Skip to main content
Top
Published in: Clinical Oral Investigations 5/2010

01-10-2010 | Original Article

Long-term evaluation of direct pulp capping—treatment outcomes over an average period of 6.1 years

Authors: Till Dammaschke, Jana Leidinger, Edgar Schäfer

Published in: Clinical Oral Investigations | Issue 5/2010

Login to get access

Abstract

To assess the treatment outcomes of direct pulp capping with calcium hydroxide, 248 teeth were examined 0.4–16.6 years (mean, 6.1 ± 4.4) after pulp capping. Only teeth diagnosed to be clinical healthy or with spontaneous pain were capped. The treatment outcome was assessed by interviewing for signs or symptoms responsiveness and sensibility testing with CO2. The overall survival rate was 76.3% after 13.3 years. Of the teeth, 80.2% were found to have a favourable treatment outcome. The pulps of 60-year-old patients showed a significant lower favourable treatment outcome when compared to patients younger than 40 years (p < 0.05). The treatment outcome was significantly less favourable in teeth restored with glass ionomer cement compared to all other teeth (p < 0.01). The likelihood to show an unfavourable treatment outcome after direct pulp capping was significantly higher for teeth with spontaneous pain than for teeth with clinically healthy pulps (p < 0.001). In addition, the likelihood for a tooth to become non-vital after direct pulp capping was significantly higher within the first 5 years after treatment than after more than 5 years (p < 0.001) after treatment.
Literature
1.
go back to reference Accorinte MLR, Loguerico AD, Reis A, Costa CAS (2008) Response of human pulps capped with different self-etch adhesive systems. Clin Oral Investig 12:119–127CrossRefPubMed Accorinte MLR, Loguerico AD, Reis A, Costa CAS (2008) Response of human pulps capped with different self-etch adhesive systems. Clin Oral Investig 12:119–127CrossRefPubMed
2.
go back to reference Büyükgüral B, Cehreli ZC (2008) Effect of different adhesive protocols vs calcium hydroxide on primary tooth pulp with different remaining dentin thicknesses: 24 months results. Clin Oral Investig 12:91–96CrossRefPubMed Büyükgüral B, Cehreli ZC (2008) Effect of different adhesive protocols vs calcium hydroxide on primary tooth pulp with different remaining dentin thicknesses: 24 months results. Clin Oral Investig 12:91–96CrossRefPubMed
3.
go back to reference Weiger R (2001) Vitalerhaltende Therapie. In: Heidemann D (ed) Endodontie. Urban & Fischer, München, pp 58–78 Weiger R (2001) Vitalerhaltende Therapie. In: Heidemann D (ed) Endodontie. Urban & Fischer, München, pp 58–78
4.
go back to reference Schroeder HE (1997) Pathobiologie oraler Strukturen. Zähne, Pulpa, Parodont, 3rd edn. Karger, Basel, p 136 Schroeder HE (1997) Pathobiologie oraler Strukturen. Zähne, Pulpa, Parodont, 3rd edn. Karger, Basel, p 136
5.
go back to reference Stanley HR (1989) Pulp capping: conserving the dental pulp—can it be done? Is it worth it? Oral Surg Oral Med Oral Pathol 68:628–639CrossRefPubMed Stanley HR (1989) Pulp capping: conserving the dental pulp—can it be done? Is it worth it? Oral Surg Oral Med Oral Pathol 68:628–639CrossRefPubMed
6.
go back to reference Hørsted-Bindslev P, Bergenholtz G (2003) Vital pulp therapies. In: Bergenholtz G, Hørsted-Bindslev P, Erik-Reit C (eds) Textbook of endodontology. Blackwell Munksgaard, Oxford, pp 66–91 Hørsted-Bindslev P, Bergenholtz G (2003) Vital pulp therapies. In: Bergenholtz G, Hørsted-Bindslev P, Erik-Reit C (eds) Textbook of endodontology. Blackwell Munksgaard, Oxford, pp 66–91
7.
