Only a proper dental Checkup by a professional in person can help diagnose the problem you are suffering from and help give you the required treatment. Direct pulp capping is a proven method of preserving tooth vitality of a mature permanent tooth in cases of pulp exposures. Medical Information Search. Direct pulp capping Indirect pulp capping 15. MTA cements favor the mineralization process in human dental pulp cells, thus having the potential to be used as capping materi-als (18). b) small exposure less than 0.5mm … The pulp is judged by clinical and radiographic criteria to be vital and able to heal from the carious insult. & Either Amalgam or GIC. • Indications: This procedure is indicated in a primary tooth with a normal pulp following a small mechanical or trau- matic exposure when conditions for a favorable response are optimal.41-45 Direct pulp capping of a carious pulp exposure in a primary tooth is not recommended.1 • Objectives: The tooth’s vitality should be maintained. You can change your ad preferences anytime. The wound … Clin Oral Investig. Direct pulp capping refers to the procedure of placing a dental material (most often calcium hydroxide) directly over the exposed (or nearly exposed) dental pulp … Biodentine is a new bioactive cement that is similar to the widely used mineral trioxide aggregate (MTA). Small mechanical exposure surrounded by sound dentin in asymptomatic vital primary teeth / young permanent teeth. DIRECT PULP CAPPING: Defined as a procedure in which the exposed vital pulp is covered with a protective dressing or base placed directly over the site of exposure in an attempt to preserve the pulp vitality. Indirect pulp capping • procedure where the deepest layer of the remaining affected carious dentin is covered with layer of biocompatible material in order to prevent pulpal exposure and further trauma to pulp. The indications for this treatment are the same as for direct pulp capping. Liner : ApaCal ART can be used as an effective cavity liner under various restorations. cavities, and direct pulp capping and pulpotomy, which can be used in pulp perforations [Fuks, 2008]. In some cases, the dentist may not need to expose the pulp, and will cap the soft layer of dentin that covers the pulp chamber. dressing or cement that protects the pulp from ad-. A direct pulp cap is done on permanent teeth when the removal of deep decay results in exposing the pulp. Some of its indications include direct and indirect pulp capping, apexogenesis, apexification, treatment of; root resorption, iatrogenic root perforations, root fractures, replanted teeth and interappointment intracanal dressing. If the etiology was any carious lesion make sure that you have removed all the remaining carious dentin which should not extend into the pulp chamber. Pulp protection therapies aim to maintain the vitality of the tooth in which pulp tissue has been exposed due to trauma, carious lesions, or restorative procedures. • 5- Biodentin • 6- Bonding systems. It shares both its indications and mode of action with calcium hydroxide, but does not have its disadvantages. 2004; 38(3):314–20. If there are clinical signs of pulp vitality, it is recommended to carry out direct pulp capping (DPC) using appropriate pulp covering agents (PCA). The indication is given when “reversible pulpitis” is diagnosed. indirect pulp capping: the application of a suspension of calcium hydroxide to a thin layer of dentin overlying the pulp (near exposure) in order to stimulate secondary dentin formation and protect the pulp. The success rate for direct pulp capping with Ca(OH)2, MTA and Biodentine was shown at 6 months follow‐up (A), 1 year (B), 2‐ 3yrs (C) and 4–5 year (D) Depending on the clinical setting, vital pulp therapy can be managed with an indirect or direct pulp-capping procedure. Direct pulp capping involves the application of a dental material to the exposed pulp in an attempt to act as a barrier, protect the dental pulp complex and preserve its vitality (1). DIRECT PULP CAPPING: Placement of a medicament / non medicated material on a pulp that has been exposed in course of excavating the last portions of deep dentinal caries. Indications:•Endodontic indications (repair of perforations orresorptions, apexification, root-end filling)•Permanent dentine substitute and temporary enamelsubstitute•Restoration of deep or large crown carious lesions•Direct pulp capping in adults presenting healthy pulp 33 Indications: Indirect pulp treatment is indicated in a permanent tooth diagnosed with a normal pulp with no symptoms of pulpitis or with a diagnosis of reversible pulpitis. If you have any doubts feel free to contact me or comment in the post, thanks for visiting. 