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2022 | OriginalPaper | Hoofdstuk

10. Vitale-pulpatherapie

Auteurs : Prof. dr. L. W. M. van der Sluis, Drs. M. de Groot, Drs. W. J. Wolters, Dr. X. Petridis, MSc in Endodontics

Uitgeverij: Bohn Stafleu van Loghum

Samenvatting

Cariës, chemische, mechanische en thermische prikkels kunnen leiden tot een bepaalde mate van pulpitis en parodontitis apicalis. Over het algemeen worden behandelingen vooral gericht op voorkómen en genezen van zowel parodontitis apicalis als pulpitis. Verwacht wordt dat ontstoken pulpaweefsel moeilijk of niet kan genezen en dat het succespercentage van een wortelkanaalbehandeling hoog is. Deze opvatting resulteert daarom vaak in grote of totale pulpaweefselamputaties bij pulpitis. De succespercentages van wortelkanaalbehandelingen zijn echter minder hoog dan gedacht. Het blijkt dat de aanwezigheid van gezond vitaal pulpaweefsel de beste bescherming is tegen parodontitis apicalis. De idee om pulpavitaliteit te behouden wint daarom aan terrein. In dit hoofdstuk wordt beschreven hoe men het herstellend vermogen van ontstoken pulpaweefsel kan inschatten en welke behandelingen er zijn om ontstoken pulpaweefsel te behandelen, behouden en doen genezen.

vorige hoofdstuk Klinische toepassingen van CBCT binnen de endodontologie

volgende hoofdstuk Inleiding tot de wortelkanaalbehandeling

Haapasalo M, Shen Y, Ricucci D. Reasons for persistent and emerging post-treatment endodontic disease. Endod Topics. 2011;18:31–50. https://doi.org/10.1111/j.1601-1546.2011.00256.x.CrossRef

Innes NPT, Frencken JE, Bjørndal L, Maltz M, Manton DJ, Ricketts D, Van Landuyt K, Banerjee A, Campus G, Doméjean S, et al. Managing carious lesions: consensus recommendations on terminology. Adv Dent Res. 2016;28:49–57. https://doi.org/10.1177/0022034516639276.CrossRefPubMed

Fejerskov O, Nyvad B, Kidd EA. Pathology of dental caries. In: Fejerskov O, Nyvad B, Kidd EAM, editors. Dental caries: the disease and its clinical management. 3rd ed. Oxford (UK): Wiley Blackwell; 2015. p. 7–9.

Pashley DH. Dynamics of the pulpo-dentine complex. Crit Rev Oral Biol Med. 1996;7:104–33.PubMedCrossRef

Bjørndal L. The caries process and its effect on the pulp: the science is changing and so is our understanding. Pediatr Dent. 2008;30:192–6.PubMed

Farges JC, Alliot-Licht B, Baudouin C, Msika P, Bleicher F, Carrouel F. Odontoblast control of dental pulp inflammation triggered by cariogenic bacteria. Front Physiol. 2013;4:326. https://doi.org/10.3389/fphys.2013.00326.CrossRefPubMedPubMedCentral

Bjørndal L, Demant S, Dabelsteen S. Depth and activity of carious lesions as indicators for the regenerative potential of dental pulp after intervention. J Endod. 2014;40(4 Suppl):S76-81. https://doi.org/10.1016/j.joen.2014.01.016.CrossRefPubMed

Cooper PR, Holder MJ, Smith AJ. Inflammation and regeneration in the dentine-pulp complex: a double-edged sword. J Endod. 2014;40(4 Suppl):S46-51. https://doi.org/10.1016/j.joen.2014.01.021.CrossRefPubMed

Finkelman RD, Mohan S, Jennings JC, Taylor AK, Jepsen S, Baylink DJ. Quantitation of growth factors IGF-I, SGF/IGF-II, and TGF-beta in human dentine. J Bone Miner Res. 1990;5:717–23.PubMedCrossRef

10.

