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Pulp management for caries in adults: maintaining pulp vitality
The Cochrane Database of Systematic Reviews
|April 20, 2007
Summary
This review found limited evidence on managing asymptomatic decayed teeth to maintain pulp vitality. Current conventional practices are suggested to continue, with a need for more high-quality randomized controlled trials (RCTs) on new materials.
Area of Science:
- Dentistry
- Endodontics
- Dental Materials Science
Background:
- Extensive caries in asymptomatic teeth presents varied management options, including pulp capping, pulpotomy, and pulpectomy.
- A shift towards alternative materials like bonding agents and mineral trioxide aggregate is observed.
- Limited long-term data exists for managing asymptomatic carious teeth with different regimens.
Purpose of the Study:
- To evaluate the efficacy of various techniques for treating asymptomatic carious teeth.
- To assess methods aimed at preserving pulp vitality in extensively decayed teeth.
Main Methods:
- Systematic electronic database searches were conducted across multiple scientific databases.
- Inclusion criteria focused on randomized controlled trials (RCTs) involving asymptomatic vital permanent teeth with extensive caries.
- Outcome measures included clinical success rates and the incidence of adverse events.
Main Results:
- Only four randomized controlled trials (RCTs) met the inclusion criteria.
- A combination of potassium nitrate, dimethyl isosorbide, and polycarboxylate cement showed a statistically significant reduction in clinical symptoms compared to other tested materials.
- Most interventions evaluated included calcium hydroxide, Ledermix, and zinc oxide eugenol.
Conclusions:
- The scarcity of high-quality studies limits definitive conclusions on contemporary materials for managing carious teeth.
- Current findings do not support significant deviations from established conventional treatment protocols.
- Further well-designed RCTs are essential to investigate the effectiveness of novel materials in pulp management.
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The Crown, Neck, and Root
The visible part of the tooth is referred to as the crown. It's covered by enamel, the hardest substance in the human body. The crown is uniquely shaped for each type of tooth, allowing for different functions such as cutting, tearing, or grinding food.