Clinical Comparison between the Outcomes of One-Step versus Stepwise Indirect Pulp Capping
Comparison of One-Step vs. Stepwise Pulp Capping
DOI:
https://doi.org/10.61919/jhrr.v4i3.1200Keywords:
pulp capping, dental pulp capping, dental caries, dental pulp exposureAbstract
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.
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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).
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