go back to reference Hermann B (1928) Ein weiterer Beitrag zur Frage der Pulpenbehandlung. Zahnärztl Rundsch 37:1327–1376 Hermann B (1928) Ein weiterer Beitrag zur Frage der Pulpenbehandlung. Zahnärztl Rundsch 37:1327–1376
8.
go back to reference Hermann B (1930) Dentinobliteration der Wurzelkanäle nach Behandlung mit Calcium. Zahnärztl Rundsch 39:888–899 Hermann B (1930) Dentinobliteration der Wurzelkanäle nach Behandlung mit Calcium. Zahnärztl Rundsch 39:888–899
9.
go back to reference Rebel H-H (1922) Über die Ausheilung der freigelegten Pulpa. Dtsch Zahnheilkd 55:3–83 Rebel H-H (1922) Über die Ausheilung der freigelegten Pulpa. Dtsch Zahnheilkd 55:3–83
10.
go back to reference Dammaschke T (2008) The history of direct pulp capping. J Hist Dent 56:9–23PubMed Dammaschke T (2008) The history of direct pulp capping. J Hist Dent 56:9–23PubMed
11.
go back to reference Barthel CR, Rosenkranz B, Leuenberg A, Roulet J-F (2000) Pulp capping of carious exposures: treatment outcome after 5 and 10 years: a retrospective study. J Endod 26:525–528CrossRefPubMed Barthel CR, Rosenkranz B, Leuenberg A, Roulet J-F (2000) Pulp capping of carious exposures: treatment outcome after 5 and 10 years: a retrospective study. J Endod 26:525–528CrossRefPubMed
12.
go back to reference Christensen GJ (1998) Pulp capping 1998. J Am Dent Assoc 129:1297–1299PubMed Christensen GJ (1998) Pulp capping 1998. J Am Dent Assoc 129:1297–1299PubMed
13.
go back to reference Matsuo T, Nakanishi T, Shimizu H, Ebisu S (1996) A clinical study of direct pulp capping applied to caries-exposed pulps. J Endod 22:551–556CrossRefPubMed Matsuo T, Nakanishi T, Shimizu H, Ebisu S (1996) A clinical study of direct pulp capping applied to caries-exposed pulps. J Endod 22:551–556CrossRefPubMed
14.
go back to reference Langeland K (1981) Management of the inflamed pulp associated with deep carious lesion. J Endod 7:169–181CrossRefPubMed Langeland K (1981) Management of the inflamed pulp associated with deep carious lesion. J Endod 7:169–181CrossRefPubMed
15.
go back to reference Stanley HR (1998) Criteria for standardizing and increasing credibility of direct pulp capping studies. Am J Dent 11(Spec Iss):S17–S34PubMed Stanley HR (1998) Criteria for standardizing and increasing credibility of direct pulp capping studies. Am J Dent 11(Spec Iss):S17–S34PubMed
16.
go back to reference Auschill TM, Arweiler NB, Hellwig E, Zamani-Alaei A, Sculean A (2003) Success rate of direct pulp-capping with calcium hydroxide. Schweiz Monatsschr Zahnmed 113:946–952PubMed Auschill TM, Arweiler NB, Hellwig E, Zamani-Alaei A, Sculean A (2003) Success rate of direct pulp-capping with calcium hydroxide. Schweiz Monatsschr Zahnmed 113:946–952PubMed
17.
go back to reference Ward J (2002) Vital pulp therapy in cariously exposed permanent teeth and its limitations. Aust Endod J 28:29–37CrossRefPubMed Ward J (2002) Vital pulp therapy in cariously exposed permanent teeth and its limitations. Aust Endod J 28:29–37CrossRefPubMed
18.
go back to reference Tronstad L, Mjör IA (1972) Capping of the inflamed pulp. Oral Surg Oral Med Oral Pathol 34:477–486CrossRefPubMed Tronstad L, Mjör IA (1972) Capping of the inflamed pulp. Oral Surg Oral Med Oral Pathol 34:477–486CrossRefPubMed
19.
