When caries extends deep enough to expose the pulp in a primary molar, pulpotomy is often considered the familiar treatment option. But does every carious pulp exposure require removal of the coronal pulp? Could a less invasive approach, such as direct pulp capping (DPC), achieve comparable results in carefully selected cases?
A split-mouth randomized clinical trial published in the International Journal of Paediatric Dentistry explored this question by comparing direct pulp capping and pulpotomy in cariously exposed primary molars. Both procedures used the same calcium silicate-based putty, NeoPUTTY, allowing the researchers to compare the treatment approaches under similar restorative conditions.
The findings suggest that direct pulp capping may be a viable alternative to pulpotomy in selected primary molars, with comparable clinical and radiographic outcomes over 12 months.
Comparing two approaches to carious pulp exposure
The trial included 100 carious primary molars in children aged 4–9 years. Following pulp exposure, the teeth were randomly assigned to receive either direct pulp capping or pulpotomy. NeoPUTTY was used as the pulp treatment material in both groups.
After placement of the calcium silicate-based putty, the teeth were restored with glass ionomer cement and stainless-steel crowns. The researchers also recorded preoperative pain and baseline clinical and radiographic variables.
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