Çürüğün tüm katmanları i̇le uzaklaştırılmasını takiben direkt ve i̇ndirekt pulpa kuafajı tedavisi: Ön çalışma

Gi̇ri̇ş ve Amaç: Bu çalışmada derin dentin çürüğü lezyonlu canlı dişlerde, çürüğün tüm katmanları ile uzaklaştırılmasını takiben uygulanan direkt ve indirek pulpa kuafajı tedavilerinin dişlerdeki canlılığın devamı ile ilgili klinik takip sonuçlarını sunmaktır. İkincil amaç, pulpa-dentin kompleksinin farklı tipteki pulpa kuafajı materyallerine ve restoratif maddelere olan yanıtını gözlemlemektir. Yöntem ve Gereçler: Bu çalışmaya derin dentin çürüğü lezyonu olan 50 daimi diş dahil edildi. Çürük tüm katmanları ile uzaklaştırıldıktan sonra, pulpanın açılıp açılmamasına bağlı olarak ya direkt pulpa yada indirekt pulpa kuafajı uygulandı. Tedaviler saf kalsiyum hidroksit, Dycal, çinko oksit öjenol, cam iyonomer siman, kompozit rezin ve amalgam gibi materyallerin farklı kombinasyonları ile gerçekleştirildi. Klinik ve radyografik değerlendirmeler 6. ayda yapıldı. Bulgular: Çürüğün tümüyle uzaklaştırmasını takiben dişlerin% 54’ünde pulpa açılımı gözlendi. Tedavi edilen dişlerden toplam dördünde (direkt pulp kuafajı 3, indirekt pulpa kuafajından 1 adet olmak üzere) klinik başarısızlık tespit edildi. Tüm başarısız dişler Dycal+kompozit rezin uygulanmış gruba aitti. Tartışma ve Sonuç: Pulpa açılımı meydana gelirse, tedavide başarısızlık olasılığı pulpada açılım olmayan gruba göre daha yüksek gözükmektedir. Ek olarak, saf kalsiyum hidroksit “Ca(OH)2” pulpa kuafajında ticari bir pat olan “Dycal” dan daha güvenilir gibi durmaktadır.

Direct and indirect pulp capping after complete caries removal: A preliminary study

Introduction: In this preliminary study, survival of vital teeth treated by direct and indirect pulp capping following the complete caries removal in deep dentin lesion was evaluated. The secondary objective was to observe the response of pulp dentin complex to different types of capping and restorative materials. Methods: 50 permanent teeth with deep dentin lesion were included to this study. After complete caries removal, different protocols were applied according to pulp exposure namely direct or indirect pulp capping. The teeth were treated with different combinations of pure calcium hydroxide, Dycal, zinc oxide eugenol, glass ionomer cement, composite resin, amalgam. Clinical and radiographical evaluations were performed at 6th month. Results: After complete caries removal, unintentional pulp exposure was observed in 54% of the teeth. Totaly 4 teeth from direct pulp-capping (n=3) and indirect pulp-capping (n=1) failed due to inflammation. All failed restorations belonged to Dycal+ composite resin groups. Discussion and Conclusion: If pulp exposure occurred, possibility of failure would be higher compared to non-exposure group. Additionally, in the success of pulp-capping treatment, pure calcium hydroxide “Ca(OH)2” as pulp-capping material seems to be more reliable than factory product calcium hydroxide paste “Dycal”.

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