Cassidy N, Fahey M, Prime SS, Smith AJ. Comparative analysis of transforming growth factor-beta isoforms 1–3 in human and rabbit dentine matrices. Arch Oral Biol. 1997;42:219–23.PubMedCrossRef

11.

Cooper PR, Takahashi Y, Graham LW, Simon S, Imazato S, Smith AJ. Inflammation-regeneration interplay in the dentine-pulp complex. J Dent. 2010;38:687–97. https://doi.org/10.1016/j.jdent.2010.05.016.CrossRefPubMed

12.

Cooper PR, McLachlan JL, Simon S, Graham LW, Smith AJ. Mediators of inflammation and regeneration. Adv Dent Res. 2011;23:290–5. https://doi.org/10.1177/0022034511405389.CrossRefPubMed

13.

Smith AJ, Scheven BA, Takahashi Y, Ferracane JL, Shelton RM, Cooper PR. Dentine as a bioactive extracellular matrix. Arch Oral Biol. 2012;57:109–21. https://doi.org/10.1016/j.archoralbio.2011.07.008.CrossRefPubMed

14.

Smith AJ, Duncan HF, Diogenes A, Simon S, Cooper PR. Exploiting the bioactive properties of the dentine-pulp complex in regenerative endodontics. J Endod. 2016;42:47–56. https://doi.org/10.1016/j.joen.2015.10.019.CrossRefPubMed

15.

Tomson PL, Lumley PJ, Smith AJ, Cooper PR. Growth factor release from dentine matrix by pulp-capping agents promotes pulp tissue repair-associated events. Int Endod J. 2017;50:281–92. https://doi.org/10.1111/iej.12624.CrossRefPubMed

16.

Siqueira JF Jr. Treatment of endodontic infections. London: Quintessence Publishing; 2011.

17.

Reeves R, Stanley HR. The relationship of bacterial penetration and pulpal pathosis in carious teeth. Oral Surg Oral Med Oral Pathol. 1966;22:59–65.PubMedCrossRef

18.

Bjørndal L, Reit C, Bruun G, Markvart M, Kjaeldgaard M, Näsman P, Thordrup M, Dige I, Nyvad B, Fransson H, Lager A, Ericson D, Petersson K, Olsson J, Santimano EM, Wennström A, Winkel P, Gluud C. Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy. Eur J Oral Sci. 2010;(118):290–7. https://doi.org/10.1111/j.1600-0722.2010.00731.x.

19.

Ricucci D, Loghin S, Siqueira JF Jr. Correlation between clinical and histologic pulp diagnoses. J Endod. 2014;40:1932–9. https://doi.org/10.1016/j.joen.2014.08.010.CrossRefPubMed

20.

Yoshiyama M, Masade J, Uchida A. Scanning electron microscopic characterization off sensitive vs. intensitive human radicular dentin. J Dent Res. 1989;68:1498–502.

21.

Fischer C, Fischer RG, Wennberg A. Prevalence and distribution of cervical dentine hypersensitivity in a population in Rio de Janeiro. Brazil J Dent. 1992;20:272–6.PubMed

22.

Flynn J, Galloway R, Orchardson R. The incidence of ‘hypersensitive’ teeth in the West of Scotland. J Dent. 1985;13:230–6.PubMedCrossRef

23.

Orchardson R, Gillam DG. Managing dentin hypersensitivity. J Am Dent Assoc. 2006;137:990–8.PubMedCrossRef

24.

Brannstrom M, Johnson G, Nordenvall KJ. Transmission and control of dentinal pain: resin impregnation for the desensitization of dentin. J Am Dent Assoc. 1979;99:612–8.PubMedCrossRef

25.

Vongsavan N, Matthews B. The relation between fluid flow through dentin and the discharge of intradental nerves. Arch Oral Biol. 1994;39(suppl):140S.CrossRef

26.