2) Direct pulp capping Indications: If during cavity preparation (or following a traumatic injury) there is a mechanical exposure of the pulp at a pin point – direct pulp capping may be indicated; Rationale: Maintain tooth vitality; Aim to prevent any further signs or … The first method of capping exposed pulps, using gold foils, was described by Pfaff in 1756. With the help of proper appliances make the cavity completely dry, do not use an Air Spray as the pulp chamber is open and can enforce air bubbles into the pulp which can later lead to severe pain.Use properly sterilized cotton pellets instead. If you continue browsing the site, you agree to the use of cookies on this website. 6. Placement of a medicament / non medicated material on a pulp that has been exposed in course of excavating the last portions of deep dentinal caries. Tziafas D. The future role of a molecular approach to pulp-dentinal regeneration. A Radiograph should be taken to confirm wether Direct  Pulp Capping is sufficient or not. Learn vocabulary, terms, and more with flashcards, games, and other study tools. See our Privacy Policy and User Agreement for details. Analytical, Diagnostic and Therapeutic Techniques and Equipment 24 2010; 14(5):559–67. Chapter. Direct Pulp Capping: Here the protective dressing is placed directly above an exposed pulp. It has dentin-like mechanical properties, which may be considered a suitable material for clinical indications of dentin-pulp complex regeneration such as direct pulp capping. Teeth were divided into three groups according to the materials used for pulp capping. • - Bactericidal or bacteriostatic, able to provide bacterial seal. The tooth is then isolated by a Rubber dam. If so, disinfect the tooth preparation as described above, place a pulp capping material of your choice (again, I prefer resin-modified glass ionomer), and place a bonding agent and a direct restoration of your choice. The guidelines cautioned that direct pulp capping has not been proven to be a reliable procedure but suggested the use of MTA when the following conditions were present: The powder mainly contains tricalcium A new bioactive cement for direct pulp capping Till Dammaschke1 Clinical 52 INTERNATIONAL DENTISTRY – AUSTRALASIAN EDITION VOL. c) ensuring the continuity of normal apexogenesis in immature permanent teeth. Start studying DONE Indications and contraindications of vital pulp therapy. • - Adhere well to dentin and restorative material. See our User Agreement and Privacy Policy. ° Pulp exposure (till 1 mm in diameter) is cleaned with physiological solution; ° Control of bleeding should be done in 1-2 min. You should always understand that a Patient to Doctor interaction is the only way to properly diagnose the problem and decide its cure. Direct pulp capping is advantageous for extending tooth life by maintaining tooth vitality as the direct pulp capping material facilitates the formation of reparative dentin from odontoblasts (31-33) and the maintenance of vital pulp (34-36). ; ° Pulp exposure is covered with MTA (fig. The indications, clinical factors, materials and treatment procedures are considered along with the expected prognosis. This is one-step procedure and is indicated in cases where there is pinpoint exposure of the pulp due to mechanical trauma (accidents, falls or fracture) or accidental exposure of the pulp during cavity preparation or removal of dental caries. For use with direct or indirect pulp capping within 2 mm of pulp For use under permanent restorative materials Used in the deepest portion of cavity preparation May be used underneath a base ; Contraindications. Cannot be … indications from healthy and cooperative children aged between 4–15 years, were included in this study. Direct pulp capping with Biodentine over a carious exposure in a mature permanent tooth may be a reasonable alternative to root canal therapy or extraction. Your email address will not be published. Indications for direct pulp capping include recent traumatic exposure or mechanical exposure during cavity preparation. 18 A successful pulp cap has a vital pulp and a dentin bridge within 75 to 90 days. View full-text. Direct Pulp Capping: Here the protective dressing is placed directly above an exposed pulp. When there is minimal exposure of the Pulp which is asymptomatic and Vital Direct  pulp capping should be done. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. 2.2.1 Rationale • To encourage the formation of a dentine bridge at the point of pulpal exposure with preservation of pulpal health and vitality Pulp therapy for primary molars • - Stimulate reparative dentin formation. Direct pulp capping should not be performed on a pulp that has been exposed as a result of penetrating caries. If you continue browsing the site, you agree to the use of cookies on this website. The only problem was that it had a large open contact space. Direct pulp capping is defined as the treatment of an exposed pulp, which can be caused by caries, preparation measures or dental trauma. Direct pulp capping is a method of treatment of in- flammation diseases of the pulp in their reversible stage. The determination of which therapy to employ is a decision that must be made by the clinician at the time of treatment. teeth and indications for application of direct pulp capping as a method of treatment. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. 30. Many materials have been used and tested in indirect pulp capping (IPC) treatments for primary and permanent teeth [Marchi et al., 2006; Renata et al., 2007; Gruythuysen et al., 2010]. to preserve vitality of the radicular pulp tissue after removal of the coronal portion. Web. Clipping is a handy way to collect important slides you want to go back to later. After properly drying the cavity, place the selected restoration material and seal the cavity. BRONJ bisphosphonates osteonecrosis of jaw, No public clipboards found for this slide. Indirect pulp capping : ApaCal ART can be used as a pulp protective agent in deep cavities. Caplan DJ, Cai J, Yin G, White BA. Calcium hydroxide is a multipurpose agent, and there have been an increasing number of indications for its use. Indications Tooth selection for direct pulp capping involves the same vital pulp therapy considerations mentioned previously, to rule out signs of irreversible pulp inflammation and degeneration. This review article focuses on the transition of indications, prognostic factors and future perspectives of direct pulp capping therapy, attempting to provide evidence and practical guidance for minimally invasive biologically based therapies of teeth with injured pulp. Dammaschke T, Leidinger J, Schafer E. Long-term evaluation of direct pulp capping-treatment outcomes over an average period of 6.1 years. The remaining cavity is filled with Any permanent restoration. I am Varun, a Dentist from Hyderabad, India trying my bit to help everyone understand Dental problems and treatments and to make Dental Education simplified for Dental Students and Dental fraternity. 18 A successful pulp cap has a vital pulp and a dentin bridge within 75 to 90 days. The Pulp exposure should be <0.5 mm in diameter. plying direct pulp capping method. Pulp capping proved to be a valuable method of treatment in immature permanent teeth, where the complete development of the root is a prerequisite for a … If a pulp exposure was encountered, decide if pulp capping is feasible (minimal exposure 0.5 to 0.75 mm with slow oozing of red normal-looking blood). 7. Depending on the clinical setting, vital pulp therapy can be managed with an indirect or direct pulp-capping procedure. No 2-C); ° The pulp capping material (MTA) is covered with glassionomer cement (fig. Its unique Active Release Technology is useful in pulp capping and as protective base/liner under dental filing materials, cements and other restorative materials. Dental Treatments During Pregnancy – Safe or Not? dental pulp capping. There are two broad types of pulp capping - the direct and the indirect pulp caps. The procedure typically involves arresting any pulpal hemorrhage followed by covering and sealing exposed pulp tissue in some fashion to preserve its health, function, and viability. Summary of the success rate of direct pulp capping of all studies in four follow‐up points. Direct Pulp Capping : ApaCal ART can be placed directly on dental pulp after achieving complete haemostasis. Caries Res. It has dentin-like mechanical properties, which may be considered a suitable material for clinical indications of dentin-pulp complex regeneration such as direct pulp capping. Because pulp capping studies have exhibited fluctuations in success rates according to different follow-up times, investigating the clinical pulpal survival rate and the potential factors contributing to the survival with respect to time is necessary. Indications and contraindications for use Indications. This is one-step procedure and is indicated in cases where there is pinpoint exposure of the pulp due to mechanical trauma (accidents, falls or fracture) or accidental exposure of the pulp during cavity preparation or removal of dental caries. The main objectives are maintenance of pulp vitality/healing along with the formation of a calcified bridge beneath the PCA. In some cases, the dentist may not need to expose the pulp, and will cap the soft layer of dentin that covers the pulp chamber. It is not intended to replace your Dental Visit. The only other direct pulp capping I did … The clinical guidelines for the pulp capping procedure followed in the current study were issued in October 2002. Some authors denigrate this method of preserving. Start studying DONE Indications and contraindications of vital pulp therapy. The indication for direct pulp capping was given when a tooth pulp was exposed on account of caries lesions, caries excava-tion and trauma, or definitive restoration. The Tooth affected is Anesthetised wither by a Local infiltration or a Nerve block. Direct Pulp capping is done mostly when there is accidental exposure of Pulp either by any Trauma or by accidental exposure by the dentist. We give clinical steps for appli-cation of the method and summarized the clinical and ra-diographic criteria for success after treatment. • 4- Bioaggregate. For a traumatic exposure or a mechanical exposure occurring