This is the first article in a series reviewing the current literature surrounding the management of deep caries in permanent teeth. Approaches to caries management are continuing to evolve, with more conservative management increasingly favoured. This philosophy has never been more important than in managing the deep carious lesion. Evidence is emerging that the use of selective caries removal to reduce the risk of pulp exposure, in conjunction with calcium silicate cements, can be successful in maintaining pulp vitality, delaying the restorative cycle and prolonging the lifespan of the tooth.
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http://dx.doi.org/10.1038/s41415-020-2590-7 | DOI Listing |
Int Endod J
January 2025
Department of Periodontics & Oral Implantology, Post Graduate Institute of Dental Sciences, Rohtak, India.
Aim: The objective of pulpotomy is to preserve the pulp vitality. However, the assessment of pulpal status following pulpotomy is often overlooked. This retrospective analysis aimed to compare the pulp responses to EPT (Electric pulp test) and cold test in mature permanent molars that have undergone either complete pulpotomy (CP) or partial pulpotomy (PP) for managing carious pulpal exposure and symptomatic irreversible pulpitis (SIP) and completed 12 months follow-up.
View Article and Find Full Text PDFClin Case Rep
January 2025
Iranian Centre for Endodontic Research, Research Institute of Dental Sciences Shahid Beheshti University of Medical Sciences Tehran Iran.
Internal root resorption (IRR) is a complex and often asymptomatic dental condition that can severely compromise tooth vitality and function. This case report presents the successful management of a perforated large IRR lesion in a 49-year-old female using an ultraconservative approach involving partial pulpectomy (PP) using calcium-enriched mixture (CEM) cement. The patient, initially presenting with an asymptomatic resorptive lesion in her left first premolar, underwent ultraconservative PP following diagnosis via conventional radiography and cone beam computed tomography.
View Article and Find Full Text PDFInt J Mol Sci
December 2024
Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy.
Dental inflammatory diseases remain a challenging clinical issue, whose causes and development are still not fully understood. During dental caries, bacteria penetrate the tooth pulp, causing pulpitis. To prevent pulp necrosis, it is crucial to promote tissue repair by recruiting immune cells, such as macrophages, able to secrete signal molecules for the pulp microenvironment and thus to recruit dental pulp stem cells (DPSCs) in the damaged site.
View Article and Find Full Text PDFJ Transl Med
January 2025
Dental School, The University of Western Australia, 17 Monash Avenue, Nedlands, WA, 6009, Australia.
Background: Treatment of deep carious lesions poses significant challenges in dentistry, as complete lesion removal risks compromising pulp vitality, while selective removal often reduces the longevity of restorations. Herein, we propose a minimally invasive approach using High-Intensity Focused Ultrasound (HIFU) for microscale removal of carious dentine. Concurrently, HIFU's antimicrobial effects against associated cariogenic biofilms and the corresponding thermal and biological impacts on surrounding tissues were investigated.
View Article and Find Full Text PDFInt J Oral Sci
January 2025
Department of Cariology and Endodontics, Wuhan University & State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
Pulpotomy, which belongs to vital pulp therapy, has become a strategy for managing pulpitis in recent decades. This minimally invasive treatment reflects the recognition of preserving healthy dental pulp and optimizing long-term patient-centered outcomes. Pulpotomy is categorized into partial pulpotomy (PP), the removal of a partial segment of the coronal pulp tissue, and full pulpotomy (FP), the removal of whole coronal pulp, which is followed by applying the biomaterials onto the remaining pulp tissue and ultimately restoring the tooth.
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