go back to reference Reuver J (1992) 592 pulp cappings in a dental office—a clinical study (1966–1990). Dtsch Zahnärztl Z 47:29–32PubMed Reuver J (1992) 592 pulp cappings in a dental office—a clinical study (1966–1990). Dtsch Zahnärztl Z 47:29–32PubMed
20.
go back to reference Baume LJ, Holz J (1981) Long term clinical assessment of direct pulp capping. Int Dent J 31:251–260PubMed Baume LJ, Holz J (1981) Long term clinical assessment of direct pulp capping. Int Dent J 31:251–260PubMed
21.
go back to reference Shankle RJ, Brauer JS (1962) Pulp capping. Clinical evidence of a dentine bridge. Oral Surg Oral Med Oral Pathol 15:1121–1127CrossRefPubMed Shankle RJ, Brauer JS (1962) Pulp capping. Clinical evidence of a dentine bridge. Oral Surg Oral Med Oral Pathol 15:1121–1127CrossRefPubMed
22.
go back to reference Ahrens G, Reuver J (1973) Follow-up studies of direct pulp capping in the daily dental practice. Dtsch Zahnärztl Z 28:862–865PubMed Ahrens G, Reuver J (1973) Follow-up studies of direct pulp capping in the daily dental practice. Dtsch Zahnärztl Z 28:862–865PubMed
23.
go back to reference Petersson K, Söderström C, Kiani-Anaraki M, Levy G (1999) Evaluation of the ability of thermal and electrical tests to register pulp vitality. Endod Dent Traumatol 15:127–131CrossRefPubMed Petersson K, Söderström C, Kiani-Anaraki M, Levy G (1999) Evaluation of the ability of thermal and electrical tests to register pulp vitality. Endod Dent Traumatol 15:127–131CrossRefPubMed
24.
go back to reference Schröder A (1981) Endodontie: Ein Leitfaden für Studium und Praxis, 2nd edn. Quintessenz, Berlin, pp 17–20, 47–68 Schröder A (1981) Endodontie: Ein Leitfaden für Studium und Praxis, 2nd edn. Quintessenz, Berlin, pp 17–20, 47–68
25.
go back to reference Fesseler A (1988) Die Untersuchung. In: Ketterl W (ed) Grundlagen der Zahn-, Mund- und Kieferheilkunde, 2nd edn. Urban & Schwarzenberg, München, pp 71–109 Fesseler A (1988) Die Untersuchung. In: Ketterl W (ed) Grundlagen der Zahn-, Mund- und Kieferheilkunde, 2nd edn. Urban & Schwarzenberg, München, pp 71–109
26.
go back to reference Seltzer S, Bender IB, Ziontz M (1963) The dynamics of pulpal inflammation: correlation between diagnostic data and actual histologic findings in the pulp. Oral Surg Oral Med Oral Pathol 16:846–871CrossRefPubMed Seltzer S, Bender IB, Ziontz M (1963) The dynamics of pulpal inflammation: correlation between diagnostic data and actual histologic findings in the pulp. Oral Surg Oral Med Oral Pathol 16:846–871CrossRefPubMed
27.
go back to reference Hyman J, Cohen M (1984) The predictive value of endodontic diagnostic tests. Oral Surg Oral Med Oral Pathol 58:343–346CrossRefPubMed Hyman J, Cohen M (1984) The predictive value of endodontic diagnostic tests. Oral Surg Oral Med Oral Pathol 58:343–346CrossRefPubMed
28.
go back to reference Dummer PMH, Hicks R, Huws D (1980) Clinical signs and symptoms in the pulp disease. Int Endod J 13:27–35CrossRefPubMed Dummer PMH, Hicks R, Huws D (1980) Clinical signs and symptoms in the pulp disease. Int Endod J 13:27–35CrossRefPubMed
29.
