title: Direct pulp capping of carious primary molars. A specialty practice based study.
abstract: OBJECTIVE
  Recommendations against direct pulp capping (DPC) for carious primary teeth are based on old, low level evidence. This study investigates the medium to long-term clinical and radiographic outcomes of such treatment.
  
  
  METHODS
  Each of 62 3-9 year old children with any deep, primary molar cavity was included if a pulp exposure occurred during caries excavation. Exclusion criteria were irreversible pulp damage/uncontrolled hemorrhage. Using rubber-dam, fast setting calcium hydroxide (CH) and tooth restoration were placed. Patients were followed up for signs/symptoms. Survival analysis, the Kaplan-Meier method and the Mantel-Cox test were usedfor statistically analyzing the data.
  
  
  RESULTS
  Seven patients (11.3%) dropped out. Controlled hemorrhage occurred in 25 exposures. Fourteen exposures were large and 46 were pin point. Out of 60 primary molars with DPC (in 55 patients), 7 failed by clinical and/or radiographic criteria. The remaining 53/60 (88.3%) teeth survived for 21.0 (±9.0) months. The 4 year cumulative survival rate by Kaplan-Meier analysis was 80%. All restorations remained in place with 3 needing replacement without affecting pulp survival.
  
  
  CONCLUSIONS
  The CH success rate of carious primary molar DPC justifies further research based on careful initial diagnosis ofpulp inflammation reversibility.
authors.affiliation: Department of Pediatric Dentistry, University of Thessaloniki, Greece.  kotsanos@dent.auth.gr
authors.forename: N
authors.initials: N
authors.lastname: Kotsanos
authors.forename: K N
authors.initials: KN
authors.lastname: Arapostathis
authors.forename: A
authors.initials: A
authors.lastname: Arhakis
authors.forename: G
authors.initials: G
authors.lastname: Menexes
mesh_terms: D002126:Calcium Hydroxide / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D055812:Community-Based Participatory Research; D003188:Composite Resins / Q000737:chemistry; D003731:Dental Caries / Q000628:therapy*; D003785:Dental Pulp Capping / Q000379:methods*; D003789:Dental Pulp Exposure / Q000628:therapy; D003793:Dental Restoration, Permanent / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000737:chemistry; D006470:Hemorrhage / Q000628:therapy; D006801:Humans; D008297:Male; D008963:Molar / Q000473:pathology*; D011446:Prospective Studies; D057872:Pulp Capping and Pulpectomy Agents / Q000627:therapeutic use; D016300:Radiography, Bitewing; D019279:Resin Cements / Q000737:chemistry; D019233:Retreatment; D015996:Survival Rate; D014094:Tooth, Deciduous / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D003188:Composite Resins; D005899:Glass Ionomer Cements; D057872:Pulp Capping and Pulpectomy Agents; D019279:Resin Cements; D002126:Calcium Hydroxide