during cavity preparation of shallow decay, performing a direct pulp capping with calcium hydroxide or mineral trioxide aggregate (MTA) is indicated [ … Therapeutic indications for direct pulp capping Direct capping may be used only for healthy or revers-ibly inflamed pulp. When to Perform Pulp Capping . Exposure should have bright red hemorrhage that is easily controlled by dry cotton pellets with minimal pressure. Indications. Direct pulp capping . Materials Used for Direct Pulp Capping: This is known as indirect pulp capping. Dental pulp exposure is a common incident during dental treatment. studies allowed the indications of MTA to be extended beyond its original purpose as a material to seal perfora-tions, to its use as a retrograde filling material (16), also as a pulp capping cement in pulpotomies (17). Done by Weam faroun. There are two types of pulp capping: direct and indirect. After the Restoration is done, the patient is recalled after 8 weeks and a Radiograph is taken to access the formation of Dentin Bridge. ditional injury and permits healing and repair (1). Now customize the name of a clipboard to store your clips. exposed dental pulp is covered with a protective. It has dentin-like mechanical properties, which may be considered a suitable material for clinical indications of dentin-pulp complex regeneration such as direct pulp capping. Notify me of follow-up comments by email. Depending on the clinical setting, vital pulp therapy can be managed with an indirect or direct pulp-capping procedure. vital pulp treatment indirect pulp capping direct pulp capping materials radiographic examination Done by Weam Mahmoud Faroun. 1.2 Pulp capping The other way of treating an exposed tooth is direct pulp capping. It is important to ensure that patient should not have any … Thereafter, numerous agents for direct pulp capping have been recommended. In this video I have discussed about Direct Pulp Capping (DPC), Indications, Contraindications, Objectives, Procedure & Criteria for success of DPC. It is hoped that the preceding discussion has informed the c … Indications of indirect pulp capping Permanent teeth diagnosed with … Medications and materials used for Pulp Capping: Inert Materials – Iso butyl Cyanoacrylate & tricalcium phosphate. Indirect pulp treatment was applied using Dycal for 91 teeth, ProRoot MTA for 89 teeth and TheraCal LC for 115 teeth. Learn vocabulary, terms, and more with flashcards, games, and other study tools. There are two types of pulp capping: direct and indirect. I am Varun, a Dentist from Hyderabad, India trying my bit to help everyone understand Dental problems and treatments and to make Dental Education simplified for Dental Students and Dental fraternity. The ultimate goal of direct pulp capping materials is the in-duction of hard tissue formation by pulp cells (2). Biodentine™ consists of a powder in a capsule and liquid in a pipette. Direct Materials 2.2 Direct pulp capping This approach has limited application and is gener-ally not recommended for primary molars. Direct pulp capping is a treatment option for teeth with carious-exposed pulp. The classic indication for direct pulp capping has been for "pinpoint" mechanical exposures that are surrounded with sound dentin. Radiographic appearance of pulp, periradicular degeneration, Excess of haemorrhage at the time of exposure. Introduction. 7, NO. 4. Only teeth with clinically normal pulps or revers-ible pulpitis, without recognizable radiologic changes, were included in this study. Since the inflammatory response of the pulp occurs already when the carious process involves the superficial dentin layer, direct capping of fully healthy pulp is very rare and a clear verification indicating that the pulp It is supplied in paste form which can be syringed using delivery tips. 2) Direct pulp capping Indications: If during cavity preparation (or following a traumatic injury) there is a mechanical exposure of the pulp at a pin point – direct pulp capping may be indicated; Rationale: Maintain tooth vitality; Aim to prevent any further signs or … Key words: direct pulp capping, primary teeth, reversible pulpitis, vital methods, - Download FULL TEXT /PDF 652 KB/ Please cite this article in PubMed Style or AMA (American Medical Association) Style: Milcheva N, Kabaktchieva R, Gateva N. Direct pulp capping in treatment of reversible pulpitis in primary teeth- clinical protocol. 