Direct Pulp Capping With Mineral Trioxide Aggregate: An Observational Study
Section snippets
METHODS AND MATERIALS
All patients in our study had been referred for endodontic treatment to a private office or the Children's Dental Health Clinic, Long Beach, Calif., and had completed periapical radiographs, periodontal probing, percussion testing and vitality assessment with cold testing. The primary author (G.B.) selected 53 teeth for treatment over an eight-year period that included 51 molars, one maxillary premolar and one maxillary incisor. All teeth exhibited initial deep caries and no prior
RESULTS
We observed 49 of 53 teeth in 37 of the patients between one and nine years (mean, 3.94 years) with a recall rate of 92.5 percent (n = 49). Three patients did not return for recall appointments and evaluations. The patients varied in age from 7 to 45 years, the mean age being 16.6 years. There were 22 females and 15 males. Three patients subjectively complained of moderate-to-severe pain before treatment; cold testing revealed a normal (nonlingering) response in 48 of 50 teeth. Pulpal exposure
DISCUSSION
Radiographic assessment of teeth that had open apexes showed that 100 percent (15/15) had progressed to complete root formation and apex closure. We noted radiographic evidence of dentin bridge formation in 82 percent of cases (40/49) and found normal PDL thickness in all observed teeth. We also noted calcifications or pulpal stone formation in 10.2 percent (5/49) of the evaluated teeth. Root canal width and pulpal volume remained approximately the same in 89.8 percent (44/49) of the cases.
CONCLUSION
The use of MTA, enhanced magnification, caries removal using a caries detector dye, NaOCl hemostasis/disinfection, and a fifth-generation hydrophilic resin and composite is part of a reliable two-visit pulp-capping protocol for direct carious exposures when the pulpal diagnosis is no more severe than irreversible pulpitis. Clinicians should be aware that the treatment described was performed by one operator; we cannot claim that every clinician will obtain similar results. Careful attention to
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2023, Journal of Dental SciencesCitation Excerpt :In our study, on the contrary, 48.5% of patients received RCT, and VPT was the second most frequent endodontic treatment (37.9%), which demonstrated that clinicians preferred to provide less invasive procedures and preserve the vitality of the pulp. The condition of the pulp tissue plays a decisive role in the outcome of conservative VPT.13 In a clinical setting, the accurate assessment of the pulp status is one of the greatest challenges for clinicians.
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Disclosure: None of the authors reported any disclosures.
The authors thank Dr. Mahmoud Torabinejad, director, Advanced Education in Endodontics, Loma Linda University, Calif., and Dr. Nicholas Chandler, associate professor, Department of Oral Rehabilitation, School of Dentistry, University of Otago, Dunedin, New Zealand, for their support and mentorship.
- 1
Dr. Bogen maintains a private endodontic practice, 321 N. Larchmont Blvd., Suite 721, Los Angeles, Calif. 90004
- 2
Dr. Kim is a professor of biostatistics, Loma Linda University, Calif.
- 3
Dr. Bakland is a professor and the chairman, Department of Endodontics, Loma Linda University, Calif.