well, that will actually depend on the lesion size .... when you say resorption you mean root resorption ?
check this one out please
http://www.aapd.org/media/policies_guidelines/g_pulp.pdf
Dear Alok Dubey,
DPC is indicated only mechanical exposure during cavity preparation which is
Hello everyone!
With indirect pulp capping by partial removal of decayed tissue, with the removal of infected dentin and maintenance of the affected dentin, we believe that we will have fewer pulpotomies and direct protections in our clinical practice.
Just adding one more topic for this discussion.
A good day to everyone!
it all depends on the size of the exposure. If its more then pulpotomy would be the option
Cvek pulpotomy is most of the time gives a successful outcome.....researches are suggesting pulpotomy in permanent as well
Usually DPC is not a treatment of choice in primary teeth of very young children. The reason cited is due to rich vascularity and rapid intrapulpal blood flow localisation of infection/inflammation in coronal pulp (which is the basic assumption made to perform DPC) of primary teeth is poor, because of which there are high chances of internal resorption/ progressive pulpal necrosis/diffuse calcifications etc leading in to treatment failiure. BUT there is one instance where DPC can be considered in primary teeth i.e: a strategically important tooth whose life expectancy is not more than few months (As the above mentioned complications take longer duration to reach clinically appreciable effect, by that time the tooth will reach its physiological exfoliation period...,
I do completely agree with Luiz Evaristo Ricci Volpato :
Moreover partial excavation without anesthesia will safely avoid any kind of pulp-exposure and further can be said that no need to re-enter systematically , but only in cases where large amount of soft dentin ( ITR= Intermediar therapeutic restoration ) would be deleterious for the mechanical support of the future "definitive" filling .
In a deep carious lesion in primary teeth, it is always better to do a pulpectomy ie complete debridement of the root canal system, over a pulpotomy. The dentin-pulp complex of the primary teeth has rapid transmission of stimulus from dentin to the pulp because of wider dentinal tubules in primary teeth.
Moreover, when any infection or inflammation is present, it is very difficult to state clinically if the inflammation is limited to coronal or radicular pulp. Hence, if we open the pulp chamber while removing the carious lesion, it is better to debride the entire root canal.
However, if the carious lesion is limited only to dentin, and not involving the pulp; or there is a clear sound dentin after the removal of caries, indirect pulp capping using calcium hydroxide, would be the best treatment option. It would help in the formation of reparative dentin, as maintain the integrity of dental pulp.
In a deep carious lesion; following excavation and there is no pulpal exposure, you can do Indirect pulp capping. But should you inadvertently exposure the pulp, you go straight and do pulpotomy. Reason, Optimal chance for favorable prognosis with DPC depends on case selection.
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