HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) A correction has been published Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Bogen, G. Articles by Bakland, L. K. PubMed PubMed Citation Articles by Bogen, G. Articles by Bakland, L. K.

JADA Continuing Education

An Observational Study

Background. Pulp capping in carious teeth has been considered unpredictable and therefore contraindicated. A recently developed material, mineral trioxide aggregate (MTA), resists bacterial leakage and may provide protection for the pulp, allowing repair and continued pulp vitality in teeth when used in combination with a sealed restoration.

Methods. Forty patients aged 7 to 45 years accepted pulp-capping treatment when they received a diagnosis no more severe than reversible pulpitis after undergoing cold testing and radiographic examination. The primary author removed caries using a caries detector dye and sodium hypochlorite solution for hemostasis and placed MTA over the exposures and all surrounding dentin. The operator then restored the teeth provisionally with unbonded Clearfil Photocore (Kuraray Medical, Okayama, Japan). During a second visit, the operator restored the teeth with bonded composite after sensibility testing and confirmed MTA curing. At recall appointments, patients were evaluated for reparative dentin formation, pulpal calcification, continued normal root development and evidence of pathosis.

Results. Over an observation period of nine years, the authors followed 49 of 53 teeth and found that 97.96 percent had favorable outcomes on the basis of radiographic appearance, subjective symptoms and cold testing. All teeth in younger patients (15/15) that initially had had open apexes showed completed root formation (apexogenesis).

Conclusions. MTA can be a reliable pulp-capping material on direct carious exposures in permanent teeth when a two-visit treatment protocol is observed.

Practice Implications. Vital pulp therapy using MTA is a treatment option for teeth diagnosed with a condition no more severe than reversible pulpitis.

Key Words: Reversible pulpitis; direct pulp capping; mineral trioxide aggregate; sodium hypochlorite

Abbreviations: MTA: Mineral trioxide aggregate. • NaOCL: Sodium hypochlorite. • PDL: Periodontal ligament.