 |
| Title |
Direct versus indirect pulp capping in maintaining pulp vitality |
| Clinical Question |
In an asymptomatic, permanent vital tooth with extensive caries, is performing a direct or indirect pulp cap more effective at maintaining tooth vitality? |
| Clinical Bottom Line |
Because there is no evidence proving that direct is better than indirect, or vice versa, currently accepted conventional practice should be employed. (See Comments on the CAT below) |
| Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| #1) 17443547 | Miyashita/2007 | 979 patients with asymptomatic vital permanent teeth with extensive caries. | Systematic Review | | Key results | The findings from this review do not suggest that there should be any significant change from accepted conventional practice procedures when the pulp of the carious tooth is considered. Materials used in capping treatment includes: Ledermix, glycerrhetinic acid/antibiotic mix, zinc oxide eugenol, calcium hydroxide, Cavitec, Life, Dycal, potassium nitrate, dimethyl isosorbide, and polycarboxylate cement. | |
| Evidence Search |
"Dental Pulp"[Mesh] AND "Dental Caries"[Mesh] ...view in PubMed |
Comments on
The Evidence |
There were limited articles that compared direct to indirect pulp capping. I also searched under the Mesh term “Dental Pulp Capping” and could not find any articles that compared these two treatments. The Cochrane review in this CAT only included four RCTs and recognized the small number of studies as a limitation to its conclusion. This study did not consider stepwise excavation treatment. |
| Applicability |
Vital permanent teeth with extensive caries. |
| Specialty/Discipline |
(General Dentistry) (Restorative Dentistry) |
| Keywords |
Direct pulp capping, indirect pulp capping, pulp vitality, dental caries, dental pulp
|
| ID# |
553 |
| Date of submission: |
03/30/2010 |
| E-mail |
riggsc@livemail.uthscsa.edu |
| Author |
Chad Riggs |
| Co-author(s) |
|
| Co-author(s) e-mail |
|
| Faculty mentor/Co-author |
Joseph Bartoloni, DDS |
| Faculty mentor/Co-author e-mail |
Bartoloni@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
by Rachel Lowery (San Antonio, TX) on 04/19/2012
I completed a PubMed search on this topic on April 19, 2012. The publication listed in this CAT is still current, the most recent, and the highest level of evidence available at this time. | |
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