PULP CAPPING

CONTENTS
Introduction Definition Classification Direct pulp capping In direct pulp capping Materials Conclusion

INTRODUCTION
Dental pulp may be defined as a special organ with a unique environment of the unyielding dentin It has a close relationship between its peripheral cell, the odontoblasts and dentin making it a functional entity. It is sometimes referred to as the pulp-dentin complex.

DEFINITION

Application of a protective agents to an exposed pulp or the remaining thin layer of dentin over a nearly exposed pulp in order to allow it to recover and maintain its vitality and function.

Pulp capping

Direct pulp capping

Indirect pulp capping

DIRECT PULP CAPPING

The placement of biocompatible agent on healthy pulp tissue that has been exposed. Treatment objective: is to seal the pulp against the bacterial leakage, encourage the pulp to wall off the exposure site by initiating the dentin bridge and maintain the vitality of the underlying pulp tissue organ.

FACTORS AFFECTING:

Coronal and radicular pulp free of bacteria

Size of exposure

Age of the patient

Tooth type and site

Hemorrhage from the pulp

PROCEDURAL STEPS
Careful diagnoses Profound anesthesia Isolation Gently rinse the exposure site Cover the exposed pulp with calcium hydroxide or MTA Place a bonding base on the surrounding dentin Restore the tooth

INDIRECT PULP CAPPING

The placement of the biocompatible agent over the thin layer of remaining carious dentin, after a deep carious excavation, from pulp tissue with no exposure of the pulp. Treatment objective: is to avoid the pulp exposure and the necessity of more invasive measures.

FACTORS AFFECTING:

Gross caries, but no spontaneous pain

No Pa or IR pathology on radiograph

Restorable tooth

Healthy individual

Affected dentin not infected dentin

TREATMENT PROCEDUREUse local anesthesia and isolation with Rubber dam. ! establish cavity outline with high speed handpiece ! remove the superficial debris and majority of the soft necrotic dentin with slow speed handpiece using large round bur.

TREATMENT PROCEDUREstop the excavation as soon as the firm resistance of soft dentin is felt. ! peripheral carious dentin is removed with a sharp spoon excavator. ! cavity flushed with saline and dried with cotton pellet.

TREATMENT PROCEDUREsite is covered with calcium hydroxideca(oh)2 ! remainder cavity is filled with reinforced zinc oxide eugenol(ZOE) cement

Pulp exposure

CONCLUSION The pulp tissue requires careful protection in all that we do in dentistry to avoid the negative responses and to encourage the positive ones