Long term clinical assessment of direct pulp capping

Area of Science:

• Dentistry
• Endodontics
• Dental Materials

Background:

• Direct pulp capping is a dental procedure to preserve pulp vitality.
• Historically, success rates were limited by infection and bacterial leakage.
• Recent advancements advocate for selective application in favorable conditions.

Purpose of the Study:

• To review definitions, history, and success rates of direct pulp capping.
• To identify factors influencing the success of direct pulp capping.
• To provide evidence-based guidelines for direct pulp capping procedures.

Main Methods:

• Review of existing literature and clinical studies.
• Analysis of success rates based on pulp condition, operator skill, and sealing.
• Examination of long-term outcomes in patients treated with direct pulp capping.

Main Results:

• Direct pulp capping is indicated for vital, accidentally injured pulp without inflammation or caries.
• Studies involving 2338 cases show increased failure risk with pre-existing pulp disease.
• Success rates reach 90% in skilled hands with a hermetic seal, compared to 80% for students.

Conclusions:

• Direct pulp capping with calcium hydroxide can achieve high success rates when indications are strictly followed.
• Operator skill and achieving a hermetic seal are critical factors for successful outcomes.
• The procedure is contraindicated for pulp exposures due to deep caries.