Outcomes of direct pulp capping in vital primary teeth with cariously and non‐cariously exposed pulp: A systematic review

Abstract

Objective: To summarize the clinical/radiographic outcomes from the evidence of studies published since 1988 on different DPC agents applied on vital pulp-exposed primary teeth. Methods: The following electronic databases were searched: PubMed, Embase, Cochrane Library, Dentistry and Oral Science Source, and Google Scholar. Inclusion criteria were randomized controlled trials (RCTs) published between January 1988 and December 2019, with at least 6 months of follow-up, comparing the clinical and radiographic success rates of two or more DPC agents applied in primary teeth with cariously and non-cariously exposed pulp. Results: Initial searches identified 83 potentially relevant studies on DPC in primary teeth. Sixty-four of these studies were excluded, whereas 19 articles satisfied the inclusion criteria and were retrieved in full text for data extraction and a methodological quality assessment. Finally, 12 of these articles were included in the systematic review. Low and moderate risks of bias were observed. Overall, DPC clinical and radiographic success rates among the selected studies ranged between 53% and 100%. Conclusions: For DPC in primary teeth, this systematic review found that diverse new biologically and compatible agents with promising success rates are currently available for paediatric dentistry practitioners. There is no evidence that justifies discarding the judicious use of DPC procedures in primary teeth. K E Y W O R D S caries exposure, direct pulp capping, primary teeth, pulpotomy, systematic review How to cite this article: Garrocho-Rangel A, Esparza-Villalpando V, Pozos-Guillen A. Outcomes of direct pulp capping in vital primary teeth with cariously and non-cariously exposed pulp: A systematic review.

Vital and Nonvital Pulp Therapy in Primary Dentition: An Umbrella Review

“…In total, 33 systematic reviews [ 1 , 2 , 3 , 4 , 5 , 6 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ] were included in the present umbrella review ( Table 1 ). All SRs covered a defined timeframe; however, one did not mention such information [ 33 ].…”

“…All SRs covered a defined timeframe; however, one did not mention such information [ 33 ]. Three systematics reviews failed to report a language restriction [ 2 , 10 , 11 ], seventeen restricted their search to studies in English [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ], one restricted to English and Persia [ 26 ], and the remaining had no language restrictions [ 1 , 3 , 4 , 5 , 6 , 9 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ].…”

Management of dental caries lesions in Latin American and Caribbean countries

“…4 Although this intervention is typically recommended for permanent dentition, recent evidence also supports its use in primary teeth with promising results. 79 Although calcium hydroxide is the most commonly used material for VPT, the introduction of calcium silicate-based cements such as mineral trioxide aggregate (MTA) and tricalcium silicate cement (Biodentine) increases possibilities with regard to clinical performance. A recent clinical trial that compared calcium hydroxide, MTA, and Biodentine for direct pulp capping demonstrated similar clinical outcomes for all three materials, with calcium silicate offering certain clinical advantages such as improved manipulation and acceptable setting time.…”

Vital Pulp Therapy in Primary Dentition: Pulpotomy—A 100-Year Challenge

“…In the light of the evidence that is getting stronger on biomaterials and their multiple indications in primary teeth, pulpotomy may be an overrated treatment option. There are more and more "voices" recently stating that there is no justification for discarding direct/indirect pulp capping or indirect pulp treatment (IPT) in favour of pulpotomy in certain clinical situations [9,35,[80][81][82][83]. Actually, recent evidence suggests that IPT (selective removal to soft dentin) is preferred over the traditional pulpotomy [4], with reported success rates of 90% and above [84,85].…”