What is Pulp Capping?
Pulp capping refers to a dental procedure used to keep gangrene of dental pulp after an exposure or near photograph at the time of preparedness of a cavity , by commit a protective dressing over the pulp . This exposure may be due to a mechanically skillful trauma after an accident or tooth fracture ; or the flesh may be exposed during a cavity cutting procedure in the dental office . The master aim of pulp capping is to protect the dental pulp and keep the vitality of the healthy flesh ; and thereby avoid other complicated procedures such as tooth root channel discussion .
Dental cavity has the power to circularize to the deeper portion of the teeth into the pulp . This can cause exposure of the pulp followed by redness and infection , a condition called as pulpitis . If leave untreated , this can lead to severe pain followed by necrosis of flesh ( i.e. destruction of the tooth ) . Therefore , it is authoritative to take necessary stairs as ahead of time as potential to carry through the pulp and maintain the vitality of the tooth . In recondite caries , the first communication channel of treatment often involve a procedure called as mining , i.e. the soft carious part of the caries is removed or hollow with a hired man instrument . This can lead to removal of easy tooth material , which overlay the pulp , leading to unfermented photograph of the flesh . In other cases , sudden injury to the tooth such as a gloaming , go down on on the face , or motor vehicle chance event , can have fracture of a vital tooth leading to sudden vulnerability of healthy mush .
Types of Pulp Capping
base on the precondition of the tooth and the operation used , pulp capping is differentiated into 2 principal types as observe below :
Direct Pulp Capping : Here the protective dressing is localize directly above an reveal mush . This is one - step routine and is indicated in vitrine where there is pinpoint picture of the pulp magazine due to mechanical hurt ( accidents , falls or fracture ) or inadvertent exposure of the mush during cavity preparation or removal of dental dental caries . It is authoritative to ascertain that patient role should not have any chronicle of pain before proceeding with this process . The tooth is protect from saliva using cotton rolls and arctic dekametre . This ensures a clean , infection free working domain . A protective fabric is placed in direct contact with the pulp , follow by a concluding dental restorative material place on top of it to seal the cavum . The tooth is monitored regularly for a class to ensure success of the procedure .
When is Direct Pulp Capping Indicated?
When is Direct Pulp Capping not indicated?
Indirect Pulp Capping : In this process , a thin layer of the subdued dentine is left over the pulp , and a protective fecundation is placed over the subdued dentine . This is a step overbold procedure and a recollective process which takes about 6 calendar month or more to complete . This procedure in indicate in tooth which has deep caries , where majority of disintegration is removed , and a thin bed of decayed dentin is left back above the mush by choice . The protective material placed on top of this stratum facilitate remineralization of dentin , which in turn seals the pulp . The success of this function is learn by change in color of the dentin leave behind , which shift from spark to dark brown , and consistence changes from delicate to hard and from wet to dry . Radiographically , there may be decrease in radiolucent area indicate remineralization . A temporary restorative material is usually hold in place over the sedative stuff for about 6 months . After six months the temporary cloth is absent and dental caries is again explored . Once there is evidence of profound dentine , a lasting restoration is placed to replete the cavity .
Indications for Indirect Pulp Capping:
Contraindications for Indirect Pulp Capping:
How is Pulp Capping Done or Mechanism of Pulp Capping
In pulp capping process , a protective or a sedative dressing such as MTA or calcium hydroxide is placed over the pulp magazine . This helps is protecting the pulp from irritants such as bacteria , cold or oestrus . Over a period of meter , this promotes regeneration of healthy dentine over the photo ( reparative dentine ) . This occurs by elevate the cell rich zone of the underlie pulp to mother reparative dentin layer over the pulp magazine . The summons of reparative dentine formation start about 30 days after localise the sedative cloth and staring in about 130 days . This process may be further delay if there is overweening trauma of wound to the odontoblasts ( cell of the pulp magazine responsible for dentine formation ) . The reparative dentin formed sealed the pulp and thus helps in maintaining the vitality of the tooth .
Materials Used for Pulp Capping
With progress in dental manufacture , a prominent routine of material are available today which are used as an agent for dental capping . The ideal requirements of these stuff are :
Some of the materials commonly used for pulp capping are :
At nowadays , MTA is the most ordinarily used stuff for flesh capping considering its higher-ranking property over other uncommitted cloth , ease of employment and achiever rate .
Pulp Capping Treatent
Pulp capping can be carried out by any experient dentist . However , complex cases are generally manage by an endodontist or a restorative dental practitioner . Diagnosis is done by obtaining a pillowcase story followed by strong-arm testing of the affected role . Radiographic examination and sensitiveness tests are carry out to determine the extent and severeness of the condition . The tooth / teeth in question are examined and a decision is made to do direct or indirect flesh capping based on the consideration of the tooth . In slip of lineal pulp capping , the procedure is carried out in a undivided sitting with follow up designation to determine the succeeder of the procedure . In case of indirect pulp capping , the procedure is carried out on 2 or more sitting .
Success and Prognosis for Pulp Capping
The outcome of the intervention procedure mostly depends on the condition of the tooth and the skills of the dentist . It also depends on the material used and the proficiency used . If the procedure is carry out properly and under excellent isolation , the success rate is amazingly high .
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