Narhi MV, Hirvonen TJ, Hakumaki MO. Activation of intradental nerves in the dog to some stimuli applied to the dentin. Arch Oral Biol. 1982;27:1053–8.PubMedCrossRef

27.

Bernal L, et al. Odontoblast TRPC5 channels signal cold pain in teeth. Sci Adv. 2021;7:eabf5567.

28.

Byers MR, Taylor PE, Khayat BG. Effects of injury and inflammation on pulpal and periapical nerves. J Endod. 1990;16:78–84.PubMedCrossRef

29.

Addy M. Tooth brushing, tooth wear and dentine hypersensitivity – are they associated? Int Dent J. 2005;55(4 Suppl 1):261–7.PubMedCrossRef

30.

Addy M, West N. Etiology, mechanisms, and management of dentine hypersensitivity. Curr Opin Periodontol. 1994;71–7.

31.

Ling TY, Gillam DG. The effectiveness of densensitizing agents for the treatment of cervical dentine sensitivity (CDS) – a review. J West Soc Periodontol Periodontal Abstr. 1996;44:5–12.PubMed

32.

Van der Weijden FN, Van Loveren C, Slot DE, Van der Weijden GA. Preventieve tandheelkunde 4. Preventie en behandeling van dentine-overgevoeligheid. Ned Tijdschr Tandheelkd. 2017;124:133–9.PubMed

33.

Van Loveren C, Van der Weijden GA. Preventieve tandheelkunde. Houten/Diegem: Bohn Stafleu Van Loghum; 1996. p. 202–3.

34.

Zhang C, Matsumoto K, Kimura Y, Harashima T, Takeda FH, Zhou H. Effects of CO₂ laser in treatment of cervical dentinal hypersensitivity. J Endod. 1998;24:595–7.PubMedCrossRef

35.

Gillam DG. Clinical trial designs for testing of products for dentine hypersensitivity. A review. J West Soc Periodontol Periodontal Abstr. 1997;45:37–46.

36.

Ling TY, Gillam DG. The effectiveness of densensitizing agents for the treatment of cervical dentine sensitivity (CDS) – a review. J West Soc Periodontol Periodontal Abstr. 1996;44:5–12.PubMed

37.

Caviedes-Bucheli J, Gomez-Sosa JF, Azuero-Holguin MM, Ormeno-Gomez M, Pinto-Pascual V, Munoz HR. Angiogenic mechanisms of human dental pulp and their relationship with substance P expression in response to occlusal trauma. Int Endod J. 2017;50:339–51.PubMedCrossRef

38.

Caviedes-Bucheli J, Lopez-Moncayo LF, Muñoz-Alvear HD, Gomez-Sosa JF, Diaz-Barrera LE, Curtidor H, Munoz HR. Expression of substance P, calcitonin gene-related peptide and vascular endothelial growth factor in human dental pulp under different clinical stimuli. BMC Oral Health. 2021;23:152.CrossRef

39.

Flemming HC, Wingender J. The biofilm matrix. Nat Rev Microbiol. 2010;8:623–33. https://doi.org/10.1038/nrmicro2415.CrossRefPubMed

40.

Stewart PS, Franklin MJ. Physiological heterogeneity in biofilms. Nat Rev Microbiol. 2008;6:199–210. https://doi.org/10.1038/nrmicro1838.CrossRefPubMed

41.

Peterson BW, He Y, Ren Y, Zerdoum A, Libera MR, Sharma PK, Van Winkelhoff A-J, Neut D, Stoodley P, Van der Mei HC, Busscher HJ. Viscoelasticity of biofilms and their recalcitrance to mechanical and chemical challenges. FEMS Microbiol Rev. 2015;39:234–45. https://doi.org/10.1093/femsre/fuu008.CrossRefPubMedPubMedCentral

42.

