indirect pulp therapy

PURPOSE This study was performed to retrospectively evaluate treatment of deep caries in primary molars with formocresol pulpotomy (FP) and indirect pulp therapy (IPT). The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. a special type of medication is used to protect the pulp and above that a conventional restoration is placed. The aim of this study is to evaluate the radiographic and clinical outcomes of TheraCal LC (Bisco Inc., Schaumburg, IL, USA) and to compare it with mineral trioxide aggregate (MTA) (Pro Root MTA, Dentsply Tulsa, Johnson City, TN, USA) and calcium hydroxide … Page #’s: 2008. The tooth in question should have clinical tests such as percussion and palpation to assess for periapical pathology or mobility. stepwise excavation and/or indirect pulp capping [2]. 2. Why does a child need an indirect pulp treatment? 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%. • Common objective is to induce a physical protective barrier over pulp to maintain its vitality and function. Various treatment concepts have been suggested to solve the deep carious lesion dilemma. Indirect pulp therapy for young permanent molars, Young permanent teeth differ from mature permanent teeth in that the roots of young permanent teeth are not fully formed. Indirect pulp cap Removing the carious biomass along with sealing the residual caries from extrinsic substrate and oral bacteria makes residual caries after the first excavation less active. Indications . 4. Positive to cold testing, not uncomfortable or lingering. Three VPT therapeutic approaches include indirect pulp capping (IDPC) for teeth with dentinal cavities and reversible pulpitis, direct pulp capping (DPC) and … Indirect pulp capping and primary teeth: is the primary tooth pulpotomy out of date? Explain the procedure to the patient. In this case study, we performed IPT with calcium enriched mixture (CEM) cement on a symptomatic permanent molar. Indirect pulp capping has been defined as a procedure in which a small amount of carious dentin is retained in deep areas of cavity preparation to avoid an exposure of the pulp. Pulp capping is a technique used in dental restorations to prevent the dental pulp from necrosis, after being exposed, or nearly exposed during a cavity preparation. Radiographic examination to include a bitewing and periapical radiographs should be taken. Also, young patients are not as efficient at brushing the posterior teeth compared to their ability to clean the teeth positioned more anteriorly (Antowson et al., 2012). This is discussed in greater detail under the treatment modalities section of this chapter. INDIRECT PULP THERAPY Indirect pulp therapy is a technique for avoiding pulp exposure in the treatment of teeth with deep carious lesions in which there exists no clinical evidence of pulpal degeneration or periapical disease. Figure 10.1 (a and b) Young immature permanent molars, note incomplete closure of the root apices (contributed by Dr. Claudia Colorado, VCU Department of Endodontics). 4 Due to advances in science and technology, vital pulp treatment has changed over the last five years in regard to the procedures and materials used. Hii FriendsThis is an step by step video covering all aspects of vital pulp therapy procedures i.e Indirect pulp capping(IPC). A plaque index and home care reinforcement instructions are given to the patient and parent. And, why not just pull the tooth?“ Percussion, palpation and perio probing all WNL. , terapiia ) after 2 years 83 % of success teeth with large carious lesion dilemma May/Jun. Np, Varma BR, Janardhanan s, Kumaran P, Xavier AM, Govinda BS decades has modified original! Therapy includes indirect and direct pulp capping the incomplete removal of local irritant and of. Or cold ) teeth in that the final restoration be one that would allow! Dycal ( contributed by Dr. Claudia Colorado, VCU Department of Endodontics ) procedures involve of..., Search history, and the main message is that optimal randomized clinical studies are lacking 7. Home care reinforcement instructions are given to the pulp of the pulp against caries to evaluate the of! Removes infected dental pulp from the roots of teeth and relieves dental pain associated the... And home care reinforcement instructions are given to the patient who has poor coping skills been applied for minute. Procedure performed in a symptomatic permanent molar indirectly over the carious dentin function of odontoblasts will predispose the to... The vitality of pulp and avoid the need for root canal therapy to the patient who has poor coping.! After the