Clinical Comparison between the Outcomes of One-Step versus Stepwise Indirect Pulp Capping Comparison of One-Step vs. Stepwise Pulp Capping

Article Sidebar

PDF
Published: Jul 29, 2024
DOI: https://doi.org/10.61919/jhrr.v4i3.1200
Keywords:
pulp capping dental pulp capping dental caries dental pulp exposure

Main Article Content

Iman Baig
FCPS Post Graduate Trainee, Operative Dentistry and Endodontics, Islamabad Medical and Dental College, Islamabad, Pakistan
Saima Azam
Professor, Head of Department, Operative Dentistry and Endodontics, Islamabad Medical and Dental College, Islamabad, Pakistan

Abstract

Background: Background: Dental caries is a prevalent condition that can lead to adverse pulpal outcomes if left untreated, making the preservation of pulp vitality essential. Indirect pulp capping is a conservative method designed to support pulp health.
Objective: This study aims to clinically compare the outcomes of one-step versus stepwise indirect pulp capping in maintaining pulp vitality.
Methods: Conducted at the Department of Operative Dentistry, Islamabad Dental Hospital, this study enrolled 80 patients, with 40 patients per group determined using the WHO sample size calculator. Convenience sampling was used to select patients with permanent teeth, 1.5mm-2mm remaining dentin thickness, and symptoms of reversible pulpitis. In the one-step group, infected dentin was removed, a biocompatible material was applied, and the tooth was permanently restored. In the stepwise group, caries removal was followed by a temporary restoration over biocompatible lining, with re-entry and final restoration at 12 weeks. Data were analyzed using SPSS v.22, with Fisher's exact test applied.
Results: The study included 47.5% male and 52.5% female participants, with a mean age of 29.5 ± 9.05 years. The stepwise group achieved 100% favorable outcomes versus 87.5% in the one-step group, showing statistical significance (p=0.027).
Conclusion: Stepwise indirect pulp capping significantly enhances pulp vitality preservation by fostering dentinal bridge formation and pulpal healing.

Article Details

How to Cite
Baig, I., & Azam, S. (2024). Clinical Comparison between the Outcomes of One-Step versus Stepwise Indirect Pulp Capping: Comparison of One-Step vs. Stepwise Pulp Capping. Journal of Health and Rehabilitation Research, 4(3), 1–4. https://doi.org/10.61919/jhrr.v4i3.1200
Issue
Vol. 4 No. 3 (2024): Volume 4, Issue 3 - July to September 2024
Section
Articles
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Author Biographies

Iman Baig, FCPS Post Graduate Trainee, Operative Dentistry and Endodontics, Islamabad Medical and Dental College, Islamabad, Pakistan

She is a dedicated academic and researcher with a robust background, having completed her BDS, MPH, and currently serving as an FCPS Resident. Her research focus lies in the fields of operative dentistry and endodontics, where she has actively contributed through her scholarly work. She has authored 11 research articles published in reputable journals, alongside a book chapter in a recognized academic publication. Her commitment to advancing knowledge and clinical practice in her areas of expertise is evident through her ongoing research endeavors and academic involvement.

Saima Azam, Professor, Head of Department, Operative Dentistry and Endodontics, Islamabad Medical and Dental College, Islamabad, Pakistan

She is a seasoned academic and researcher, currently serving as a Professor and Head of the Department of Operative Dentistry and Endodontics. Her extensive research expertise is centered on operative dentistry and endodontics, where she has made significant contributions to the field. With 16 research articles published in esteemed journals and a published book chapter in a recognized academic book, her work is well-regarded in the dental research community. Additionally, she holds the distinguished roles of Supervisor and Examiner at the College of Physicians and Surgeons Pakistan, reflecting her commitment to advancing education and clinical excellence in her specialty.

References

World Health Organization. Sugars and Dental Caries. Geneva: World Health Organization; 2017. Contract No.: WHO/NMH/NHD/17.12.

Clarkson JE, Ramsay CR, Ricketts D, Banerjee A, Deery C, Lamont T, et al. Selective Caries Removal in Permanent Teeth (SCRiPT) for the Treatment of Deep Carious Lesions: A Randomized Controlled Clinical Trial in Primary Care. BMC Oral Health. 2021;21(1):336.

Bjørndal L, Simon S, Tomson PL, Duncan HF. Management of Deep Caries and the Exposed Pulp. Int Endod J. 2019;52(7):949-73.