Chavez de Paz LE. Redefining the persistent infection in root canals: possible role of biofilm communities. J Endod. 2007;33:652–62.PubMedCrossRef

43.

Pashley DH, Tao L, Boyd L, King GE, Horner JA. Scanning electron microscopy of the substructure of smear layers in human dentine. Arch Oral Biol. 1988;33:265–70.PubMedCrossRef

44.

Drake DR, Wiemann AH, Rivera EM, Walton RE. Bacterial retention in canal walls in vitro: effect of smear layer. J Endod. 1994;20(2):78–82.PubMedCrossRef

45.

Violich DR, Chandler NP. The smear layer in endodontics – a review. Int Endod J. 2010;43:2–15. https://doi.org/10.1111/j.1365-2591.2009.01627.x.CrossRefPubMed

46.

Wang Z, Shen Y, Ma J, Haapasalo M. The effect of detergents on the antibacterial activity of disinfecting solutions in dentine. J Endod. 2012;38:948–53. https://doi.org/10.1016/j.joen.2012.03.007.CrossRefPubMed

47.

Wu MK, Dummer PM, Wesselink PR. Consequences of and strategies to deal with residual post-treatment root canal infection. Int Endod J. 2006;39:343–56.PubMedCrossRef

48.

European Society of Endodontology. Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J. 2006;39(12):921–30.CrossRef

49.

Estrela C, Bueno MR, Leles CR, Azevedo B, Azevedo JR. Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis. J Endod. 2008;34(3):273–9. https://doi.org/10.1016/j.joen.2007.11.023.CrossRefPubMed

50.

Molander A, Reit C, Dahlén G, Kvist T. Microbiological status of root-filled teeth with apical periodontitis. Int Endod J. 1998;31:1–7.PubMedCrossRef

51.

Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature – Part 2. Influence of clinical factors. Int Endod J. 2008;41:6–31.

52.

Brynolf I. Histological and roentgenological study of periapical region of human upper incisors. Odontol Revy. 1967;18(Suppl):11.

53.

Wu MK, Shemesh H, Wesselink PR. Limitations of previously published systematic reviews evaluating the outcome of endodontic treatment. Int Endod J. 2009;42:656–66. https://doi.org/10.1111/j.1365-2591.2009.01600.x.CrossRefPubMed

54.

Ørstavik D, Qvist V, Stoltze K. A multivariate analysis of the outcome of endodontic treatment. Eur J Oral Sci. 2004;112:224–30.PubMedCrossRef

55.

Sjogren U, Hagglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod. 1990;16:498–504.PubMedCrossRef

56.

Abella F, Patel S, Duran-Sindreu F, Mercadé M, Bueno R, Roig M. Evaluating the periapical status of teeth with irreversible pulpitis by using cone-beam computed tomography scanning and periapical radiographs. J Endod. 2012;38:1588–91. https://doi.org/10.1016/j.joen.2012.09.003.CrossRefPubMed

57.

Al-Nuaimi N, Patel S, Davies A, Bakhsh A, Foschi F, Mannocci F. Pooled analysis of 1-year recall data from three root canal treatment outcome studies undertaken using cone beam computed tomography. Int Endod J. 2017;28. https://doi.org/10.1111/iej.12844.

58.

Shemesh H, Wesselink PR, Wu MK. Incidence of dentineal defects after root canal filling procedures. Int Endod J. 2010;43:995–1000. https://doi.org/10.1111/j.1365-2591.2010.01740.x.CrossRefPubMed

59.

Liu R, Kaiwar A, Shemesh H, Wesselink PR, Hou B, Wu MK. Incidence of apical root cracks and apical dentineal detachments after canal preparation with hand and rotary files at different instrumentation lengths. J Endod. 2013;39:129–32. https://doi.org/10.1016/j.joen.2012.09.019.CrossRefPubMed

60.

