Abstract

Introduction: Indirect pulp treatment (IPT) is a conservative vital pulp procedure that is performed in teeth presenting deep carious lesions with reversible pulp status. IPT technique involves partial caries removal in affected teeth leaving the dentin that is poten- tially remineralisable, which is covered by different biocompatible materials (e.g. calcium hydroxide and calcium silicate). Case reports: Five caries-affected children aged 4-to-8 years old were selected for this case report. They presented 10 primary molars affected by deep dentinal cavities (adjacent to the pulp), without any clinical manifestation of irreversible pulp pathology (e.g. prolonged sensitivity to cold and/or heat and some time to sweets). IPT was undertaken by a postgraduate student in paediatric dentistry, the procedure included complete caries removal from the cavosurface margin of each cavity prepara- tion, reportedly a key element to clinical success. Calcium hydroxide (Dycal!; from Denstply) or calcium silicate (Bioden- tine!; from Septodont) were used to induce pulp protection and dentin remineralisation. Dental cavities were restored by using resin-based composite (Z350; from 3M). Follow-up after 24-month showed that both materials were successful in main- taining pulp vitality as no children presented clinical or radio- graphic pathology. Comments: IPT with incomplete removal of caries-affected den- tine looks to be a successful approach in primary teeth when cal- cium hydroxide or calcium silicate is used as restorative material at least for 24 months. Accurate diagnosis of pulp health status, proper restoration sealing and long-term clinical/radiographic fol- low-up also play key roles in the success of IPT that need consid- eration.