Indirect pulp capping

Sometimes, especially deep carious lesions in the vital, free from symptoms tooth presents the Clinician with a dilemma. If the lesion to be completely cut out that the flesh will be a direct impact of mouth, or some sick dentin to be left to avoid direct pulp impact?

Complete removal of tooth decay from the periphery of the cavity is not negotiable and must be carefully completed before attempting to manage the affected tissue of the tooth pulp wall. A clean working environment must also be protected, ideally, well-sealing rubber dam, but at least with the appropriate suction and wool insulation. Traditional teaching is then based on the idea that the coming before carious lesions contains demineralized, but barren dentin, which can be safely left in the depth of the cavity.

It is currently impossible to estimate with accuracy up to the day when this state is reached, and the practice is very diverse and subjective. With an acceptable degree excavation has been reached, the dentin/pulp complex is treated with dressing described as the?indirect the pulp of the cap", as a rule, the parameter of calcium hydroxide, cement, before recovering cavity against the oral environment.

The goal of calcium hydroxide and cement to create bactericidal, high pH of the environment in which the cellulose can go further dentin to wall itself off from further damage. He argued that calcium hydroxide actively promotes the deposition of reparative dentin, but there is no evidence that it has some special powers in connection with this, other than to provide clean arena for the production of wood pulp to get on his natural activity in the face of irritation. There is no clear data on the success of such procedures, although all experienced dentists have witnessed repeated caries and pulp participation under restoration. ..