Q.

Does "2 out of 5 times it works" refer to mechanical exposures only,
or both carious and mechanical exposures? I'm assuming it's 2 out of 5
times when direct pulp capping is a viable alternative?

And - in which percentage of endo cases would you attempt direct pulp
capping (presuming the patient agrees to this) rather than RCT?
Thanks!

A.

This is a slippery slope question.

I say carious exposure will never be okay without root canal therapy.
Mechancial? Well maybe. It depends on how much trauma the nerve
can take before necrosis (nerve tissue death).

W_B over at sci.med.dentistry claims that pulpitis, or "inflammed
pulp" means a definite 100% root canal therapy. But I have seen some
of those reverse with the application of calcium hydroxide and
zinc-oxide/eugenol temporary filling. ZoE is known as an obtundant.

DEF. verb. obtund. Reduce the edge or violence of

A colleague of mine goes one step further. He claims,

"Many crown prepraration procedures REQUIRE
root canal therapy so I ALWAYS do that FIRST."

A couple of months later he told me,

"Large MOD restorations always end up
requiring crowns so I never do MODs (3-surface)."

Six months later he told me,

"You know those larger two-surface restorations ......"

Well there he lost me. After that we only talked
about computers and fun stuff. No more tooth talk for him!

PULP CAP:

a. mineral oxide triaggregate (MTA).
b. Calcium hydroxide
c. Adhesive bonding material.

Some research papers reverse (b) and (c)
in order of efficacy. (a) is considered best.

Joel

This is posted here:

http://tinyurl.com/7y47e