Direct Pulp Capping

Direct pulp capping is considered for a tooth with moderate to deep caries when the pulp is diagnosed as normal or reversibly inflamed. Diagnosis uses tests alongside clinical signs, symptoms and radiographs when appropriate.

Comfort comes after the tooth's pulp status has been assessed with clinical signs and symptoms, testing and radiographs when appropriate. The procedure then places the capping material directly over the exposed pulp.

For permanent teeth with normal pulp or reversible pulpitis, calcium silicate cement significantly improves treatment success over calcium hydroxide in the cited 36-month comparison.

The permanent-tooth comparison follows patients for 36 months, while the wider vital pulp therapy comparisons report outcomes at 24 and 36 months. Those are study follow-up points, not a guaranteed lifetime for one tooth.

The process starts by establishing pulp status with cold or electric testing, clinical signs and symptoms, plus radiographs when appropriate. The selected capping material is then used over the exposed pulp.

Reported vital pulp therapy success ranges from 91 to 97 percent in the comparison. The evidence includes recommendations with different strengths and levels of certainty, so the result should be read alongside the pulp diagnosis. Direct capping, indirect pulp treatment, partial pulpotomy and full pulpotomy are compared as ways to retain vital pulp tissue.

The guidance compares direct pulp capping with indirect pulp treatment, partial pulpotomy and full pulpotomy as vital pulp therapy options.

The decision turns first on pulp status and caries depth, then on the selected vital pulp therapy and capping material. Calcium silicate cement is the preferred material in the specified permanent-tooth setting. The assessment uses clinical findings, symptoms, pulp tests and radiographs when appropriate before the material is placed.

Direct pulp capping is a clinical vital-pulp procedure, so a treatment quote relates to the pulp assessment, caries management, capping material and restoration needed to seal the tooth.