go back to reference Pereira JC, Segala AD, Costa CAS (2000) Human pulpal response to direct pulp capping with an adhesive system. Am J Dent 13:139–147PubMed Pereira JC, Segala AD, Costa CAS (2000) Human pulpal response to direct pulp capping with an adhesive system. Am J Dent 13:139–147PubMed
30.
go back to reference Schreger E, Nossek H, Kciuk K, Jungnickel U (1988) Clinical and roentgenologic examinations after direct capping. Stomatol DDR 38:754–757PubMed Schreger E, Nossek H, Kciuk K, Jungnickel U (1988) Clinical and roentgenologic examinations after direct capping. Stomatol DDR 38:754–757PubMed
31.
go back to reference Hørsted P, Søndergaard B, Thylstup A, El-Attar K, Fejerskov O (1985) A retrospective study of the direct pulp capping with Ca(OH)2 compounds. Endod Dent Traumatol 1:29–34CrossRefPubMed Hørsted P, Søndergaard B, Thylstup A, El-Attar K, Fejerskov O (1985) A retrospective study of the direct pulp capping with Ca(OH)2 compounds. Endod Dent Traumatol 1:29–34CrossRefPubMed
32.
go back to reference Patterson SS, van Huysen G (1954) The treatment of pulp exposures. Oral Surg Oral Med Oral Pathol 7:194–206CrossRefPubMed Patterson SS, van Huysen G (1954) The treatment of pulp exposures. Oral Surg Oral Med Oral Pathol 7:194–206CrossRefPubMed
33.
go back to reference Berk H (1963) Pulp capping: re-evaluation of criteria based on clinical and histological findings. Int Dent J 13:577–581 Berk H (1963) Pulp capping: re-evaluation of criteria based on clinical and histological findings. Int Dent J 13:577–581
34.
go back to reference Künzel W, Runkel F (1963) Problems of direct pulp capping. Part I. Clinical evaluation of direct pulp capping by means of, respectively, Calxyl, Reogan, and Regeneran. Dtsch Stomatol 13:225–231 Künzel W, Runkel F (1963) Problems of direct pulp capping. Part I. Clinical evaluation of direct pulp capping by means of, respectively, Calxyl, Reogan, and Regeneran. Dtsch Stomatol 13:225–231
35.
go back to reference Gülzow HJ, Müller H (1966) Clinical and roentgenological follow-up studies of direct cappings and vital amputations. Dtsch Zahnärztl Z 21:176–179PubMed Gülzow HJ, Müller H (1966) Clinical and roentgenological follow-up studies of direct cappings and vital amputations. Dtsch Zahnärztl Z 21:176–179PubMed
36.
go back to reference Haskell EW, Stanley HR, Chellemi J, Stringfellow H (1978) Direct pulp capping treatment: a long-term follow up. J Am Dent Assoc 97:607–612PubMed Haskell EW, Stanley HR, Chellemi J, Stringfellow H (1978) Direct pulp capping treatment: a long-term follow up. J Am Dent Assoc 97:607–612PubMed
37.
go back to reference Heyduck G, Wegner H (1978) Clinical, radiological and histological results after vital treatment of exposed pulp. Stomatol DDR 28:614–619PubMed Heyduck G, Wegner H (1978) Clinical, radiological and histological results after vital treatment of exposed pulp. Stomatol DDR 28:614–619PubMed
38.
go back to reference Honegger D, Holz J, Baume L-J (1979) Long-term clinical supervision of direct pulp capping (performed by the students of the School of Dentistry, Geneva). Schweiz Monatsschr Zahnheilkd 89:1020–1041 Honegger D, Holz J, Baume L-J (1979) Long-term clinical supervision of direct pulp capping (performed by the students of the School of Dentistry, Geneva). Schweiz Monatsschr Zahnheilkd 89:1020–1041
39.
go back to reference Attin T, Hellwig E, Kaletsch H (1993) Erfolgsaussichten der direkten Pulpaüberkappung bei Zähnen mit Caries profunda. Quintessenz 44:1613–1622 Attin T, Hellwig E, Kaletsch H (1993) Erfolgsaussichten der direkten Pulpaüberkappung bei Zähnen mit Caries profunda. Quintessenz 44:1613–1622
40.