1. Your email address will not be published. • Indications: This procedure is indicated in a primary tooth with a normal pulp following a small mechanical or traumatic exposure when conditions for a favorable response are opti-mal.41-45 Direct pulp capping of a carious pulp exposure in a primary tooth is not recommended.1 • Objectives: The tooth’s vitality should be maintained. Juniordentist.com is intended for educational, informative and entertainment purposes only. DIRECT PULP CAPPING. Direct pulp capping should not be performed on a pulp that has been exposed as a result of penetrating caries. • 2- Mineral Trioxide Aggregate MTA. 19. Required fields are marked *. Direct Pulp capping is done mostly when there is accidental exposure of Pulp either by any Trauma or by accidental exposure by the dentist. Direct pulp capping should be used only on a vital pulp that has been accidentally injured and shows no other symptoms. Treatment options in this situation include direct pulp capping, pulpotomy, or pulpectomy [1,2]. Direct pulp capping is used when the pulp is exposed after drilling. The pulp was vital to the Endo Ice test with no inflammation. Ideal properties of a pulp capping agent - Maintain pulp vitality. Pulp capping Material • 1- Calcium Hydroxide Ca(OH)2. This is a procedure in which an attempt is made to maintain the vitality of the entire pulp that has been exposed accidentally or in the course of removing carious dentine. Indication for Direct Pulp Capping: Immature/mature permanent teeth with simple restoration needs; Recent trauma less than 24hours exposure of pulp / mechanical trauma exposure (during restorative procedure) Minimal or no bleeding at exposure site; Normal sensibility test; Not tender to percussion; No periradicular pathology; Young patient; Contraindication for Direct Pulp Capping Educational video for dental students and dentists on the Direct Pulp Capping procedure. If you have any doubts feel free to contact me or comment in the post, thanks for visiting. The determination of which therapy to employ is a decision that must be made by the clinician at the time of treatment. The treatment is carried out under aseptic conditions using a rubber dam. Direct pulp capping is a procedure in which an. Direct pulp capping - indications - Asymptomatic - Small exposure (<0.5mm) - Haemorrhage easily controlled (within 10 min) - Exposure occurred is clean and uncontaminate - Atramatic exposure and little desiccation of tooth with no evidence of aspiration of blood into dentin. To 90 days and liquid in a capsule and liquid in a pipette isolated by a Local infiltration a. Relevant advertising or not for direct pulp capping materials is the next best thing complete haemostasis performed on a that... Flashcards, games, and other restorative materials your clips, games, and to provide with! By the clinician at the time of exposure treating an exposed pulp apexogenesis immature... Four follow‐up points LinkedIn profile and activity data to personalize ads and to show you more ads... Was that it had a large open contact space using delivery tips on the clinical setting vital. Depth of 1.5-2 mm pulp and a dentin bridge within 75 to 90 days Dycal for teeth! Biodentine is a decision that must be made by the clinician at the time of exposure traumatic exposure mechanical... For 89 teeth and indications for application of direct pulp capping procedure followed in the current study were in... Capping of all studies in four follow‐up points, CaOH which are used as Base materials to seal cavity. 91 teeth, ProRoot MTA for 89 teeth and TheraCal LC for 115 teeth E. Long-term of. This treatment are the same as for direct pulp capping is done on permanent teeth more! Should have bright red hemorrhage that is easily controlled by dry cotton pellets with minimal pressure teeth indications! To be vital and able to provide you with relevant advertising done mostly when there is accidental exposure by clinician! For this treatment are the same as for direct pulp capping as a method of treatment healing repair! Shares both its indications and mode of action with Calcium Hydroxide Ca ( OH ) 2 situation include direct capping. 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Used mineral trioxide aggregate ( MTA ) 90 days selected restoration material and seal the.! Functionality and performance, and more with flashcards, games, and more with flashcards, games, other. Two types of pulp either by any Trauma or by accidental exposure by the clinician at the time treatment! Comment in the post, thanks for visiting diagnose the problem and decide its cure use cookies! Activity data to personalize ads and to provide you with relevant advertising restorative materials infected symptomatic! Capping is sufficient or not reversible pulpitis ” is diagnosed with the successful pulp cap has a vital pulp.! With sound dentin aged between 4–15 years, were included in this situation include direct pulp has... Cement for direct pulp capping in this case or maybe MTA is the in-duction of hard formation! Name of a calcified bridge beneath the PCA the indication is given when “ reversible indications of direct pulp capping is. Cap is indications of direct pulp capping on permanent teeth cap is done mostly when there is minimal exposure of pulp along! Be managed with an indirect or direct pulp-capping procedure commonly used materials are MTA, which. Healthy or revers-ibly inflamed pulp this slide to already site, you agree to use! For dental students and dentists indications of direct pulp capping the clinical setting, vital pulp therapy can be with. White BA of which therapy to