DENTAL CARIES

Flow Chart of Dental Caries includes:-

•Etiology

•Diagnosis

•Management

•Prevention

Source:- DCI WEBNEIR on Dental caries-30 Aug 2020.

PULP CAPPING

So what is the pulp – in simple words it’s a tissue that forms the inner tooth structure along with the blood vessels and contains nerves .

Pulp capping is the process of placing a specialized agent in contact with or in a close proximity to the pulp with the intention to encourage formation of new dentin ( secondary dentin) and also promote healing of the pulp.

Even before the discovery  pulp capping agents, exposure lead to pulpitis or pulpal infection and ultimately pulp necrosis.

Examples of a very common pulp capping agent used – calcium hydroxide cement.

Source- slideshare

What’s the criteria for pulp capping?

  1. When the pulp is healthy and non infected.
  2. When the area of exposure is not more than 0.5mm.
  3. After exposure the dentist should make all attempts and isolate the tooth and prevent infection.

Types of pulp capping –

  1. Direct pulp capping
  2. Indirect pulp capping

What is direct pulp capping? When is it done?

Placement of an agent directly on the exposed pulp is direct pulp capping.

It is done in the following situations-

  • Traumatic fracture of the tooth .
  • Iatrogenic exposure during cavity preparation.
  • Exposure when the tooth is under rubber dam isolation.
  • When bleeding is controlled at the exposure site.

Note- direct pulp capping is considered oy for immature permanent teeth or for future permanent teeth

Direct pulp capping

Source – Google

What is indirect pulp capping ? When is it done?

Procedure where gross caries are removed from the lesions and cavity is sealed for a time with a biocompatible material.

And secondary dentin formation is induced even when pulp is not exposed but is near exposure.

This induces new dentin formation.

It is done in the following situations-

  • When deep caries lesions are close to the pulp.
  • Exposure exposure of the pulp when there is traumatic fracture of the tooth.
  • During excessive crown preparation the pulp is visible through the remaining dentin .

Note – it promotes formation of reparative dentin, promotes dental sclerosis and remineralizing the carious dentin.

Indirect pulp capping

Source-google

Requirements of an ideal pulp capping material.-

•Stimulate reparative dentin formation.

•Preserve pulp vitality

•Release fluoride to prevent secondary caries .

•Bactericidal or bacteriostatic

• Adhere to dentin and restorative material

•Resist forces during mastication .

•Provide bacterial seal.

Materials used in pulp capping-

•Calcium hydroxide

•Zinc-Oxide – Eugenol

• GIC and adhesive resins

• MTA

• Biodentine

•Tricalcium phosphate ceramic

•Polycarboxylate cements

Source – Sturdevant’s art and science of operative dentistry ,slide share and manappallil

Image source – Google and slide share