Deep caries with Clinical Pulp Exposure 😮 Endodontist Dr Domenico Ricucci

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Deep caries with clinical pulp exposure - Dr. Domenico Ricucci • In the previous video, Dr. R discussed the biological bases to treat deep caries without pulp exposure. • In this post he is discussing all those clinical situations in which, despite the clinical diagnosis of “reversible pulp inflammation”, a pulp exposure is revealed during caries excavation. • Many clinicians erroneously believe that “an exposed pulp is a condemned pulp”. Many patients are suffering because too many teeth today are unnecessarily root canal treated. This belief originates from previous studies reporting very low success rate after direct pulp capping. These studies shall be critically reviewed. • Dr. R is presenting the relevant histologic/histobacteriologic facts and their correlations with the various clinical conditions, to help clinicians recognising those cases where the pulp vitality can be maintained through a direct pulp capping procedure. • It has to be clearly stated that, fundamentally, the teeth that can be subjected to direct pulp capping are those where the clinical diagnosis is “reversible pulp inflammation”. This means that bacteria have supposedly not entered the pulp space yet. The maximum of care is recommended, through a thorough clinical examination, collecting the clinical story, taking perfect radiographs, and using all the available sensibility tests. • Caution is always advised in the diagnosis because, despite the good correlation between clinical and histologic pulp diagnoses, still we do not reach 100% success in our diagnostic evaluation. Not to mention that some pulps undergo necrosis without any clinical symptoms. Therefore, there is still a need for refined and improved means for reliable pulp diagnosis. • Like in the previous post, he is insisting on the fact that, contrary to the conclusions of recent publications, the final treatment plan cannot be established on the basis of clinical examination alone, but requires access to the deepest part of the carious lesion. • Once again, readers are referred to the following publications. • Ricucci D, Loghin S, Siqueira JF Jr. Correlation between clinical and histologic pulp diagnoses. J Endod 2014; 40:1932-9. • Ricucci D, Loghin S, Lin L, Spångberg LSW, Tay F. Is hard tissue formation in the dental pulp after the death of the primary odontoblasts a regenerative or a reparative process? J Dent 2014; 42:1156-70. • Ricucci D, Siqueira JF Jr, Li Y, Tay FR. Vital pulp therapy: histopathology and histobacteriology-based guidelines to treat teeth with deep caries and pulp exposure. J Dent 2019; 86:41-52. • Ricucci D, Grande NM, Plotino G, Tay FR. Histologic response of human pulp and periapical tissues to tricalcium silicate-based materials - a series of successfully treated cases. J Endod 2020; 46:307-17. • • **Free Root Canal Course** • www.allthingsdentistry.com • ** ENDO GEAR I USE ** • www.allthingsdentistry.com • -- LINKS -- • / allthingsdent • / all_things_dent • / all_things_. . • ** ENDO GEAR I USE ** • https://www.allthingsdentistry.com/en... • -- Related Content -- • Root Canal with Calcified Canals and S Curve (Wave One Gold): • Root Canal with Calcified Canals and ... • Top 5 Root Canal Videos (on Youtube): • Root Canal Procedure - Top 5 Secrets • Root Canal Through a New Crown (Wave One Gold) • Root Canal Through a New Porcelain Cr... • #Rootcanal #Dentistry #AllThingDentistry #Odontologia • / allthingsdent • / all_things_dent

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