Direct pulp capping
Despite careful excavation, slurries are often subjected to the mouth during the preparation of the cavity. They are also often subject to complex coronal fractures of the teeth. The key factors determining the outcome of the main conditions of the pulp of the tooth and the ability of a dentist to prevent tissue infection. The state of the pulp and sometimes can be easily assessed on history of symptoms, or the results of sensitivity tests before treatment. However, histological state pulp, has little to reported symptoms, and from conventional cellulose tested, even if it was done before local anesthesia and preparation cavity, very raw.
When caries expanded in the flesh in the present carious exposure, the pulp is contaminated with microorganisms, and also has little chance of survival, even if not presenting symptoms. Similarly, traumatic impact on the left to open his mouth in 24 hours contaminated by micro-organisms, and has little chance of survival if the cavity just restored.
The best forecast for traumatic dental pulp expositions treatment as soon as possible after the event. The tooth should be well isolated sealing rubber dam, pulp clean the wound, and hemostasis, protected with sodium hypochlorite. Hemostasis is crucial to the success of any direct coverage dental pulp procedures. Failure to achieve adequate hemostasis probably reflects more than expected, inflammation of the pulp of the tooth, and therefore a poor prognosis. Classically, the pulp is then covered with setting hydroxide calcium cement for further disinfection are pulp and encourage the deposition of reparative dentin bridge. However, there is strong evidence that bridges induced calcium hydroxide are incomplete and porous and do not provide long-term cellulose protection, especially if restorations leak at a later stage (COX et al. 1996). In recent years, considerable interest has focused on the dentin-bonded composite materials as materials that are able to provide a clean, well-sealed environment for more predictable and full of the pulp of the tooth repair.
These approaches are now accepted and widely practiced, though the long-term effects are unknown. Calcium hydroxide is no longer holds the position of glory unique cellulose regenerative agent, and the realization that the conditions created restorative material, which allow healing to take place opened the search for alternative approaches. A variety of materials, including steklovarenie cements, and extremely well seal and biocompatible mineral Trioxide aggregate (Maillefer/firm, Ballaigues, Switzerland) have their supporters. Radical new biologically active approaches such as the use of human growth factors induced dentin bridge formation under a broad investigation. This, however, it is important to stress once again that the main condition of the pulp is the key to success. Even biologically active molecular approaches will be ineffective in case of dying pulp...