Implants and radiotherapy.

Abstract

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Direct pulp capping (DPC) has been considered with some scepticism by practitioners in the past, due to reported unpredictable outcomes. Newer techniques, materials and a better understanding of pulpal biology have, however, focused attention again on the procedure. Using New York (USA) health insurance data from 2006 to 2019, 4,136 unique teeth which received DPC were followed. Overall survival rate of the procedure (DPC to either root canal therapy [RCT] or extraction) was 83.2% over a mean observation period of 52 months. Of the 16.8% that experienced failure (n = 694), 58.4% received RCT and 41.6% were extracted. Failure was most likely in the first year following DPC. Tooth survival following DPC was 92.9% over a six-year follow-up period. Adjusted analyses showed that DPC on molar teeth was less likely to fail but when it did, extraction was more likely to follow, perhaps because of limited access to molar RCT. Same-day placement of a permanent restoration was a significant predictor of DPC procedure survival.