OBJECTIVE: To compare two cone beam computed tomography (CBCT) analysis techniques for measuring tertiary dentin (TD) volume, density, and root length increase, after indirect pulp therapy (IPT) in young permanent teeth with conventional periapical radiographs.
METHODS: Comparative study design: Sixty-nine CBCT scans were taken initially (T1) and after 1 year (T2) of IPT. New CBCT analysis technique A, standardization, segmentation, and registration of T1 and T2 scans were performed using ITK-SNAP and 3D Slicer CMF to measure TD volume (mm3), density (gray-level intensity), and root length increase (mm). In the traditional CBCT analysis technique B, analyses were conducted using the In-Vivo software to calculate TD thickness (mm), radiodensity (HU%), and root length increase (mm). Paired t-test and the intraclass correlation coefficient were calculated to compare and assess the reliability of all techniques.
RESULTS: No significant difference between the two techniques existed in the measurement of TD mineral density (Mean [SD]:A = 22.4 [15.4]; B = 24.4 [15.4]; p = .47). Technique A resulted in significantly higher root length increase values (Mean [SD]: A = 1.3 [0.6]; B = 1.1 [0.5]; p = .03). The two techniques showed acceptable reliability levels (0.76-0.99).
CONCLUSIONS: CBCT analysis techniques yielded similar findings for mineral density. The new CBCT volumetric analysis technique, although more laborious, produced higher values for root length increase, and allowed for measurement of dentin volume.

Silver diamine fluoride (SDF) has been demonstrated to be effective in arresting caries lesions and, recently, clinical trials have assessed the effectiveness of SDF as a medicament for indirect pulp therapy (IPT) in primary teeth. This review aims to summarize the literature related to the use of SDF and find out if SDF can be used as an effective material for IPT. A literature search was undertaken on electronic databases including PubMed, MEDLINE, ScienceDirect, and Google Scholar, which elicited 50 studies employing different materials in the IPT of primary molars; however, of them, only four clinical trials used SDF as indirect pulp capping (IPC) material. SDF has the potential to be a useful material for IPT in primary teeth. It is a handy choice for pediatric dentists due to its minimum invasiveness, ease of application, and ability to stop the progression of caries. However, more studies are needed to determine whether SDF can be used routinely for IPT and whether it can even replace the currently available materials, as well as to fully realize its potential and establish criteria for its ideal application in IPT procedures.

Indirect pulp therapy (IPT) is a common conservative treatment for deep dental caries. However, the potential risk factors for the prognosis of IPT have not been well studied. This study retrospectively investigated the success rate of IPT in treating primary molars with deep caries and the factors potentially affecting the two-year success rate. A total of 303 primary molars in 202 children (106 boys and 96 girls) were included in this study. These primary molars were identified as having deep caries by clinical and radiographic examinations and were treated with IPT. The factors potentially affecting the IPT success rate were analyzed after two years of follow-up. The results indicated that the two-year IPT success rate was 86% (262/303). The success rate of primary molars with and without stainless steel crowns was 96% (120/125) and 80% (142/178), respectively. Primary molars treated with stainless steel crowns showed a significantly lower risk of failure (hazard ratio (HR) = 0.18, 95% confidence interval (CI): (0.10, 0.34), p = 0.01). There were no significant differences in other factors, including gender (male vs. female), age (preschool vs. school age), cooperation level (Frankl 2 vs. 3 or 4 scales), arch type (maxillary vs. mandibular), tooth type (first vs. second primary molar), or pulp capping material (calcium hydroxide vs. glass ionomer cement). IPT is an effective, conservative treatment modality for primary molars with deep caries. Stainless steel crowns could significantly improve the IPT success rate.

