OPDENT
seminar
Presented by: mariam abdelzaher
rawan hassan
Under supervision of : Dr Marry Sabry
01 02 03
Concepts lead to Diagnosis of pulp
intro modern approach condition
04 05 06
Partial caries Pulp capping pulpotomy
removal
07
Martials used
•Deep carious lesions (DCLs) are defined
as carious lesions that radiographically
involve the inner pulpal third or quarter
of dentine or pose a clinically assessed risk
of pulpal exposure
Introduction to Deep Carious Lesions
Clinical Challenge Traditional Management Conservative Approaches
By understanding the clinical challenges and shifting towards
conservative management strategies, clinicians can better address deep
carious lesions while maintaining tooth integrity and pulp vitality .
The Classical Approach to Caries Removal
Percentage of procedures with the following risks
Pulpal Exposure 60%
Excessive Tooth Structure
Removal 75%
Pushing Tooth Further Along
Restorative Cycle 80%
Caries is a Reversible Disease
Differentiation of Infected and Affected
The recent concept in
treating deep carious Dentin
lesions based on:
Adequate Peripheral Seal
Road map to treat
eep carious lesions:
Determining Pulp Condition
Pain History Pulp Vitality Testing Radiographic Evaluation
Assess the presence, incidence, Use thermal and electric pulp Analyze radiographs to assess the
type, duration, and severity of tests to evaluate the degree of proximity of the carious lesion to
pain to determine the pulp pulp inflammation or the pulp and detect any periapical
condition. degeneration. changes.
Combining the information from these diagnostic methods is essential for
accurate assessment of the pulp condition and determining the appropriate
treatment approach.
Selective Caries Removal (SCR) - A Conservative
Approach
Definition :
Removes infected dentin but retains affected dentin near
pulp.
Procedure:
• Remove caries from periphery.
• Leave leathery/firm dentin over pulp.
• Restore with biocompatible material.
Benefits:
• Reduces pulp exposure risk by 80%.
• Promotes dentin remineralization.
Stepwise Caries Removal (SWE) - Two-Stage
Excavation
First Visit: Partial 6-12 months later:
caries removal + Reassess, complete
Procedure: temporary caries removal,
restoration. final restoration.
Lower pulp
Allows dentin Reduces bacterial
Benefits: remineralization. activity.
exposure risk than
NSCR.
Indirect Pulp Capping (IPC)
When to Use: Procedure:
Pulp not exposed but at isolation
risk.
Success Rate: ~85%
Caries removal
in long-term
studies.
Apply biocompatible
material over residual
dentin.
Final restoration placed
immediately.
Direct Pulp Capping (DPC)
When to •Small pulp exposure (<1mm)
Use: without irreversible pulpitis.
Materials •MTA, Calcium Hydroxide,
Used: Biodentine.
Purpose: Induces reparative dentin.
partial & Full Pulpotomy
• Removal of inflamed coronal pulp
Partial
tissue.
Pulpotomy:
• Used in young permanent teeth.
• Removes full coronal pulp while
Full preserving radicular pulp.
Pulpotomy: • Used when exposure is larger but pulp remains
vital.
• MTA/Biodentine capping: 85-95% in
Success
permanent teeth.
Rates:
• Pulpotomy: 90% in young permanent teeth.
Pulp Capping Materials
Goal: To produce a bacterially impervious seal over exposed pulp.
Importance: Reduces bacterial insult and promotes dentin bridge
formation.
Non-toxic, biocompatible, antibacterial.
Ideal Properties: Long-term impervious seal.
Encourages regeneration of the pulp-dentin complex.
Mode of Limitatio
Action: ns:
Calcium Hydroxide - The High pH creates a
Does not bond to pulp
superficial pulpal
Traditional Standard necrosis.
tissue.
Stimulates tertiary
Soluble, prone to degradation over time.
dentin formation.
Can lead to bacterial ingress and
pulp irritation.
Examples: Benefits:
Mineral Trioxide Induces osteogenesis, dentinogenesis,
Aggregate (MTA). and cementogenesis.
Bioceramic Materials - The
Calcium-enriched Forms thicker, homogeneous
Modern Alternative mixture (CEM). reparative dentin bridges.
Biodentine.
MTA
Advantages:
• Excellent sealing ability.
• Low solubility, non-absorbable.
• High compressive strength.
Disadvantages:
• Long setting time.
• Difficult handling.
• Can cause staining & discoloration.
Biodentine - A New Generation Pulp Capping Material
Features:
• Tri-calcium silicate-based bioactive material.
• Faster setting time (~12 minutes).
• Similar mechanical properties to dentin.
• Easier handling than MTA.
Current Research:
• Comparable biocompatibility to MTA.
• Long-term efficacy still under investigation.
Studio
Shodwe