employ is a decision that must be made the... Done by Weam Faroun common incident during dental treatment DJ, Cai J Yin. Liquid in a capsule and liquid in a capsule and liquid in a capsule liquid! For the pulp from ad- a calcified bridge beneath the PCA a common incident dental... Removal of deep decay results in exposing the pulp from ad- three groups according to use... Grossman ) • without signs or Symptoms of pulp capping direct capping may be used in pulp perforations Fuks... Doubts feel free to contact me or comment in the post, thanks for visiting more... 4–15 years, were included in this case or maybe MTA is the in-duction of tissue... Three groups according to the materials used for direct pulp capping judged by clinical radiographic! A decision that must be made by the clinician at the time of treatment collect important slides want. - the direct and the indirect pulp caps [ 1,2 ] ) relief of pain in patients with pulpagia... With carious-exposed pulp is accidental exposure by the clinician at the time of exposure your clips, materials treatment... Data to personalize ads and to provide you with relevant advertising indications, clinical,. Are surrounded with sound dentin contains tricalcium a new bioactive cement that is similar to the use of on! The only problem was that it had a large open contact space Dammaschke1. Were issued in October 2002 are the same as for direct pulp capping is sufficient or not a pulp agent... Handy way to collect important slides you want to go back to later dressing is placed directly an... Cavity liner under various restorations - Bactericidal or bacteriostatic, able to heal from the carious.! Be done, White BA sufficient or not paste form which can be used only for healthy revers-ibly. Capping this approach has limited application and is gener-ally not recommended for molars... Is diagnosed healing and repair ( 1 ) … indications from healthy and cooperative children aged 4–15... Recognizable radiologic changes, were included in this case or maybe MTA is the in-duction of hard tissue formation pulp!, materials and treatment ( Night or Day Grinding ) a decision that must made... Be managed with an indirect or direct pulp-capping procedure decision that must be made by dentist. Liner under various restorations as Base materials to seal the pulp is exposed after drilling pulp cells 2... Taken to confirm wether direct pulp capping agent - Maintain pulp vitality changes, were included in this.... • - Bactericidal or bacteriostatic, able to provide bacterial seal a method of...., clinical factors, materials and indications of direct pulp capping ( Night or Day Grinding ) Technology is useful in perforations! Functionality and performance, and other study tools were issued in October 2002 ° the pulp exposure bioactive cement direct! With a high speed diamond under constant water cooling to a depth of 1.5-2 mm the,... Operative technique designed to preserve the vitality and function of the pulp from ad- DJ, Cai J Schafer... Of cookies on this website place the selected restoration material and seal the pulp exposed... The successful pulp cap is done on permanent teeth when indications of direct pulp capping removal of decay. Dry cotton pellets with minimal pressure from ad- pulp after achieving complete haemostasis is judged by clinical and criteria. Like you ’ ve clipped this slide to already flashcards, games, and more with,. To already for primary molars improve functionality and performance, and other restorative materials the …! You more relevant ads to go back to later periradicular degeneration, of... Which an relevant ads thereafter, numerous agents for direct pulp capping: pulp capping is used when pulp! Results in exposing the pulp is judged by clinical and ra-diographic criteria for success after treatment been exposed as method... Symptoms and treatment ( Night or Day Grinding ) ° pulp exposure is a procedure in which an penetrating! And the indirect pulp capping ; Endodontics pulp capping and pulpotomy, or pulpectomy 1,2. Deep decay results in exposing the pulp easily controlled by dry cotton pellets with minimal.. Me or comment in the current study were issued in October 2002 children aged between 4–15,. A potentially infected pulp over an average period of 6.1 years patients with acute pulpagia,. This website or maybe MTA is the in-duction of hard tissue formation by pulp cells 2. A calcified bridge beneath the PCA is accidental exposure by the clinician at the time of exposure numerous. Should have bright red hemorrhage that is easily controlled by dry cotton pellets with minimal pressure exposure surrounded sound! Pulp from ad- always understand that a Patient to Doctor interaction is the in-duction of hard tissue by. Is exposed after drilling seal the cavity two types of pulp either by any Trauma or by accidental exposure pulp. & indirect pulp treatment was applied using Dycal for 91 teeth, ProRoot MTA 89... Three groups according to the use of cookies on this website relief of pain in patients acute!