Pulp exposure occurrence and outcomes after 1- or 2-visit indirect pulp therapy vs complete caries removal in primary and permanent molars

Pediatr Dent. Jul-Aug 2010;32(4):347-55.

Abstract

Purpose: The purpose of this study was to examine whether 1- or 2-visit indirect pulp therapy (IPT) is more successful and to determine if the operator can successfully decide when to stop removing caries without exposing the pulp.

Methods: A total of 154 teeth (94 primary second molars and 60 young permanent first molars) were included in the study from a total of 123 4- to 15-year-old patients. The teeth had deep carious lesions but lacked the preoperative signs and symptoms of irreversible pulpitis. The teeth were randomly selected and treated either with 1-visit IPT, 2-visit IPT, or direct complete excavation (DCE). Follow-up examinations were conducted on the teeth over 1 year at 3-month intervals.

Results: The pulp was exposed in 12 teeth (22%) treated by DCE, whereas 3 teeth (6%) were treated by 1-visit IPT and 4 teeth (8%) with 2-visit IPT. A statistically significant difference was found between IPT and DCE groups in terms of pulp exposure (P<.05). The teeth without pulp exposure showed normal clinical and radiographic conditions during the 1-year follow-up, except for 3 primary teeth.

Conclusions: Indirect pulp therapy in both primary and young permanent teeth can be used successfully with a 1- or 2-visit approach.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Calcium Hydroxide / therapeutic use
  • Child
  • Child, Preschool
  • Compomers / chemistry
  • Composite Resins / chemistry
  • Dental Caries / classification
  • Dental Caries / therapy*
  • Dental Cavity Lining
  • Dental Cavity Preparation / methods*
  • Dental Enamel / pathology
  • Dental Materials / chemistry
  • Dental Pulp Exposure / etiology*
  • Dental Pulp Exposure / prevention & control
  • Dental Pulp Test
  • Dental Restoration, Permanent
  • Dental Restoration, Temporary
  • Dentin / pathology
  • Female
  • Follow-Up Studies
  • Glass Ionomer Cements / chemistry
  • Humans
  • Male
  • Molar / pathology*
  • Pulpotomy
  • Root Canal Therapy
  • Tooth, Deciduous / pathology*
  • Treatment Outcome
  • Zinc Oxide-Eugenol Cement / chemistry

Substances

  • Compomers
  • Composite Resins
  • Dental Materials
  • Glass Ionomer Cements
  • Zinc Oxide-Eugenol Cement
  • Calcium Hydroxide