Pulp Capping with Mineral Trioxide Aggregate at Pulp Exposure

Abstract

To prevent the pulp from deteriorating when a dental restoration gets near the pulp, the dentist will place a small amount of a sedative dressing, such as MTA. This material, protect the pulp from noxious agents (heat, cold and bacteria) and stimulate the cell-rich zone of the pulp to lay down a bridge of reparative dentin. Dentin formation usually starts within 30 days of the pulp capping (there can be a delay in onset of dentin formation if the odontoblasts of the pulp are injured during cavity removal) and is largely completed by 130 days. MTA pulp capping was performed at open reversible pulpitis-presence of ulceration among carious dentin-pulp exposure. Teeth had no difficulty controlling bleeding from exposure, pin point should be up than 1mm exposure after caries has been removed, no treatment plan for a laboratory-fabricated prosthesis that is placed on the tooth, asymptomatic teeth without a history of pain. The procedure for pulp capping consisted of several steps. First, the dental cavity was drilled, if pulp was disclosed, the area was cleaned and the pulp point was covered with MTA to protect it from becoming infected. Once the pulp is capped, the dentist will place a temporary or permanent dental filling in the tooth. Of the 84 teeth with pulp exposure in 30 patients that were included in the current study by clinical evaluation. Performing a pulpectomy is typically suggested upon frank exposure of the pulp, but a pulp cap using MTA was used for 51 teeth in 11 patients. Patient ages ranged from 21 to 58 years. The current study estimated pulp vitality after MTA pulp caps with clinical and radiographical criteria. Follow up appointments were prescribed after 1,5, 2-3, 6, and 8 months. 20 from these 51 teeth dropouted after 1,5 months for irreversible pulpitis (n = 15) or restorative considerations required a more predictable foundation (n = 5). At recall after 6 months, 11 patients with pulp caps were clinically and radiographically assessed. Totally, 6 months pulp survival was 67.7%, while the 8 months survival rate was 56.2%. Within the limitations of the current study on procedures performed, it may be concluded that, for MTA pulp caps applied to carious exposures in adults, certain preoperative conditions patient age, exposure size and amount of bleeding are not predictive of clinical outcome. Considering the comparatively low success rate for the сurrent cohort, more studies are needed to define predictive criteria for successful pulp capping with MTA. The success measured as pulp survival over a period of one year of pulp caps performed may be low. This study provides data regarding the impact of exposure sizes and other preoperative variables on outcomes of MTA pulp caps in adults. Эффект минерал триоксид агрегата (МТА) при прямом покрытии пульпы состоит в стимуляции образования репаративного дентина в течение 1-4 месяцев. Наложение МТА на вскрытую точку пульпы диаметром до 1 мм при её вскрытии во время препарирования глубокого кариеса проводилось при возможности контролировать кровотечение из пульповой камеры и отсутствии болей в зубе в анамнезе. 23 из 31 зуба через 2-3 месяца после покрытия не имели симптомов (74%), все зубы не имели патологических изменений на рентгенограмме. Через 6 месяцев эффективность покрытия с МТА составила 67.7%, через 8 месяцев – 56.2%. Ефект мінерал триоксид агрегату (МТА) при прямому покритті пульпи полягає в стимуляції утворення репаративного дентину протягом 1-4 місяців. Накладення МТА на розкриту точку пульпи діаметром до 1 мм при її розкритті під час препарування глибокого карієсу проводилося при можливості контролювати кровотечу з пульпової камери і відсутності болю в зубі в анамнезі. 23 з 31 зуба через 2-3 місяці після покриття не мали симптомів (74%), всі зуби не мали патологічних змін на рентгенограмі. Через 6 місяців ефективність покриття з МТА склала 67,7%, через 8 місяців – 56,2%.