Marquis VL, Dao T, Farzaneh M, Abitbol S, Friedman S. Treatment outcome in endodontics: the Toronto Study. Phase III: initial treatment. J Endod. 2006;32(4):299–306.PubMedCrossRef

61.

Simon SR, Berdal A, Cooper PR, Lumley PJ, Tomson PL, Smith AJ. Dentine-pulp complex regeneration: from lab to clinic. Adv Dent Res. 2011;23:340–5. https://doi.org/10.1177/0022034511405327.CrossRefPubMed

62.

Bogen G, Kuttler S. Mineral trioxide aggregate obturation: a review and case series. J Endod. 2009;35:777–90. https://doi.org/10.1016/j.joen.2009.03.006.CrossRefPubMed

63.

Marques MS, Wesselink PR, Shemesh H. Outcome of direct pulp capping with mineral trioxide aggregate: a prospective study. J Endod. 2015;41:1026–31. https://doi.org/10.1016/j.joen.2015.02.024.CrossRefPubMed

64.

Taha NA, Ahmad MB, Ghanim A. Assessment of Mineral Trioxide Aggregate pulpotomy in mature permanent teeth with carious exposures. Int Endod J. 2017;50:117–25. https://doi.org/10.1111/iej.12605.CrossRefPubMed

65.

Aguilar P, Linsuwanont P. Vital pulp therapy in vital permanent teeth with cariously exposed pulp: a systematic review. J Endod. 2011;37:581–7. https://doi.org/10.1016/j.joen.2010.12.004.CrossRefPubMed

66.

Simon S, Perard M, Zanini M, Smith AJ, Charpentier E, Djole SX, Lumley PJ. Should pulp chamber pulpotomy be seen as a permanent treatment? Some preliminary thoughts. Int Endod J. 2013;46:79–87. https://doi.org/10.1111/j.1365-2591.2012.02113.x.CrossRefPubMed

67.

Asgary S, Eghbal MJ, Ghoddusi J, Yazdani S. One-year results of vital pulp therapy in permanent molars with irreversible pulpitis: an ongoing multicenter, randomized, non-inferiority clinical trial. Clin Oral Investig. 2013;17:431–9. https://doi.org/10.1007/s00784-012-0712-6.CrossRefPubMed

68.

Alqaderi H, Lee CT, Borzangy S, Pagonis TC. Coronal pulpotomy for cariously exposed permanent posterior teeth with closed apices: a systematic review and meta-analysis. J Dent. 2016;44:1–7. https://doi.org/10.1016/j.jdent.2015.12.005.CrossRefPubMed

69.

Asgary S, Eghbal MJ, Fazlyab M, Baghban AA, Ghoddusi J. Five-year results of vital pulp therapy in permanent molars with irreversible pulpitis: a non-inferiority multicenter randomized clinical trial. Clin Oral Investig. 2015;19:335–41. https://doi.org/10.1007/s00784-014-1244-z.CrossRefPubMed

70.

Eren B, Onay EO, Ungor M. Assessment of alternative emergency treatments for symptomatic irreversible pulpitis: a randomized clinical trial. Int Endod J. 2017. https://doi.org/10.1111/iej.12851.CrossRefPubMed

71.

Taha NA, Khazali MA. Partial pulpotomy in mature permanent teeth with clinical signs indicative of irreversible pulpitis: a randomized clinical trial. J Endod. 2017;43:1417–21.PubMedCrossRef

72.

Wolters WJ, Duncan HF, Tomson PL, Karim IE, McKenna G, Dorri M, Stangvaltaite L, Van der Sluis LWM. Minimally invasive endodontics: a new diagnostic system for assessing pulpitis and subsequent treatment needs. Int Endod J. 2017;50:825–9. https://doi.org/10.1111/iej.12793.CrossRefPubMed

73.

Bjørndal L, Larsen T. Changes in the cultivable flora in deep carious lesions following a stepwise excavation procedure. Caries Res. 2000;34:502–8.PubMedCrossRef

74.

