Management of Deep Caries and the Exposed Pulp.

08:00 EDT 15th April 2019 | BioPortfolio

Summary of "Management of Deep Caries and the Exposed Pulp."

Caries prevalence remains high throughout the world, with the burden of disease increasingly affecting older and socially disadvantaged groups in Western cultures. If left untreated, caries will advance through dentine stimulating pulpitis and eventually pulp infection and necrosis; however, if conservatively managed pulpal recovery occurs even in deep carious lesions. Traditionally, deep caries management was destructive with non-selective (complete) removal of all carious dentine; however, the promotion of minimally invasive biologically based treatment strategies has advocated for selective (partial) caries removal and a reduced risk of pulp exposure. Selective caries removal strategies can be, one-visit as indirect pulp treatment or two-visit, using a stepwise approach. Management strategies for the treatment of the cariously exposed pulp are also shifting with avoidance of pulpectomy and the re-emergence of vital pulp treatment (VPT) techniques such as partial and complete pulpotomy. These changes stem from an improved understanding of the pulp-dentine complex's defensive and reparative response to irritation, with harnessing the release of bioactive dentine-matrix-components and careful handling of the damaged tissue considered critical. Notably, the development of new pulp capping materials such as mineral-trioxide-aggregate, which although not an ideal material, has resulted in more predictable treatments from both a histological and clinical perspective. Unfortunately, the changes in management are only supported by relatively weak evidence with case-series, cohort studies and preliminary studies containing low patient numbers forming the bulk of the evidence. As a result, critical questions related to the superiority of one caries removal technique over another, the best pulp capping biomaterial or whether pulp exposure is a negative prognostic factor remain unanswered. There is an urgent need to promote minimally invasive treatment strategies in Operative Dentistry and Endodontology; however, the development of accurate diagnostic tools, evidence-based management strategies and education in management of the exposed pulp are critical in the future. This article is protected by copyright. All rights reserved.


Journal Details

This article was published in the following journal.

Name: International endodontic journal
ISSN: 1365-2591


DeepDyve research library

PubMed Articles [13001 Associated PubMed Articles listed on BioPortfolio]

Pulpotomy for carious pulp exposures in permanent teeth: a systematic review and meta-analysis.

The most commonly-accepted strategy for managing irreversible pulpitis, an irreversible condition of dental pulp inflammation, is root canal treatment, which is limited by high costs and complex techn...

State of the Art Enamel Remineralization Systems: The Next Frontier in Caries Management.

The principles of minimally invasive dentistry clearly dictate the need for clinically effective measures to remineralize early enamel caries lesions. While fluoride-mediated remineralization is the c...

Biological properties of modified bioactive glass on dental pulp cells.

Dental caries is a bacteria-caused condition classified among the most common chronic diseases worldwide. Treatment of dental caries implies the use of materials having regenerative and anti-bacterial...

A scoping review of caries risk management protocols in Australia and New Zealand.

To identify and map the caries risk management protocols with multiple strategies, which were used in Australia and New Zealand and reported in the existing literature.

Predictive Validity of a Caries Risk Assessment Model at a Dental School.

Caries risk assessment (CRA) is an essential component informing clinical decision making for personalized caries management. The aim of this study was to assess the predictive validity of the CRA mod...

Clinical Trials [5214 Associated Clinical Trials listed on BioPortfolio]

Evaluation of Pulp Symptoms After Minimal Caries Removal in Treatment of Deep Caries

The objective of this study is to assess and compare the possible post-operative pulpal symptoms (Spontaneous pain, pain on percussion, swelling, sinus or fistula), incidence of pulp expos...

Experimental Research on Deep Carious Lesion Treatment of Molars

Maintaining dental pulp vitality is crucial for tooth preservation and functionality. Untreated dental caries may lead to pulp necrosis and infection, affecting children's growth and well-...

Similar Outcomes of Vital Pulp Therapy Using Mineral Trioxide Aggregate or Biodentine™

This study aimed to evaluate the clinical performance of White MTA (MTA, Angelus, Londrina, Brazil) and Biodentine™ in pulp capping of cariously exposed mature permanent teeth. The inve...

Vital Pulp Therapy in Carious Teeth With Hypomineralization

Vital pulp therapy (VPT) is a general term for multiple procedures (indirect pulp cap, direct pulp cap and pulpotomy) all directed toward preserving pulp vitality and enable complete root ...

Evaluation of Post Operative Pain Following Indirect Pulp Capping Using Antibacterial Bonding System

The aim of this study is to compare the clinical and radiographic success of indirect pulp capping of vital young permanent teeth with deep caries using two-step antibacterial bonding syst...

Medical and Biotech [MESH] Definitions

Application of a protective agent to an exposed pulp (direct capping) or the remaining thin layer of dentin over a nearly exposed pulp (indirect capping) in order to allow the pulp to recover and maintain its normal vitality and function.

Inflammation of the DENTAL PULP, usually due to bacterial infection in dental caries, tooth fracture, or other conditions causing exposure of the pulp to bacterial invasion. Chemical irritants, thermal factors, hyperemic changes, and other factors may also cause pulpitis.

A dental specialty concerned with the maintenance of the dental pulp in a state of health and the treatment of the pulp cavity (pulp chamber and pulp canal).

Death of pulp tissue with or without bacterial invasion. When the necrosis is due to ischemia with superimposed bacterial infection, it is referred to as pulp gangrene. When the necrosis is non-bacterial in origin, it is called pulp mummification.

Deep grooves or clefts in the surface of teeth equivalent to class 1 cavities in Black's classification of dental caries.

Quick Search


DeepDyve research library

Relevant Topics

Antiretroviral Therapy Clostridium Difficile Ebola HIV & AIDS Infectious Diseases Influenza Malaria Measles Sepsis Swine Flu Tropical Medicine Tuberculosis Infectious diseases are caused by pathogenic...

A biomaterial is defined as a substance that has been engineered to take a form which, alone or as part of a complex system, is used to direct, by control of interactions with components of living systems, the course of any therapeutic or diagnostic proc...

Searches Linking to this Article