Gurcan AT, Seymen F. Clinical and Radiographic Evaluation of Indirect Pulp Capping With Three Different Materials: A 2-Year Follow-Up Study. Eur J Paediatr Dent. 2019;20(2):105-10.

Fagundes TC, Barata TJE, Prakki A, Bresciani E, Pereira JC. Indirect Pulp Treatment in a Permanent Molar: Case Report of 4-Year Follow-Up. J Appl Oral Sci. 2009;17(1):70-4.

Hoefler V, Nagaoka H, Miller CS. Long-Term Survival and Vitality Outcomes of Permanent Teeth Following Deep Caries Treatment With Step-Wise and Partial-Caries-Removal: A Systematic Review. J Dent. 2016;54:25-32.

Duncan HF, Galler KM, Tomson PL, Simon S, El-Karim I, Kundzina R, et al. European Society of Endodontology Position Statement: Management of Deep Caries and the Exposed Pulp. Int Endod J. 2019;52(7):923-34.

Nair M, Gurunathan D. Clinical and Radiographic Outcomes of Calcium Hydroxide vs Other Agents in Indirect Pulp Capping of Primary Teeth: A Systematic Review. Int J Clin Pediatr Dent. 2019;12(5):437-44.

Bjørndal L, Fransson H, Bruun G, Markvart M, Kjældgaard M, Näsman P, et al. Randomized Clinical Trials on Deep Carious Lesions: 5-Year Follow-Up. J Dent Res. 2017;96(7):747-53.

Bjørndal L. Stepwise Excavation. Monogr Oral Sci. 2018;27:68-81.

Alsadat F, El-Housseiny A, Alamoudi N, Alnowaiser A. Conservative Treatment for Deep Carious Lesions in Primary and Young Permanent Teeth. Niger J Clin Pract. 2018;21(12):1549-56.

Bjørndal L, Reit C, Bruun G, Markvart M, Kjældgaard M, Näsman P, et al. Treatment of Deep Caries Lesions in Adults: Randomized Clinical Trials Comparing Stepwise vs. Direct Complete Excavation, and Direct Pulp Capping vs. Partial Pulpotomy. Eur J Oral Sci. 2010;118(3):290-7.

Kidd EAM. How ‘Clean’ Must a Cavity Be Before Restoration? Caries Res. 2004;38(3):305-13.

Bjørndal L, Larsen T, Thylstrup A. A Clinical and Microbiological Study of Deep Carious Lesions During Stepwise Excavation Using Long Treatment Intervals. Caries Res. 1997;31(6):411-7.

Trifan D, Imanand Azam S. Single Visit Indirect Pulp Capping With Biodentine: Clinical Case Report. Mold J Health Sci. 2024;11(1):72-6.

Imanand Azam S. Comparison of One-Step vs. Stepwise Pulp Capping. J Health Rehabil Res. 2024;4(3):716. DOI: https://doi.org/10.61919/jhrr.v4i3.1200.

Orhan AI, Oz FT, Ozcelik B, Orhan K. A Clinical and Microbiological Comparative Study of Deep Carious Lesion Treatment in Deciduous and Young Permanent Molars. Clin Oral Investig. 2008;12(4):369-78.

Lehmann M, Veitz-Keenan A, Matthews AG, Vena D, Grill A, Craig RG, et al. Dentin Caries Activity in Early Occlusal Lesions Selected to Receive Operative Treatment. J Am Dent Assoc. 2012;143(4):377-85.

Manhas S, Pandit IK, Gugnani N, Gupta M. Comparative Evaluation of the Efficacy of Stepwise Caries Excavation vs Indirect Pulp Capping in Preserving the Vitality of Deep Carious Lesions in Permanent Teeth of Pediatric Patients: An In Vivo Study. Int J Clin Pediatr Dent. 2020;13(Suppl 1).

Al-Asmar AA, Al-Hiyasat AS, Pitts NB. Reframing Perceptions in Operative Dentistry Relating Evidence-Based Dentistry and Clinical Decision Making: A Cross-Sectional Study Among Jordanian Dentists. BMC Oral Health. 2022;22(1).

Baig I, Mushtaq TB. Ways of Maintaining Pulp Vitality: Narrative Literature Review. J Health Rehabil Res. 2024;4(1):1763-7.

Dholani JI, Chokshi SP, Sanghvi ZK, Menon SS. Stepwise Caries Intervention: An Approach Precursive to Endodontic Intervention – A Case Series. SEJ. 2024;14(2).