A Clinical Report on Partial Pulpotomy and Capping with Calcium Hydroxide in Permanent Incisors with Complicated Crown Fracture

Resident’s Name: Anna Haritos Date: August 22, 2008
Article title: A Clinical Report on Partial Pulpotomy and Capping with Calcium Hydroxide in Permanent Incisors with Complicated Crown Fracture
Author(s): Miomir Cvek, DMD PhD
Journal: Journal of Endodontics
Volume (number): 4 (8)
Month, Year: Aug, 1978
Major topic: partial pulpotomies on permanent incisors with pulpal exposures from fracture
Minor topic(s): none
Type of Article: Scientific article
Main Purpose: To evaluate the frequency of healing of accidentally exposed pulp treated by partial pulpotomy
Overview of method of research: The sample consisted of 60 incisors, (51 maxillary and 9 mandibular); The patients ages ranged from 7016. Before treatment the following data was recorded: mobility, percussion sensitivity, interval from accident, and size and appearance of pulpal lesion. Photographs and radiographs were taken. All teeth were treated as follows: rubber dam isolation, 0.5% chlorhexidine solution to clean field, removal of part of coronal pulp and surrounding dentin with sterile diamond bur with resulting 2 mm cavity, copious irrigation and control of bleeding with sterile saline solution, covering of pulpal wound with calcium hydroxide product, Calasept, and sealing of cavity with sterile zinc oxide-eugenol cement. In the 3 teeth that had crown-root fractures, all of the pulpal tissue coronal to the lesion was removed. Clinical and radiographic examinations were done at 3 weeks, 3 months and 6 months. When a continuous hard barrier was seen radiographically, the ZOE and calcium hydroxide was removed under aseptic conditions, the barrier was clinically examined with a probe, and then Dycal (CaOH) and composite was placed.
Findings: Prior to treatment, all teeth were sensitive to electrical stimulation, and had a proliferated pulpal tissue or demonstrated bleeding (no necrosis). 96% (58 teeth) demonstrated healing. Healing was defined as the following: no clinical symptoms, no radiographical pathologic changes, continued root development of immature teeth, verifiable continuous hard tissue barrier, and sensitivity to electrical stimulation.
Key points/Summary: Size of pulpal exposure, and interval between accident and treatment are not critical to the healing of a primarily healthy pup.
Assessment of article: Amazing results considering the strict guidelines for healing