go back to reference Al-Hiyasat AS, Barrieshi-Nusair KM, Al-Omari MA (2006) The radiographic outcome of direct pulp-capping procedures performed by dental students. A retrospective study. J Am Dent Assoc 137:1699–1705PubMed Al-Hiyasat AS, Barrieshi-Nusair KM, Al-Omari MA (2006) The radiographic outcome of direct pulp-capping procedures performed by dental students. A retrospective study. J Am Dent Assoc 137:1699–1705PubMed
41.
go back to reference Ahlström T, Krasse B (1956) Direkt pulpaöverkappning på permanenta tänder. En klinisk röntgenologisk efterundersökning. Odontol Revy 7:397–403 Ahlström T, Krasse B (1956) Direkt pulpaöverkappning på permanenta tänder. En klinisk röntgenologisk efterundersökning. Odontol Revy 7:397–403
42.
go back to reference Harndt R, Schachtsiek G (1962) Klinische Kontrolle direkter Überkappungen der gesunden Pulpa. Dtsch Zahnärztebl 16:734–739 Harndt R, Schachtsiek G (1962) Klinische Kontrolle direkter Überkappungen der gesunden Pulpa. Dtsch Zahnärztebl 16:734–739
43.
go back to reference Beetke E, Wenzel B, Lau B, Bienengräber V (1990) Direct capping of the artificial exposed pulp in teeth with deep caries. Stomatol DDR 40:246–249PubMed Beetke E, Wenzel B, Lau B, Bienengräber V (1990) Direct capping of the artificial exposed pulp in teeth with deep caries. Stomatol DDR 40:246–249PubMed
44.
go back to reference Weiss MB, Massler M, Spence JM (1963) Operative effects on adult dental pulp. Dent Prog 4:6–15 Weiss MB, Massler M, Spence JM (1963) Operative effects on adult dental pulp. Dent Prog 4:6–15
45.
go back to reference Kakehashi S, Stanley HR, Fitzgerald RJ (1965) The effects of surgical exposure of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol 20:340–349CrossRefPubMed Kakehashi S, Stanley HR, Fitzgerald RJ (1965) The effects of surgical exposure of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol 20:340–349CrossRefPubMed
46.
go back to reference Cox CF, Bergenholtz G, Heys DR, Syed SA, Fitzgerald M, Heys RJ (1985) Pulp capping of dental pulp mechanically exposed to oral microflora: a 1–2 year observation of wound healing in the monkey. J Oral Pathol 14:156–168CrossRefPubMed Cox CF, Bergenholtz G, Heys DR, Syed SA, Fitzgerald M, Heys RJ (1985) Pulp capping of dental pulp mechanically exposed to oral microflora: a 1–2 year observation of wound healing in the monkey. J Oral Pathol 14:156–168CrossRefPubMed
47.
go back to reference Cox CF, Keall CL, Keall HJ, Ostro E, Bergenholtz G (1987) Biocompatibility of surface-sealed dentin materials against exposed pulps. J Prosthet Dent 57:1–9CrossRefPubMed Cox CF, Keall CL, Keall HJ, Ostro E, Bergenholtz G (1987) Biocompatibility of surface-sealed dentin materials against exposed pulps. J Prosthet Dent 57:1–9CrossRefPubMed
48.
go back to reference Østravik D, Pitt Ford TR (1998) Essential endodontology: prevention and treatment of apical periodontitis. Blackwell, Oxford, pp 192–210 Østravik D, Pitt Ford TR (1998) Essential endodontology: prevention and treatment of apical periodontitis. Blackwell, Oxford, pp 192–210
49.
go back to reference Shovelton DS, Friend LA, Kirk EEJ, Rowe AHR (1971) The efficacy of pulp capping materials. A comparative trial. Brit Dent J 130:385–391CrossRefPubMed Shovelton DS, Friend LA, Kirk EEJ, Rowe AHR (1971) The efficacy of pulp capping materials. A comparative trial. Brit Dent J 130:385–391CrossRefPubMed
50.
