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Two different types of pulp cap are distinguished. In direct pulp capping, the protective dressing is placed directly over an exposed pulp; and in indirect pulp capping, a thin layer of softened dentin, that if removed would expose the pulp, is left in place and the protective dressing is placed on top. [4]
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.
Some caries excavation methods lead to leaving caries-affected dentin behind to serve as the bonding substrate, mostly in indirect pulp capping. It is reported that the immediate bond strengths to caries-affected dentin are 20-50% lower than to sound dentin, and even lower with caries-infected dentin. [2]
They are commonly used as pulp capping agents and lining materials for silicate and resin-based filling materials. [3] Calcium-silicate liner used as a pulp capping material. It is usually supplied as two pastes, a glycol salicylate and another paste containing zinc oxide with calcium hydroxide. On mixing, a chelate compound is formed.
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.
In pulp therapy, areas of decay and infected pulp tissue are removed, then the pulp is sealed with medicaments. [5] Medicaments are medications placed over the pulp to maintain survival and promote repair. Treatment options include: Indirect pulp capping (IPC) Direct pulp capping (DPC) Pulpotomy; Pulpectomy
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An indirect restoration fabricated on model from Ips emax ceramic ready to be cemented on natural tooth structure. In this technique the restoration is fabricated outside of the mouth using the dental impressions of the prepared tooth. Common indirect restorations include inlays and onlays, crowns, bridges, and veneers.