Dentaltown May 2017 - 87

Indirect pulp cap
Indirect pulp therapy can be utilized in
cases of reversible pulpitis. Teeth should be
free of signs of irreversible pulpitis (spontaneous pain, lingering pain to cold, pain
that is not controlled by over-the-counter
analgesics), respond to sensibility testing
(cold, electric pulp test) and show no signs
of periapical pathology.
While remaining dentin thickness cannot
be evaluated clinically or radiographically,
teeth should have greater than 0.5 millimeter
of sound dentin between pulp and lesion. If
there's less than 0.5mm, pathologic pulpal
changes may exist.14

The goals of indirect pulp therapy are
aimed at limiting the progression of a carious
lesion by removing access of substrate to
the bacteria in the lesion, thus stopping the
progression. Studies have shown high success
rates.15 When bacterial cultures are taken
after initial caries removal, a reduction in
colony-forming units is obtained regardless
of the material.16 The bacterial entombment
discussed earlier is one of MTA's advantages
because it can help provide an additional
seal and aid in the arrestment of a lesion.10
Indirect pulp caps can be used when
performing partial or complete caries
removal. While one goal of partial caries

removal (stepwise excavation) is to avoid
a pulpal exposure, practitioners should be
able to successfully manage an exposure
should it occur.
Case 1: Partial caries removal
A 6-year-old female presented with four
deep carious lesions on permanent first molars.
The patient was symptomatic to cold the past
few weeks. No history of spontaneous pain
was reported at the time of examination.
Periapical radiographs showed open
apices, and no apical pathology was evident.
The patient was treated in two appointments. The patient was anesthetized and

