The pulp capping procedure in primary teeth "revisited".
The purpose of this review is to "revisit" an earlier paper (1992) on the subject of direct pulp capping in primary teeth and bring some new considerations for the procedure by the use of dentin bonding adhesives. It has come to be recognized that the customary employment of calcium hydroxide for this therapy has some shortcomings that reduce the prognosis for a favorable outcome. For at least a decade, many investigations have found that postoperative sensitivity, thermal stimuli, pulp inflammation and pathosis can be attributed not to the composition of various dental materials and their insertion techniques, but to microleakage with subsequent bacterial invasion at the enamel/restoration and the dentin/pulp interfaces. It is imperative, as pointed out, that there be an impervious resinous bond between the dentin and the dentinopulpal complex which can be achieved by the use of dentinal adhesive agents to eliminate microleakage outward movement of pulpal fluids. Various steps in the bonding technique for the treatment of deep dentin caries and/or a pulp exposure has raised some concerns for their effect on the pulp. This review discusses these concerns, which can lead to the conclusion that the use of dentinal bonding adhesives is a safe and biologically feasible procedure, whether it be in permanent or primary teeth.
Kopel
H M
HM
Section of Pediatric Dentistry, School of Dentistry, Center for the Health Sciences, University of California, Los Angeles 90095-1668, USA.
D000269:Adhesives / Q000627:therapeutic use; D002126:Calcium Hydroxide / Q000627:therapeutic use; D001840:Dental Bonding; D003731:Dental Caries / Q000628:therapy; D003743:Dental Enamel / Q000382:microbiology; D003763:Dental Leakage / Q000150:complications / Q000382:microbiology; D003782:Dental Pulp / Q000382:microbiology; D003785:Dental Pulp Capping / Q000379:methods; D003788:Dental Pulp Diseases / Q000209:etiology; D003789:Dental Pulp Exposure / Q000628:therapy; D003793:Dental Restoration, Permanent / Q000009:adverse effects; D003804:Dentin / Q000382:microbiology; D017220:Dentin-Bonding Agents / Q000627:therapeutic use; D006801:Humans; D011379:Prognosis; D011671:Pulpitis / Q000209:etiology; D012449:Safety; D014094:Tooth, Deciduous; D014098:Toothache / Q000209:etiology; D016896:Treatment Outcome
D000269:Adhesives; D017220:Dentin-Bonding Agents; D002126:Calcium Hydroxide