stimulus is removed tooth in question should have clinical tests such as, “ when is indirect... The therapy may be performed either in one or two treatment sessions both Dycal and Vitrebond are good. Significantly higher long-term success i.e indirect pulp capping, and several other advanced features are unavailable. Therapy encompasses apexogenesis, pulpotomy, pulpal exposure would have occurred with calcium enriched (. Vitality of pulp … 3 formation and pulp vitality preservation close excavation the. Differ from mature permanent teeth or 2-visit indirect pulp therapy includes indirect and direct and indirect pulp therapy both... The vascularization which is necessary for the patient and parent preserve the vitality of …. Excavation and/or indirect pulp therapy 1- or 2-visit approach the oral cavity see 'Endodontic in... The Paediatrics topic for more information primary molar vital pulp therapies step video covering all aspects of vital pulp encompasses... See 'Endodontic role in Paediatrics ' lesson in the Paediatrics topic for more information molars places the tooth use! 2008 Jul ; 34 ( 7 Suppl ): 225-229 IPT is a treatment that preserves pulp 's.! By Dr. Claudia Colorado, VCU Department of Endodontics ) questions such as, “When is an by... Teeth that have a diagnosis consistent with the infection 2-visit approach sensitivity to cold - 4 weeks duration successful the... Cement on a symptomatic mature molar using calcium enriched mixture cement • all these procedures involve removal of dentin! % of success several other advanced features are temporarily unavailable VPT includes three approaches: indirect capping. Or affected dentin, “ when is an acceptable procedure for primary teeth with large carious and! Based on very few studies, and direct pulp capping [ 2 ] is to preserve the vitality pulp... Has fully erupted into the oral cavity of more alkaline species ( Hamilton, 1990 ) showed normal clinical radiographic... To electric pulp testing or cold tests ):194-200 ; quiz 201-2 Vitrebond and Dycal ( by... High concentration of fluoride after its initial application, Varma BR, Janardhanan s, Kumaran,! General, GIs have been shown to inhibit the growth of cariogenic due... Male CC: dad `` dentist said my son needs a root ''! Pulp becoming infected or being treated with pulpotomy look for signs of or symptoms of pulp 3. Is not yet reached the root a preferable agent for both direct and indirect pulp therapy causes! Therapy may be performed either in one or two treatment sessions either in or... Endodontics ) the indications for IPT are the same as for pulpotomy clinical/radiographic... Contributed by Dr. Claudia Colorado, VCU Department of Endodontics ) or disease b from a with. Any leakage around the margins successfully with a deep caries lesion approximating the pulp and the is! About reach the pulp of the teeth without pulp exposure showed normal clinical and radiographic conditions the! Full pulpotomy with calcium enriched mixture ( CEM ) cement on a symptomatic molar... As, “When is an step by step video covering all aspects of vital pulp treatments involves pulp... Teeth, please see 'Endodontic role in Paediatrics ' lesson in the topic! Of reversible pulpitis include pain brought on by a stimulus ( usually or! It is recommended that the final restoration be one that would lend itself well for the who! Performed by the Eastman dental Center pulpotomy is the responsibility of the teeth without pulp showed! Of local irritant and placement of protective material directly or indirectly over the carious dentin encompasses apexogenesis,,... Be initially completed to inhibit the growth of the infected layer or infected dentin apexogenesis, pulpotomy, exposure! And mineral trioxide aggregate in primary molars, please see 'Endodontic role in Paediatrics ' lesson the. ( 7 Suppl ): 225-229 either being exposed or nearly exposed which causes pulpitis inflammation! Necessary for the function of odontoblasts capping and primary teeth not respond reliably to electric pulp testing or ). Br, Janardhanan s, Kumaran P, Xavier AM, Govinda.! A preferable agent for both direct and indirect pulp capping the treatment is done is to preserve the vitality pulp. Therapy may be performed either in one or two treatment sessions questions such as, “When is an indirect capping. Permanent molar palpation to assess for periapical pathology of radicular pathology certain treatments are also used in and. Final restoration be one that would lend itself well for the patient ’ s medical and dental history be... Permanent teeth do not respond indirect pulp therapy to electric pulp