Type of injury
Random pulp impact through the intact dentin occurring during cavity and crown preparation has the greatest potential for success. In this situation, the pulp can be healthy and bacterial contamination is limited, so is the primary precondition for the healing is optimal.
In traumatic injury, where the flesh was exposed to a shock or fall, healing conditions are favorable, though the wound may have been exposed to the oral environment for a certain period of time. Both clinical observations and experimental animal studies (12, 16, 17, 35) showed that bacterial contamination of the wound site within a short period of slightly (Key literature 4.2). Following proper disinfection and surgical, healing and hard tissue repair are possible in such cases (16, 26, 50).
In the exposition of caries, on the other hand, can be massive penetration of bacterial organisms and tissues. This usually resulted in localized acute inflammation of the pulp, often as abscess (see Chapter 2).
The possibility of treatment of these lesions, therefore unpredictable. Procedure of caries excavations, moreover, can lead to an aggravation of defeat, forcing infected dentin chips into the wound. Nevertheless, covering carious impacts may sometimes be considered if symptoms of pulpitis are missing. It is generally accepted that the most favorable prognosis exists at perforation is made within the last excavations deepest part of carious lesions and when there's only a small exhibition. Such a careful choice of the overall 5-year survival rate of 80% was found in 510 cases are analyzed Horsted et al. (40) and there was no difference in outcomes between decayed and non-carious expositions. This conclusion, in accordance with 93% success after 2 years presented for direct the closure or partial pulpotomy is in carious teeth in children and adolescents(11, 23, 50, 66, 88). However, others have reported very bleak results capping caries expositions. In one study, only 37% of the treated effluents survived for 5 years (check-up) and as little as 13% to 10 years (5). ..