Pulp Exposure Occurrence and Outcomes after 1-or 2-visit Indirect Pulp Therapy Vs Complete Caries Removal in Primary and Permanent Molars

Purpose: The purpose of this study was to examine whether 1- or 2-visit indirect pulp therapy (IPT) is more successful and to determine if the operator can successfully decide when to stop removing codes without exposing the pulp. Methods: A total of 154 teeth (94 primary second molars and 60 young permanent first molars) were included in the study from a total of 723 4- to 15-year-old patients. The teeth had deep carious lesions but lacked the preoperative signs and symptoms of irreversible pulpitis. The teeth were randomly selected and treated either with 7-visit IPT, 2-visit IPT, or direct complete excavation (DCE). Follow-up examinations were conducted on the teeth over 7 year at 3-month intervals. Results: The pulp was exposed in 12 teeth (22%) treated by DCE, whereas 3 teeth (6%) were treated by 1-visit IPT and 4 teeth (8%) with 2-visit IPT. A statistically significant difference was found between IPT and DCE groups in terms of pulp exposure (P<.05). The teeth without pulp exposure showed normal clinical and radiographic conditions during the 1-year follow-up, except for 3 primary teeth. Conclusions: Indirect pulp therapy in both primary and young permanent teeth can be used successfully with a 1- or 2-visit approach. (Pediatr Dent 2010;32347-55) Received August 3, 2008 vertical bar Last Revision October 28, 2008 vertical bar Revision Accepted December 7, 2008