Identification of hierarchical factors to guide clinical decision making for successful long-term pulp capping.

Abstract

OBJECTIVE:

Clinicians have few quantitative studies that rank the in vivo pulp capping effects of commonly used restorative materials. These factors were investigated to provide guidance to clinicians.

METHOD AND MATERIALS:

One hundred sixty-one standardized pulp-exposed cavities were prepared in nonhuman primate teeth. Exposed pulps were capped with calcium hydroxide, resin-modified glass-ionomer cements, and resin composites. Teeth were collected from 7 to 720 days to observe a full range of responses. Pulpal reactions were categorized according to the standards set by the International Standards Organization. Bacteria were detected with McKay's stain.

RESULTS:

The incidence of bacterial microleakage was 19.7% with resin composite, 21.1% with resin-modified glass-ionomer cement, and 47.0% with calcium hydroxide. The severity of pulpal inflammation increased with the presence of bacteria or tunnel defects. The severity of pulpal inflammation prevented dentinal bridge formation at varying levels: slight for resin composite and resin-modified glass-ionomer cement, and severe with calcium hydroxide. The incidence of severe inflammation or pulpal necrosis was 7.9% with resin composite, 10.6% with calcium hydroxide, and 10.5% with resin-modified glass-ionomer cement. Other variables, such as pulpal exposure width and tertiary dentin formation, were not highly correlated to pulpal inflammation.

CONCLUSION:

Pulp capping with resin composite provided the lowest incidence of bacterial microleakage, the lowest levels of pulpal inflammation, and the lowest incidence of necrosis.

• Authors: Peter E Murray, Abeer A Hafez, Anthony J Smith, Charles F Cox
• Journal: Quintessence international (Berlin, Germany : 1985) (Quintessence Int) Vol. 34 Issue 1 Pg. 61-70 (Jan 2003) ISSN: 0033-6572 [Print] Germany
• PMID: 12674361 (Publication Type: Journal Article)

Chemical References

• Composite Resins
• Dental Materials
• Glass Ionomer Cements
• Resin Cements
• Zinc Oxide-Eugenol Cement
• Calcium Hydroxide

Topics

• Analysis of Variance
• Animals
• Calcium Hydroxide (therapeutic use)
• Composite Resins (therapeutic use)
• Confidence Intervals
• Decision Trees
• Dental Leakage (microbiology)
• Dental Materials (therapeutic use)
• Dental Pulp (drug effects, microbiology)
• Dental Pulp Capping (methods)
• Dental Pulp Exposure (therapy)
• Dental Pulp Necrosis (etiology)
• Dentin, Secondary (drug effects)
• Glass Ionomer Cements (therapeutic use)
• Macaca mulatta
• Pulpitis (etiology, microbiology)
• Resin Cements (therapeutic use)
• Statistics, Nonparametric
• Time Factors
• Treatment Outcome
• Zinc Oxide-Eugenol Cement