Case 1

Preop bitewings

Preop periapicals

Six-month recall periapicals

Clinical photos, incomplete caries removal and final restoration

dentaltown.com \\ MAY 2017

87



http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown May 2017

No label
Dentaltown May 2017 - No label
Dentaltown May 2017 - Cover1
Dentaltown May 2017 - Cover2
Dentaltown May 2017 - 1
Dentaltown May 2017 - 2
Dentaltown May 2017 - 3
Dentaltown May 2017 - 4
Dentaltown May 2017 - 5
Dentaltown May 2017 - 6
Dentaltown May 2017 - 7
Dentaltown May 2017 - 8
Dentaltown May 2017 - 9
Dentaltown May 2017 - 10
Dentaltown May 2017 - 11
Dentaltown May 2017 - 12
Dentaltown May 2017 - 13
Dentaltown May 2017 - 14
Dentaltown May 2017 - 15
Dentaltown May 2017 - 16
Dentaltown May 2017 - 17
Dentaltown May 2017 - 18
Dentaltown May 2017 - 19
Dentaltown May 2017 - 20
Dentaltown May 2017 - 21
Dentaltown May 2017 - 22
Dentaltown May 2017 - 23
Dentaltown May 2017 - 24
Dentaltown May 2017 - 25
Dentaltown May 2017 - 26
Dentaltown May 2017 - 27
Dentaltown May 2017 - 28
Dentaltown May 2017 - 29
Dentaltown May 2017 - 30
Dentaltown May 2017 - 31
Dentaltown May 2017 - 32
Dentaltown May 2017 - 33
Dentaltown May 2017 - 34
Dentaltown May 2017 - 35
Dentaltown May 2017 - 36
Dentaltown May 2017 - 37
Dentaltown May 2017 - 38
Dentaltown May 2017 - 39
Dentaltown May 2017 - 40
Dentaltown May 2017 - 41
Dentaltown May 2017 - 42
Dentaltown May 2017 - 43
Dentaltown May 2017 - 44
Dentaltown May 2017 - 45
Dentaltown May 2017 - 46
Dentaltown May 2017 - 47
Dentaltown May 2017 - 48
Dentaltown May 2017 - 49
Dentaltown May 2017 - 50
Dentaltown May 2017 - 51
Dentaltown May 2017 - 52
Dentaltown May 2017 - 53
Dentaltown May 2017 - 54
Dentaltown May 2017 - 55
Dentaltown May 2017 - 56
Dentaltown May 2017 - 57
Dentaltown May 2017 - 58
Dentaltown May 2017 - 59
Dentaltown May 2017 - 60
Dentaltown May 2017 - 61
Dentaltown May 2017 - 62
Dentaltown May 2017 - 63
Dentaltown May 2017 - 64
Dentaltown May 2017 - 65
Dentaltown May 2017 - 66
Dentaltown May 2017 - 67
Dentaltown May 2017 - 68
Dentaltown May 2017 - 69
Dentaltown May 2017 - 70
Dentaltown May 2017 - 71
Dentaltown May 2017 - 72
Dentaltown May 2017 - 73
Dentaltown May 2017 - 74
Dentaltown May 2017 - 75
Dentaltown May 2017 - 76
Dentaltown May 2017 - 77
Dentaltown May 2017 - 78
Dentaltown May 2017 - 79
Dentaltown May 2017 - 80
Dentaltown May 2017 - 81
Dentaltown May 2017 - 82
Dentaltown May 2017 - 83
Dentaltown May 2017 - 84
Dentaltown May 2017 - 85
Dentaltown May 2017 - 86
Dentaltown May 2017 - 87
Dentaltown May 2017 - 88
Dentaltown May 2017 - 89
Dentaltown May 2017 - 90
Dentaltown May 2017 - 91
Dentaltown May 2017 - 92
Dentaltown May 2017 - 93
Dentaltown May 2017 - 94
Dentaltown May 2017 - 95
Dentaltown May 2017 - 96
Dentaltown May 2017 - 97
Dentaltown May 2017 - 98
Dentaltown May 2017 - 99
Dentaltown May 2017 - 100
Dentaltown May 2017 - 101
Dentaltown May 2017 - 102
Dentaltown May 2017 - 103
Dentaltown May 2017 - 104
Dentaltown May 2017 - 105
Dentaltown May 2017 - 106
Dentaltown May 2017 - 107
Dentaltown May 2017 - 108
Dentaltown May 2017 - 109
Dentaltown May 2017 - 110
Dentaltown May 2017 - 111
Dentaltown May 2017 - 112
Dentaltown May 2017 - 113
Dentaltown May 2017 - 114
Dentaltown May 2017 - 115
Dentaltown May 2017 - 116
Dentaltown May 2017 - 117
Dentaltown May 2017 - 118
Dentaltown May 2017 - 119
Dentaltown May 2017 - 120
Dentaltown May 2017 - 121
Dentaltown May 2017 - 122
Dentaltown May 2017 - 123
Dentaltown May 2017 - 124
Dentaltown May 2017 - 125
Dentaltown May 2017 - 126
Dentaltown May 2017 - 127
Dentaltown May 2017 - 128
Dentaltown May 2017 - Cover3
Dentaltown May 2017 - Cover4
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2021
https://www.nxtbook.com/farran/dentaltown/2021January
https://www.nxtbook.com/farran/dentaltown/2020December
https://www.nxtbook.com/farran/dentaltown/2020November
https://www.nxtbook.com/farran/dentaltown/2020NewGrad
https://www.nxtbook.com/farran/dentaltown/2020October
https://www.nxtbook.com/farran/dentaltown/2020September
https://www.nxtbook.com/farran/dentaltown/2020August
https://www.nxtbook.com/farran/dentaltown/2020July
https://www.nxtbook.com/farran/dentaltown/2020June
https://www.nxtbook.com/farran/dentaltown/2020May
https://www.nxtbook.com/farran/dentaltown/2020April
https://www.nxtbook.com/farran/dentaltown/2020March
https://www.nxtbook.com/farran/dentaltown/2020February
https://www.nxtbook.com/farran/dentaltown/2020January
https://www.nxtbook.com/farran/dentaltown/2019December
https://www.nxtbook.com/farran/dentaltown/2019November
https://www.nxtbook.com/farran/dentaltownuk/2019OctoberNovember
https://www.nxtbook.com/farran/dentaltown/2019October
https://www.nxtbook.com/farran/dentaltown/2019NewGrad
https://www.nxtbook.com/farran/dentaltown/2019September
https://www.nxtbook.com/farran/dentaltown/2019August
https://www.nxtbook.com/farran/dentaltown/2019July
https://www.nxtbook.com/farran/dentaltownuk/2019JuneJuly
https://www.nxtbook.com/farran/dentaltown/2019June
https://www.nxtbook.com/farran/dentaltown/2019May
https://www.nxtbook.com/farran/dentaltownuk/2019AprilMay
https://www.nxtbook.com/farran/dentaltown/2019April
https://www.nxtbook.com/farran/dentaltown/2019March
https://www.nxtbook.com/farran/dentaltown/2019February
https://www.nxtbook.com/farran/dentaltownuk/2019FebruaryMarch