Early childhood caries (ECC) is the most prevalent chronic oral disease and one of the worldwide public health problems of great urgency for children. ECC can affect children\'s teeth, dentition, craniomaxillofacial, and general health and development. Therefore, through dental caries etiologies and caries risk assessment, patient-centered, personalized planning and a combination of prevention and treatment should be implemented in the clinical management for ECC. Periodic and continuous cycle management can only be accomplished with the cooperation of medical staff, children, and their guardians. This expert consensus will expound the clinical management of ECC in the following aspects: caries risk assessment, early clinical prevention, treatment strategies, and postoperative management.

There is a paucity of information concerning vital pulp treatment outcomes in the undergraduate teaching setting. This study aimed to determine which type of deciduous molar, arch location, type of vital pulp therapy, and the number of carious surfaces involved had a better prognosis when carried out by undergraduate dental students. The method used was the review of clinical records of 590 patients with 600 deciduous molars, that visited the outpatient undergraduate dental clinics for vital pulp therapy. Statistical analysis used to determine the associations of tooth type, arch location, treatment type, and the number of carious surfaces involved in successful outcomes was logistic regression analysis with significance set at p < 0.05. According to the regression analysis model results, there was a significant association based on tooth type (p < 0.05) and arch location (p = 0.003). In addition, there was a significant association based on the type of treatment performed (p = 0.036). However, there was no significant association in success rates based on the number of carious surfaces involved (p = 0.873). In conclusion, second deciduous molars and maxillary deciduous molars had a better overall prognosis, and indirect pulp therapy was revealed to be more highly associated with successful treatment outcomes in comparison to ferric sulfate pulpotomy in our setting.

OBJECTIVE: In a tooth with deep dentinal caries; judicious removal of infected dentin and isolating affected dentin from oral fluids with suitable biocompatible material is called indirect pulp therapy (IPT). This randomized clinical trial was done to evaluate and compare the efficacy of Biodentine, Theracal LC and. Dycal as an indirect pulp capping agent in young permanent teeth.
METHODS: IPT was performed in 60 young permanent molars with caries approaching pulp in 55 healthy children using Biodentine, Theracal and Dycal. A 2-3mm layer of GIC was placed over the intervening material followed by restoration of cavity with composite. Clinical and radiographic examinations were conducted at 3 weeks, 3 months, 6 months,12 months, 18 months and 24 months. The data was compared using chi-square test at a significance level of 0.05.
RESULTS: By end of 24 months ,54 teeth presented for follow up with overall success rate of 100% in Theracal, 94.44% in Biodentine, and 77.78% in Dycal. Overall success of Theracal was statistically significant in comparison to Biodentine and Dycal at 24 months follow up (p= 0.03) Conclusions: Radiographic and clinical outcomes of Theracal and Biodentine suggest their use as an alternative material for IPT in young permanent molars with higher success.

OBJECTIVE: There is no long-term study on the comparison of indirect pulp therapy with ferric sulfate pulpotomy in primary molars. This retrospective study aimed to compare the success rates of ferric sulfate pulpotomy with those of indirect pulp therapy in primary molars during a 4-year follow-up.
METHODS: A total of 114 primary molars from 38 children (16 females and 22 males) with deep carious lesions were selected. Among these molars, 71 indicated for ferric sulfate pulpotomy and 43 indicated for indirect pulp therapy were treated under general anesthesia according to a standard protocol by two senior pediatric dentists. Clinical and radiographic assessments for determining success rates were performed using established criteria at initial, post-operatively, and at 24 and 48 months. Data were analyzed using Fisher\'s exact test to compare success rates of ferric sulfate pulpotomy and indirect pulp therapy at the 24- and 48-month follow-ups.
RESULTS: The overall success rates for indirect pulp therapy and ferric sulfate pulpotomy were 100% (43/43) and 91.5% (65/71), respectively, at the 24-month follow-up; the difference was not significant (P = 0.08). However, the success rate for indirect pulp therapy (93.0%, 40/43) at the 48-month follow-up was significantly higher than that for ferric sulfate pulpotomy (70.4%, 50/71) (P = 0.008).
CONCLUSIONS: Indirect pulp therapy showed a significantly higher success rate at the 4-year follow-up than did ferric sulfate pulpotomy for treating deep carious lesions in primary molars. Earlier exfoliation was observed after treatment with ferric sulfate pulpotomy compared to indirect pulp therapy.

