J. Dreyhaupt, N. Martin, H.J. Staehle, T. Pfefferle, Mineral trioxide aggregate or calcium hydroxide direct pulp capping an analysis of the chnical treatment outcome, J. Endod. 36 (2010)... 

R. Caicedo, P. Abbott, D. Alongi, M. Alarcon, Clinical, radiographic and histological analysis of the effects of mineral trioxide aggregate used in direct pulp capping and pul-potomies of primary teeth, Aust. Dent. J. 51 (2006) 296-305. 

N. Farsi, N. Alamoudi, K. Balto, A. Mushayt, Clinical assessment of mineral trioxide aggregate (MTA) as direct pulp capping in young permanent teeth, J. CUn. Pediatr. Dent. 31 (2006) 72-76. 

M.S. Marques, P.R. Wesselink, H. Shemesh, Outcome of direct pulp capping with mineral trioxide aggregate a prospective study, J. Endod. 41 (2015) 1026-1031. 

Yanagiguchi, K., Ikeda, T., Takai, R, Ogawa, K., and Hayashi, Y. 2001. Wound heahng following direct pulp capping with chitosan-ascorbic acid complex in rat incisors. In Chitin and Chitosan—Chitin and Chitosan in Life Science, eds. T. Uragami, K. Kurita, and T. Fukamizo, pp. 240-242. Tokyo, Japan Kodansha Scientific. 

---