Abstract
This case describes a novel indirect pulp capping approach to managing gross caries in a healthy tooth.
References
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Case report: single visit indirect pulp cap using biodentine
From Volume 44, Issue 2, February 2017 | Pages 141-145
Article
The function of a vital dentine-pulp complex includes dentinogenesis throughout life and in response to injury. The pulp also contains circulating immune cells designed to confront bacterial challenges, and proprioceptive mechanisms to protect against excessive occlusal loading.1
Indirect pulp capping is indicated on a tooth with a carious lesion in close proximity to the pulp either being asymptomatic or showing signs and/or symptoms of reversible pulpitis. The tooth may be restored permanently, or re-entered 6 months later (stepwise excavation).2 Indirect pulp capping has been shown to have a better prognosis than direct pulp capping.3
There is good evidence to show that, at the advancing front of a carious lesion, considerable demineralization of dentine occurs prior to bacterial invasion.4 A clinical study by Mertz-Fairhurst et al demonstrated that partial caries removal and sealing with composite resulted in the arrest of carious lesions without any signs or symptoms of pulpitis after 10 years.5 Partial caries removal is the preferred treatment as long as the restoration may be well sealed on a caries-free enamel-dentine junction.6 From the available literature it seems that a single visit procedure is preferred not only for patient convenience, but also because it has a comparable outcome to complete caries excavation.3,5,6
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