go back to reference Beerendonk KH (1939) Klinische und röntgenologische Untersuchungen mit Calxyl. Zahnärztl Rundsch 48:186–191 Beerendonk KH (1939) Klinische und röntgenologische Untersuchungen mit Calxyl. Zahnärztl Rundsch 48:186–191
51.
go back to reference Pajarola WF (1940) Die Überkappung gesunder und infizierter Pulpen mit Calxyl. Schweiz Monatsschr Zahnheilkd 50:511–540 Pajarola WF (1940) Die Überkappung gesunder und infizierter Pulpen mit Calxyl. Schweiz Monatsschr Zahnheilkd 50:511–540
52.
go back to reference Fenner H (1944) Spätresultate der Einwirkung des Calxyls bei der direkten Pulpaüberkappung und bei der Vitalamputation der Pulpa. Schweiz Mschr Zahnheilk 54:651–680 Fenner H (1944) Spätresultate der Einwirkung des Calxyls bei der direkten Pulpaüberkappung und bei der Vitalamputation der Pulpa. Schweiz Mschr Zahnheilk 54:651–680
53.
go back to reference Tananbaum NI (1951) Pulp capping with zinc oxide-eugenol and calcium hydroxide: clinical studies on 135 patients. J Dent Child 18:16–20PubMed Tananbaum NI (1951) Pulp capping with zinc oxide-eugenol and calcium hydroxide: clinical studies on 135 patients. J Dent Child 18:16–20PubMed
54.
go back to reference Castagnola L (1953) Die Lebenderhaltung der Pulpa in der konservierenden Zahnheilkunde. Hanser, München Castagnola L (1953) Die Lebenderhaltung der Pulpa in der konservierenden Zahnheilkunde. Hanser, München
55.
go back to reference Mumaw ED, Cooper P (1957) Simplified method of pulp capping adult teeth with calcium hydroxide. US Armed Forces Med J 8:979–984 Mumaw ED, Cooper P (1957) Simplified method of pulp capping adult teeth with calcium hydroxide. US Armed Forces Med J 8:979–984
56.
go back to reference Pritz W (1957) Erfahrungen mit Calxyl zur Pulpenüberkappung. ZWR 58:120–124 Pritz W (1957) Erfahrungen mit Calxyl zur Pulpenüberkappung. ZWR 58:120–124
57.
go back to reference Nyborg H (1958) Capping of the pulp. The processes involved and their outcome. A report of the follow-ups of a clinical series. Odontol Tidskr 66:296–386 Nyborg H (1958) Capping of the pulp. The processes involved and their outcome. A report of the follow-ups of a clinical series. Odontol Tidskr 66:296–386
58.
go back to reference Sapone J (1962) Pulp-capping of vital teeth. Dent Prog 3:47–52 Sapone J (1962) Pulp-capping of vital teeth. Dent Prog 3:47–52
59.
go back to reference Armstrong WP, Hoffman S (1962) Pulp-cap study. Oral Surg Oral Med Oral Pathol 15:1505–1509CrossRef Armstrong WP, Hoffman S (1962) Pulp-cap study. Oral Surg Oral Med Oral Pathol 15:1505–1509CrossRef
60.
go back to reference Jones MD, Gibb GH (1969) Direct pulp capping with Dycal. J Can Dent Assoc 35:584–587PubMed Jones MD, Gibb GH (1969) Direct pulp capping with Dycal. J Can Dent Assoc 35:584–587PubMed
Metadata
Title
Long-term evaluation of direct pulp capping—treatment outcomes over an average period of 6.1 years
Authors
Till Dammaschke
Jana Leidinger
Edgar Schäfer
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Clinical Oral Investigations / Issue 5/2010
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-009-0326-9

Other articles of this Issue 5/2010

Clinical Oral Investigations 5/2010 Go to the issue