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Pulp Capping Agents: A Literature Review
Board / Fri 9:30, 26 Jun 2015

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PULP CAPPING AGENTS: A LITERATURE REVIEW

Juveria Hussain1, Ana Bedran-Russo2,Adriana Semprum-Clavier2

1 Student, DMD Advanced Standing Program, College of Dentistry, UIC, Chicago, IL, USA

2 Department of Restorative Dentistry, College of Dentistry, UIC, Chicago, IL, USA

 

OBJECTIVES: 

  1. To review contemporary dental literature on agents used for pulp capping.
  2. Based on the strength of evidence, to determine if newer pulp capping agents perform similar to the traditional and gold standard intermediate restorative materials.

METHOD OF REVIEW:

  • An evidence based search was conducted in the electronic research database MEDLINE from 2004 to 2014.
  • The search was limited to ‘English’ with MeSH words: ‘pulp capping’, ‘mineral trioxide aggregate’, ‘calcium hydroxide’, ‘theracal’ and ‘biodentine’.
  • Based on the inclusion and exclusion criteria, a total of 70 articles were retrieved.
  • The relevant articles were selected and their references cited were searched and reviewed.

FINDINGS:

  • Based on the level of evidence, publication date and relevance to the research question, 15 articles were selected and carefully reviewed.
  • The success of the pulp capping agents was measured histologically by the thickness and morphology of the dentinal bridge, pulpal inflammation, cytotoxicity and biocompatibility.3-8
  • The literature consistently does not recommend the use of adhesive resin systems and glass ionomer cements as direct pulp capping agents due to their high cytotoxicity and low biocompatibility.1,2,5
  • Successful clinical outcome has been demonstrated by both calcium hydroxide and MTA as direct and indirect pulp capping agents.1-8
  • Calcium hydroxide is considered as the gold standard of pulp capping agents against which the new generation of pulp capping agents are tested.1,2 It has excellent anti-microbial properties and ability to induce mineralization.1,2

CONCLUSIONS:

  • Overall, among the commercially available pulp capping agents, the literature suggests MTA to be superior both clinically and histologically.
  • Several prognostic factors determine the successful outcome of the pulp capping treatment such as the type, site and size of exposure, control of hemorrhage, microleakage, type of pulp capping agent, its biocompatibility and sealing ability.
  • Further research is required to determine the long term prognosis of the new generation calcium silicate based pulp capping agents.
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