Abstract
The maintenance of pulp vitality and conduction of reparative dentin can be possible by indirect pulp capping with mineral trioxide aggregate (MTA) and calcium hydroxide as pulp capping agents. The objective of the study is to assess the clinical and radiological outcomes of MTA and calcium hydroxide as indirect pulp capping agents in deep carious lesions of permanent teeth. The present study included 50 permanent teeth having deep carious lesions with reversible pulp status were selected and then randomly divided into two groups of 25 teeth in a group. Standard indirect pulp capping procedures were followed. Patients were recalled at 3, 6 and 12 months interval to assess postoperative pain, the vitality of the pulp and formation of reparative dentin. In all observation periods, MTA showed more capable of reducing pain and maintain pulp vitality which was statistically significant than that of calcium hydroxide. At 12 months observation period, 24 teeth (96%) of MTA and 19 teeth (76%) of calcium hydroxide showed reparative dentin formation. It can be concluded that MTA is more effective than that of calcium hydroxide.
Highlights
Concepts and treatment principles of deep carious lesions are an area of debate and constant change because the traditional concept of complete caries removal in very deep preparation has been challenged
The removal of infected dentin leaving a thin layer of deeper affected dentin while complete carious lesion removal would result in pulp exposure
Postoperative pain, pulp vitality and conduction of reparative dentin by mineral trioxide aggregate (MTA) and calcium hydroxide as indirect pulp capping agents were verified in vivo
Summary
Concepts and treatment principles of deep carious lesions are an area of debate and constant change because the traditional concept of complete caries removal in very deep preparation has been challenged. It is well known that bacteria in the dentin cause pulpal inflammation and considered as a beneficial for pulp regeneration.[1] an important priority in the treatment of deep carious lesion is to preserve pulp vitality.[2] after pulp exposure, such as conservative treatment is questionable and unpredictable. If pulp has become infected and exposed during caries removal, the successful outcome will be substantially reduced.[2] indirect pulp treatment in the form of one step or two step procedures has been suggested by some of the previous studies.[3,4,5] In this technique, the removal of infected dentin leaving a thin layer of deeper affected dentin while complete carious lesion removal would result in pulp exposure. Portland cement is an effective and alternative to MTA.[8]
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