Authors: Cvek M.
Title: A clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fracture.
Journal: J Endod
Date: Aug 1978
Citation: 4(8):232-7
Category: Pediatric Endodontics
Evidence-based Ranking: 4
Purpose/Objectives: To assess the frequency of healing of accidentally exposed pulp treated by partial pulpotomy and calcium hydroxide dressing.

Materials & Methods: Total sample consist of 60 teeth, 51 maxillary and nine mandibular incisors. Patients ranged from 7 to 16 years. At the examination before treatment, the interval from the accident and the size and appearance of the pulpal lesion were recorded, and the crown-fracture area was photographed. All teeth were tested vital. For treatment, the tooth was isolated with a rubber dam and cleaned with a 0.5% chlorhexidine solution. Proportional to the area of exposed pulp tissue, only part of the coronal pulp and surrounding dentin was removed with sterile diamond instrument in a high-speed handpiece and cooled with sterile saline. Bleeding was controlled with saline, the pulpal wound was covered with calcium hydroxide, and the cavity was sealed with sterile ZOE cement. Teeth were checked clinically and radiographically at 3w, 3m, and 6m. The observation period ranged from 14 to 60 months, with an average of 31 months. For evaluation, the teeth were sub grouped according to the interval between accident and treatment and the size of exposed pulp tissue. Healing was considered to have taken place if there were no clinical symptoms; no radiographically periradicular pathological changes; and a continuous hard tissue barrier at the site of the surgical incision.

Results: The variables had no influence on the frequency of healing, which is 96%. The initial formation of hard tissue at the site of incision was visible in the radiographs 3 to 12 weeks after treatment and a complete barrier was noticed after 3 to 6 months.

ReviewerÂ’s Comments: Good in vivo look at traumatic pulp exposure and the interval between the time of accident and treatment.