DPC in Primary Molars.
Condition: Direct Pulp Capping in Primary Teeth
Study type: Interventional
Phase: Phase 4

Summary: 
      To evaluate clinical and radiographical outcomes of direct pulp capping using calcium
      hydroxide (CH), mineral trioxide aggregate (MTA), and premedicated direct pulp capping (PDPC)
      with formocresol (FC) in primary teeth.
    

Detailed description: 
      The pulp is imperiled by many environmental impacts. Caries, trauma, restorations, and
      mechanical injury during cleaning, all are possible aggressions that may injury the pulp
      tissue. When lesion disrupt enamel barrier, dentin can be degraded by Gram-positive bacteria,
      such as actinomyces, lactobacilli, and streptococci, that largely dominate the microflora of
      carious lesion. Pulp response differs according to the degree of the insult. The inflammatory
      reaction can cause permanent damage or be followed by repair, as the pulp cells have the
      ability to differentiate into odontoblasts forming dentin matrix facilitating wound healing.

      Calcium hydroxide was introduced to the dental practice in the 1920s, and early clinical
      studies using it in direct pulp capping showed an 80-90 percent success rate.Recent studies
      with longer follow-up periods suggest lower success rates for it.Calcium hydroxide was used
      in many forms alone and mixed with other materials for many applications in the dental
      profession. For direct pulp capping calcium hydroxide powder and aqueous paste were used at
      first then premixed and cement-based types were developed.

      Mineral trioxide aggregate (MTA) was introduced to the dental practice in the 1990s as a
      root-end filling material. MTA is used as a gold standard in endodontics and has a variety of
      applications such as root-end filling, apexification, root and truck perforations,
      apexogenesis, pulp capping in permanent and primary teeth, and dressing for pulpotomy in
      primary teeth. It is mainly composed of tricalcium silicate, tricalcium aluminate, dicalcium
      silicate, bismuth oxide, and calcium sulfate dehydrate.

      Several studies have shown the efficacy of direct pulp capping using calcium hydroxide and
      MTA in permanent teeth. However, its use in primary teeth is controversial and few studies
      are available regarding that subject. Formocresol is not known to be used in direct pulp
      capping techniques, however, its high clinical success in pulpotomy techniques for primary
      teeth promoted the investigation of its possible use as direct capping medicament. In
      addition, there are not enough collected clinical and histological data about direct capping
      in primary teeth to assess the true success of treatment. Accordingly, the study was directed
      to evaluate the histological and clinical success of different materials in direct pulp
      capping for primary teeth.
    

Intervention name(s): Direct pulp capping with calcium hydroxide; Direct pulp capping with MTA; Direct pulp capping with Formocresol
Intervention type(s): Drug; Drug; Drug
Intervention description(s): Capping exposed dental pulps during cavity preparation in primary teeth with calcium hydroxide; Capping exposed dental pulps during cavity preparation in primary teeth with MTA; Capping exposed dental pulps during cavity preparation in primary teeth with zinc oxide eugenol after medication with formocresol
Intervention MeSH terms: Calcium
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment