title: Indirect pulp therapy: an alternative to pulpotomy in primary teeth.
abstract: Preservation of the primary teeth until their normal exfoliation is essential for normal oral function and facial growth of the child. To that end, treatment of primary teeth with large carious lesions approximating the pulp should be aimed at preserving the tooth. Currently, the pulpotomy is the most frequently used pulp treatment for cariously involved primary teeth. The purpose of this manuscript is to describe the use of an alternative to the pulpotomy, indirect pulp therapy (IPT), for the treatment of vital, primary teeth with carious involvement approaching the pulp. Accurate diagnosis of the vitality status of the pulp is critical to the success of IPT and involves careful radiographic and clinical assessment of the teeth to be sure they are healthy or at worst, reversibly inflamed. The indications for IPT are the same as for pulpotomy. The technique involves one appointment, requires that some carious dentin be left to avoid pulp exposure and requires the placement of a biologically sealing base and sealing final restoration. Teeth treated with IPT have success rates at least as good as those treated with pulpotomies, and IPT offers an acceptable alternative to pulpotomy as a treatment for vital, asymptomatic, cariously involved primary teeth.
authors.affiliation: Department of Pediatric Dentistry, Baylor College of Dentistry--Texas A&M Health Science Center, Dallas, Texas, USA. sseale@bcd.tamhsc.edu
authors.forename: N Sue
authors.initials: NS
authors.lastname: Seale
mesh_terms: D003731:Dental Caries / Q000000981:diagnostic imaging / Q000628:therapy*; D003738:Dental Cements / Q000627:therapeutic use; D003743:Dental Enamel / Q000473:pathology; D003751:Dental Fistula / Q000000981:diagnostic imaging; D003782:Dental Pulp / Q000000981:diagnostic imaging / Q000503:physiopathology; D003785:Dental Pulp Capping / Q000379:methods*; D003789:Dental Pulp Exposure / Q000517:prevention & control; D003790:Dental Pulp Necrosis / Q000175:diagnosis; D003804:Dentin / Q000473:pathology; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D057872:Pulp Capping and Pulpectomy Agents / Q000627:therapeutic use; D011671:Pulpitis / Q000175:diagnosis / Q000628:therapy; D011672:Pulpotomy; D016300:Radiography, Bitewing; D014094:Tooth, Deciduous / Q000000981:diagnostic imaging / Q000473:pathology*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D003738:Dental Cements; D057872:Pulp Capping and Pulpectomy Agents