direct pulp capping yes or no?
- Thread starter jcomplex
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- Dentist
When I was in school it varied by instructor. The endo department despised direct pulp caps. In their minds exposure=RCT. ALWAYS. 😀
The rule I use in my office is that I will place a direct pulp cap if it was a clean exposure - usually when you are just cleaning up the last little areas of discoloration, all gross decay is pretty much removed and you get a tiny little perforation. This is pretty rare.
If it is a carious exposure it is getting endo. I don't want that patient calling me in a month with a toothache. No matter how much you warn them of the chances of the pulp cap failing they will not remember and YOU will be blamed. Just don't do it.
Pedo teeth do NOT get direct pulp caps. They get pulpotomies - this is the standard of care. (I also will not place anything but SSC over a pulpotomy. I've extracted too many pulped pedo teeth restored with composite and amalgam.)
I do indirect pulp caps all the time though. Saves the patient weeks of sensitivity when you have placed a restoration right on top of the pulp.
The rule I use in my office is that I will place a direct pulp cap if it was a clean exposure - usually when you are just cleaning up the last little areas of discoloration, all gross decay is pretty much removed and you get a tiny little perforation. This is pretty rare.
If it is a carious exposure it is getting endo. I don't want that patient calling me in a month with a toothache. No matter how much you warn them of the chances of the pulp cap failing they will not remember and YOU will be blamed. Just don't do it.
Pedo teeth do NOT get direct pulp caps. They get pulpotomies - this is the standard of care. (I also will not place anything but SSC over a pulpotomy. I've extracted too many pulped pedo teeth restored with composite and amalgam.)
I do indirect pulp caps all the time though. Saves the patient weeks of sensitivity when you have placed a restoration right on top of the pulp.
Most of our school including endo faculty support our use of MTA for direct pulp capping of mechanical pulp exposures less than 1mm in diameter.