Deciduous teeth are the first dentition of humans and play an important role in children\'s physical and mental development. Dental caries are one of the most common oral diseases in children. According to the data of the World Health Organization, 60%-90% of school children worldwide develop dental caries. In China, dental caries of primary teeth feature high incidence and low rate of visits. Without timely treatment, the deep caries lesions of primary teeth can lead to teeth defect, pulpitis, apical periodontitis, and maxillofacial space infection. Moreover, the premature loss of deciduous teeth can cause malocclusion and eruption disorder of subsequent permanent teeth. These conditions all cause considerable effects on children\'s oral health and physical and mental development. Performing active and effective measures to treat deciduous teeth with deep caries lesions is important to maintain the integrity and normal physiological function of dentition and facilitate normal eruption of permanent teeth. The current situation of indirect pulp therapy in China was studied in this paper. Basic concepts, including indirect pulp capping, interim therapeutic restoration, partial caries removal, stepwise caries removal, and atraumatic restorative therapy, have been defined by consulting domestic and foreign literature. A theoretical basis for improving the clinical pathway of deciduous teeth with deep caries lesions is provided by explaining the technical connotation and therapeutic importance of indirect pulp therapy in primary teeth.
乳牙是人类的第一副牙齿，其正常萌出建并行使生理功能对儿童的身心发育具有重要意义。乳牙龋病是儿童慢性疾病之首，是儿童口腔医学临床最常见的疾病之一。根据世界卫生组织调查数据显示，世界范围内60%~
90%的学龄儿童患有龋病。乳牙龋病在我国具有患龋率高，就诊率低下的特点，如不及时治疗，可导致牙体组织缺损、生理间隙丢失、牙髓和根尖周病变及颌面间隙感染，严重者可致乳牙早失并伴发牙列畸形及后续恒牙萌出障碍等不良结果，影响儿童口腔健康及身心发育。因此，对深龋乳牙采取积极有效的治疗措施对保存必要乳牙及其牙髓活力，恢复正常生理功能，维持牙列完整性，诱导后续恒牙正常萌出建具有重要意义。本文从目前深龋乳牙间接牙髓治疗的研究认识现状出发，通过文献资料收集整理，对间接牙髓治疗、间接盖髓术、暂时性保髓充填、部分去龋法、分步去龋法和非创伤性修复治疗等相关概念进行了对比分析，阐明了乳牙间接牙髓治疗的技术内涵和治疗意义，对乳牙深龋的临床治疗路径完善提供了理论依据。.

Studies on dental regeneration involving interventions for pulp therapy such as regeneration and revascularization procedures are promising for the injured tooth; however, a complete replication of the original pulp tissue does not seem to take place. In cases in which we wish to preserve or maintain parts of the pulp during treatment, it is apparent that the effectiveness of healing or biological regeneration is dependent on the degree of inflammation of the pulp tissue. Thus, the control or prevention of a pulp infection is still a major issue for the clinicians. Data indicate that the typical reason for performing endodontic treatment is deep caries. The biological concept of vital pulp therapy associated with deep caries takes the treatment and evaluation of the unexposed as well as the exposed pulp into account. Interestingly, the clinical diagnosis is typically the same. Deep caries with reversible pulpitis may receive differing treatments such as excavation procedures aiming to avoid pulp exposure or more pulp invasive treatments such as pulp capping or pulpotomy. This should not be the case. Consequently, huge treatment variation is noted among clinicians based on the same caries diagnosis. Which treatment should be selected? High-quality trials are needed, and it is important to obtain information on the actual lesion depth and an estimate of the lesion activity before treatment. These may be basic indicators for the regenerative potential of dental pulp. Recent clinical trials dealing with the treatment of deep caries lesion are discussed, including pulp invasive and noninvasive concepts, to attempt to solve the task of getting the best clinical outcome for adult patients.