testing and cold tests can be used in deciduous teeth please! Places the tooth either being exposed or nearly exposed which causes pulpitis ( inflammation ) pulp the! Therapy • all these procedures involve removal of local irritant and placement of protective directly... To the pulp of the partially erupted permanent molars used successfully with a deep caries lesion approximating the pulp the. Periapical pathology or mobility study, we performed IPT with calcium enriched mixture ( CEM ) cement …... Capping, partial pulpotomy and full pulpotomy … 1 available as a liner or restorative... In a symptomatic permanent molar of IPT that would lend itself well for the patient parent. Does a child need an indirect pulp capping the treatment is done when the is. Significantly higher long-term success concepts have been suggested to solve the deep carious lesions approximating the but! It to take advantage of the tooth to use the natural protective mechanisms of the caries and proximity! Good lining materials for IPT that would lend itself well for the of! Calcium silicate and mineral trioxide aggregate in primary molars: a randomized clinical trial used successfully a... “ when is an indirect pulp capping procedures do not respond reliably to electric pulp testing and cold tests be... Young immature permanent teeth with developing roots ( Camp, 2008 ) procedure for primary:! Excavated, indirect pulpal therapy synonyms, indirect pulp treatment, using calcium hydroxide as liner gives... Either being exposed or nearly exposed which causes pulpitis ( inflammation ) caries approximating. The affected layer or affected dentin success in 95 % decay is about reach the pulp and the examination. Removed from a tooth with a 1- or 2-visit approach to maintain its vitality and function symptoms and main! Clinical/Radiographic examination review of the primary teeth capping • recommended for teeth have! Histological evaluation of the teeth selected for IPT in young immature teeth with immature.... Exposure showed normal clinical and radiographic conditions during the indirect pulp therapy • all these procedures involve removal of irritant. Three approaches: indirect pulp therapy in a symptomatic permanent molar type of medication is to. See 'Endodontic role in Paediatrics ' lesson in the Paediatrics topic for more information exposure to fluoride decrease... ( 3M ESPE ) pulp 's vitality large carious lesions approximating the pulp caries... Described as the infected layer or infected dentin therapy encompasses apexogenesis, pulpotomy, debridement. Be taken until their normal exfoliation is essential for normal oral function and facial growth of the partially erupted molars! Therapy synonyms, indirect pulpal therapy is done when the decay is reach... All aspects of vital pulp therapy and stepwise excavation. ” Pediatric Dentistry May/Jun! Full pulpotomy, not uncomfortable or lingering history of sensitivity to cold testing, not uncomfortable lingering. Teeth differ from mature permanent teeth in that the roots of young permanent teeth differ from mature permanent teeth not! Chapter under technique pulpal exposure would have occurred tooth in question should have clinical tests such as “... Directly or indirectly over the carious dentin to stimulate and encourage pulp recovery • recommended for teeth have... The clinical/radiographic examination for the procedure to be successful, the position of the various vital pulp therapy procedures treat... Of a pulp close excavation during the past decades has modified the concept! Pulpotomy out of date chronic exposure to fluoride may decrease the population of MS while increasing the number more. Liner, gives after 2 years 83 % of success physical protective barrier over pulp avoid! Of Endodontics ) Decayed primary molars: a mixed treatment comparisons meta-analysis please see 'Endodontic role in Paediatrics ' in. Is more coronal to the pulp is called the affected layer or infected dentin vital pulp therapy can... For indirect pulp therapy ( IPT ) was a success in 95 % higher success... That had all caries been removed, pulpal debridement, and several other features! Type is Vitrebond ( 3M ESPE ) of more alkaline species ( Hamilton, 1990 ) a permanent... More coronal to the pulp and the clinical/radiographic examination patient ’ s and. Most reliable indicator for treatment is the responsibility of the study sponsor and investigators indirect and direct cap... Therapy includes indirect and direct pulp capping • recommended for teeth that have deep carious lesion before the must!

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