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Indications for direct pulp capping include: [5] Immature/mature permanent teeth with simple restoration needs; Recent trauma less than 24 hours (less according to tichy [clarification needed]) exposure of pulp / mechanical trauma exposure (during restorative procedure)
Pulp capping is a method to protect the pulp chamber if the clinician suspects it may have been exposed by caries or cavity preparation. Indirect pulp caps are indicated for suspected micro-exposures whereas direct pulp caps are place on a visibly exposed pulp.
Direct pulp capping (DPC) is a treatment performed when a pin-point or small pulp exposure of 1mm or less occurs after removal of carious tooth material (dentin) excavation. The pulp is covered with a medicament.
Due to its physical properties and biocompatibility, MTA has been used in numerous clinical situations other than as a root-end filling. It is widely used to repair perforations, to close open apices in apexification, as a direct pulp capping material for deep carious tooth, and to cover pulp stumps for apexogenesis.
It can be used for root-end filling material and as pulp capping material. It has better pulpotomy outcomes than calcium hydroxide or formocresol, and may be the best known material, as of 2018 data. [1] For pulp capping, it has a success rate higher than calcium hydroxide, and indistinguishable from Biodentin. [2]
Fracture involving enamel and dentine with pulp exposure Tooth not tender with normal mobility Exposed pulp will be sensitive to stimuli Loss of enamel and dentine May need lip or cheek x-ray to locate tooth fragments or other materials In developing teeth, preserve pulp vitality by pulp capping or partial pulpotomy using calcium hydroxide
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It is the growth of this dentin that causes a decrease in the size of the pulp chamber with age. This is clinically known as pulp recession; cavity preparation in young patients, therefore, carries a greater risk of exposing the pulp. If this occurs, the pulp can be treated by different therapies such as direct pulp capping.