https://www.nxtbook.com/farran/dentaltown/2019January
https://www.nxtbook.com/farran/dentaltownuk/2018Winter
https://www.nxtbook.com/farran/dentaltown/2018December
https://www.nxtbook.com/farran/dentaltown/2018November
https://www.nxtbook.com/farran/dentaltownuk/2018November
https://www.nxtbook.com/farran/dentaltown/2018October
https://www.nxtbook.com/farran/dentaltownuk/2018October
https://www.nxtbook.com/farran/dentaltown/2018NewGrad
https://www.nxtbook.com/farran/dentaltown/2018September
https://www.nxtbook.com/farran/dentaltownuk/2018September
https://www.nxtbook.com/farran/dentaltown/2018August
https://www.nxtbook.com/farran/dentaltownuk/2018July
https://www.nxtbook.com/farran/dentaltown/2018July
https://www.nxtbook.com/farran/dentaltownuk/2018June
https://www.nxtbook.com/farran/dentaltown/2018June
https://www.nxtbook.com/farran/dentaltownuk/2018May
https://www.nxtbook.com/farran/dentaltown/2018May
https://www.nxtbook.com/farran/dentaltownuk/2018April
https://www.nxtbook.com/farran/dentaltown/2018April
https://www.nxtbook.com/farran/dentaltown/2018March
https://www.nxtbook.com/farran/dentaltownuk/2018March
https://www.nxtbook.com/farran/dentaltown/2018February
https://www.nxtbook.com/farran/dentaltownuk/2018February
https://www.nxtbook.com/farran/dentaltown/2018January
https://www.nxtbook.com/farran/dentaltown/2017December
https://www.nxtbook.com/farran/dentaltownuk/2017Winter
https://www.nxtbook.com/farran/dentaltown/2017November
https://www.nxtbook.com/farran/dentaltown/2017October
https://www.nxtbook.com/farran/dentaltownuk/2017october
https://www.nxtbook.com/farran/dentaltown/NewGrad2017
https://www.nxtbook.com/farran/dentaltown/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017August
https://www.nxtbook.com/farran/dentaltown/2017August
https://www.nxtbook.com/farran/dentaltown/2017July
https://www.nxtbook.com/farran/dentaltownuk/2017July
https://www.nxtbook.com/farran/dentaltown/2017June
https://www.nxtbook.com/farran/dentaltownuk/2017may
https://www.nxtbook.com/farran/dentaltown/2017May
https://www.nxtbook.com/farran/dentaltownuk/2017April
https://www.nxtbook.com/farran/dentaltown/2017April
https://www.nxtbook.com/farran/dentaltown/2017March
https://www.nxtbook.com/farran/dentaltownuk/dentaltownuk/2017march
https://www.nxtbook.com/farran/dentaltown/February2017
https://www.nxtbook.com/farran/dentaltown/2017January
https://www.nxtbook.com/farran/dentaltown/2016December
https://www.nxtbook.com/farran/dentaltown/2016November
https://www.nxtbook.com/farran/dentaltown/2016October
https://www.nxtbook.com/farran/dentaltown/2016nge
https://www.nxtbook.com/farran/dentaltown/2016september
https://www.nxtbook.com/farran/dentaltown/2016august
https://www.nxtbook.com/farran/dentaltown/2016july
https://www.nxtbook.com/farran/dentaltown/2016june
https://www.nxtbook.com/farran/dentaltown/2016may
https://www.nxtbook.com/farran/dentaltown/2016april
https://www.nxtbook.com/farran/dentaltown/2016march
https://www.nxtbook.com/farran/dentaltown/2016february
https://www.nxtbook.com/farran/dentaltown/2016january
https://www.nxtbook.com/farran/dentaltown/2015december
https://www.nxtbook.com/farran/dentaltown/2015november
https://www.nxtbook.com/farran/dentaltown/2015october
https://www.nxtbook.com/farran/dentaltown/2015nge
https://www.nxtbook.com/farran/dentaltown/2015september
https://www.nxtbook.com/farran/dentaltown/2015august
https://www.nxtbook.com/farran/dentaltown/2015july
https://www.nxtbook.com/farran/dentaltown/2015june
https://www.nxtbook.com/farran/dentaltown/2015may
https://www.nxtbook.com/farran/dentaltown/2015april
https://www.nxtbook.com/farran/dentaltown/2015march
https://www.nxtbook.com/farran/dentaltown/2015february
https://www.nxtbook.com/farran/dentaltown/2015january
https://www.nxtbook.com/farran/dentaltown/2014december
https://www.nxtbook.com/farran/dentaltown/2014decemberb
https://www.nxtbook.com/farran/dentaltown/2014november
https://www.nxtbook.com/farran/dentaltown/2014october
https://www.nxtbook.com/farran/dentaltown/2014newgrad
https://www.nxtbook.com/farran/dentaltown/2014september
https://www.nxtbook.com/farran/dentaltown/2014august
https://www.nxtbook.com/farran/dentaltown/2014july
https://www.nxtbook.com/farran/dentaltown/2014june
https://www.nxtbook.com/farran/dentaltown/2014may
https://www.nxtbook.com/farran/dentaltown/2014april
https://www.nxtbook.com/farran/dentaltown/2014march
https://www.nxtbook.com/farran/dentaltown/2014february
https://www.nxtbook.com/farran/dentaltown/2014january
https://www.nxtbook.com/farran/dentaltown/2013december
https://www.nxtbook.com/farran/dentaltown/2013november
https://www.nxtbook.com/farran/dentaltown/2013october
https://www.nxtbook.com/farran/dentaltown/2013newgrad
https://www.nxtbook.com/farran/dentaltown/2013september
https://www.nxtbook.com/farran/dentaltown/2013august
https://www.nxtbook.com/farran/dentaltown/2013july
https://www.nxtbook.com/farran/dentaltown/2013june
https://www.nxtbook.com/farran/dentaltown/2013may
https://www.nxtbook.com/farran/dentaltown/2013april
https://www.nxtbook.com/farran/dentaltown/2013march
https://www.nxtbook.com/farran/dentaltown/2013february
https://www.nxtbook.com/farran/dentaltown/2013january
https://www.nxtbook.com/farran/dentaltown/2012december
https://www.nxtbook.com/farran/dentaltown/2012November
https://www.nxtbookmedia.com