DIRECT PULP CAPPING PREREQUISITES TO CLINICAL TREATMENT SUCCESS
Dr. med. dent
Poliklinik für Zahnerhaltung, Münster, Germany.
Although treatment after direct pulp capping is discussed controversially, the outcome of this type of treatment given in the dental literature varies between 70 % and nearly 98 %. Criteria important for the success of such treatment include several factors. The pulp tissue should be vital and free of (irreversible) inflammation. A sensibility test prior to direct pulp capping must yield a positive result. The patient should not complain about discomfort or pain. Since massive bleeding is indicative of an infected pulp, reaching hemostasis of the bleeding pulp tissue after exposure should be easy. In the case of cavity cleaning or hemostasis sodium hypochlorite seems to be the appropriate cleaning agent. Protection against the invasion of microorganisms in the pulp is a key factor for the success of direct pulp capping. Hence, rubberdam should be used and a bacteria-tight amalgam or composite restoration should be placed immediately after direct pulp capping. The age of a patient and the diameter of the pulp exposure are not compelling contraindications for direct pulp capping.