Clinical evaluation of biodentine: Its efficacy in the management of deep dental caries

Background The outcome of vital pulp treatment after carious pulp exposure is multifactorial and related to the procedure, biomaterial and pre‐operative pulpal diagnosis. Objectives To conduct a systematic review and meta‐analysis determining the outcome of direct pulp capping (DPC) in mature permanent teeth with a cariously exposed pulp and a clinical diagnosis of reversible pulpitis, and ascertain whether the capping material influences the outcome. Methods Sources: MEDLINE Ovid‐SP, Cochrane Central Register of Controlled Trials (CENTRAL), International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, Embase and Web of Science until April 2020. Inclusion: Prospective, retrospective cohort studies and randomized trials investigating DPC outcome or comparing different capping materials after carious pulp exposure. Exclusion: Primary teeth, mechanical, traumatic or not specified pulp exposure, teeth with irreversible pulpitis or no pulpal diagnosis. Risk of bias assessed using Cochrane and modified Downs and Black quality assessment checklist. Meta‐analysis on combined clinical/radiographic outcome was performed using a random effect model. Success was defined as absence of signs and symptoms of irreversible pulpitis, apical periodontitis or loss of pulp vitality. Results Quality assessment highlighted four non‐randomized studies to be of fair and five of poor quality. Four randomized trials had a high risk of bias. The pooled success rate differed based on material and follow‐up. Calcium hydroxide success rate was 74% at 6‐months, 65% at 1‐year, 59% at 2–3 years and 56% at 4–5 years. Mineral trioxide aggregate (MTA) success was 91%, 86%, 84% and 81% at the same time points. Biodentine success was 96% at 6‐months, 86% at 1 year and 86% at 2–3 years. The meta‐analysis revealed MTA had better success than calcium hydroxide at 1‐year (OR 2.66, 95% CI; 1.46‐ 4.84, P = 0.001) and 2‐ to 3‐year follow‐up (OR 2.21, 95% CI; 1.42–3.44, P = 0.0004). There was no difference between MTA and Biodentine. Discussion These results were based on poor methodological quality studies. The effect size for of MTA vs Ca(OH)2, although modest, was consistent with narrow CI. Conclusions Low‐quality evidence suggests a high success rate for direct pulp capping in teeth with cariously exposed pulps with better long‐term outcomes for MTA and Biodentine compared with calcium hydroxide.

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“…2008, Kusumvalli et al . 2019). Details of the included studies are outlined in Table 2 and those of the study populations in Table 3.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of direct pulp capping for management of cariously exposed pulps in permanent teeth: a systematic review and meta‐analysis

et al. 2020

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“…The second doctrine stated that the tooth can be treated conservatively with vital pulp therapy which helps in preservation of pulp. [15] Vital pulp is the key factor for vital pulp therapy procedure. Pulp sensibility tests do not accurately dictate the vital status of the pulp.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Clinical Study With One Year Follow Up of Deep Caries Management Using a Novel Biomaterial

Roma

Gupta

Hegde

2022

Preprint

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Objectives: The objectives of this study was to check the outcome of the direct and indirect pulp capping procedure using MTA (Mineral Trioxide Aggregate) by comparing the pre – and post – operative pain by using VAS scale, associating the pre- and post- operative changes in intraoral periapical radiograph and clinical symptoms. Materials and Methods: In this prospective clinical study 10 cases (5 for direct and 5 for indirect) with deep carious lesions (symptomatic) with no periapical changes were selected for the trial. The participants were subjected to deep caries management procedure under rubber dam where MTA is placed as pulp capping material followed by immediate restoration with sandwich technique using composite resin. The participants were followed up at recall visits of 1 month, 3 months, 6 months and 1 year intervals for clinical and radiographic evaluation. Results: The results of the study, analyzing the VAS, clinical symptoms and radiographic changes did not show any signs of pain, clinical and radiographic symptoms at 1 month, 3 months, 6 months and 1 year intervals. Conclusions: It was concluded that MTA can be used for deep caries management as a pulp capping material which being equivalent to calcium hydroxide.

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“…One doctrine debated that root canal treatment should be performed regardless of the pulpal status of the tooth. The second doctrine stated that the tooth can be treated conservatively with vital pulp therapy which helps in preservation of pulp [17].…”

Section: Discussionmentioning

confidence: 99%

A prospective clinical study with one year follow up of deep caries management using a novel biomaterial

2022

View full text Add to dashboard Cite

Objectives The objectives of this study was to check the outcome of the direct and indirect pulp capping procedure using MTA (Mineral Trioxide Aggregate) by comparing the pre—and post—operative pain by using VAS scale, associating the pre- and post- operative changes in intraoral periapical radiograph and clinical symptoms. Materials and methods In this prospective clinical study 10 cases (5 for direct and 5 for indirect) with deep carious lesions (symptomatic) with no periapical changes were selected for the trial. The participants were subjected to deep caries management procedure under rubber dam where MTA is placed as pulp capping material followed by immediate restoration with sandwich technique using composite resin. The participants were followed up at recall visits of 1 month, 3 months, 6 months and 1 year intervals for clinical and radiographic evaluation. Results The results of the study, analyzing the VAS, clinical symptoms and radiographic changes did not show any signs of pain, clinical and radiographic symptoms at 1 month, 3 months, 6 months and 1 year intervals. Conclusions It was concluded that MTA can be used for deep caries management as a pulp capping material which being equivalent to calcium hydroxide.

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Clinical evaluation of biodentine: Its efficacy in the management of deep dental caries

Cited by 9 publications

References 1 publication

Efficacy of direct pulp capping for management of cariously exposed pulps in permanent teeth: a systematic review and meta‐analysis

Efficacy of direct pulp capping for management of cariously exposed pulps in permanent teeth: a systematic review and meta‐analysis

A Prospective Clinical Study With One Year Follow Up of Deep Caries Management Using a Novel Biomaterial

A prospective clinical study with one year follow up of deep caries management using a novel biomaterial

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