Paddick JS, Brailsford SR, Kidd EA, Beighton D. Phenotypic and genotypic selection of microbiota surviving under dental restorations. Appl Environ Microbiol. 2005;71:2467–72.PubMedPubMedCentralCrossRef

75.

Bjørndal L. In deep cavities stepwise excavation of caries can preserve the pulp. Evid Based Dent. 2011;12:68. https://doi.org/10.1038/sj.ebd.6400803.CrossRefPubMed

76.

Ricketts D, Lamont T, Innes NP, Kidd E, Clarkson JE. Operative caries management in adults and children. Cochrane Database Syst Rev. 2013;3:CD003808. https://doi.org/10.1002/14651858.CD003808.pub3.

77.

Bjørndal L, Larsen T, Thylstrup A. A clinical and microbiological study of deep carious lesions during stepwise excavation using long treatment intervals. Caries Res. 1997;31:411–7.PubMedCrossRef

78.

Maltz M, Koppe B, Jardim JJ, Alves LS, De Paula LM, Yamaguti PM, Almeida JCF, Moura MS, Mestrinho HD. Partial caries removal in deep caries lesions: a 5-year multicenter randomized controlled trial. Clin Oral Investig. 2017. https://doi.org/10.1007/s00784-017-2221-0.CrossRefPubMed

79.

Maltz M, Garcia R, Jardim JJ, De Paula LM, Yamaguti PM, Moura MS, Garcia F, Nascimento C, Oliveira A, Mestrinho HD. Randomized trial of partial vs. stepwise caries removal: 3-year follow-up. J Dent Res. 2012;91:1026–31. https://doi.org/10.1177/0022034512460403.

80.

Maltz M, Henz SL, De Oliveira EF, Jardim JJ. Conventional caries removal and sealed caries in permanent teeth: a microbiological evaluation. J Dent. 2012;40:776–82. https://doi.org/10.1016/j.jdent.2012.05.011.CrossRefPubMed

81.

Maltz M, Jardim JJ, Mestrinho HD, Yamaguti PM, Podestá K, Moura MS, De Paula LM. Partial removal of carious dentine: a multicenter randomized controlled trial and 18-month follow-up results. Caries Res. 2013;47:103–9. https://doi.org/10.1159/000344013.CrossRefPubMed

82.

Hoefler V, Nagaoka H, Miller CS. Long-term survival and vitality outcomes of permanent teeth following deep caries treatment with step-wise and partial-caries-removal: A Systematic Review. J Dent. 2016;54:25–32. https://doi.org/10.1016/j.jdent.2016.09.009.CrossRefPubMed

83.

Schwendicke F, Dörfer CE, Paris S. Incomplete caries removal: a systematic review and meta-analysis. J Dent Res. 2013;92:306–14. https://doi.org/10.1177/0022034513477425.CrossRefPubMed

84.

Wu MK, Wesselink PR, Walton RE. Apical terminus location of root canal treatment procedures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89:99–103.PubMedCrossRef

85.

Schwendicke F, Brouwer F, Schwendicke A, Paris S. Different materials for direct pulp capping: systematic review and meta-analysis and trial sequential analysis. Clin Oral Investig. 2016;20:1121–32.PubMedCrossRef

86.

Baume LJ, Holz J. Long term clinical assessment of direct pulp capping. Int Dent J. 1981;31:251–60.PubMed

87.

Dominguez MS, Witherspoon DE, Gutmann JL, Opperman LA. Histological and scanning electron microscopy assessment of various vital pulp-therapy materials. J Endod. 2003;29:324–33.PubMedCrossRef

88.

Li Z, Cao L, Fan M, Xu Q. Direct pulp capping with calcium hydroxide or mineral trioxide aggregate: a meta-analysis. J Endod. 2015;41:1412–7. https://doi.org/10.1016/j.joen.2015.04.012.CrossRefPubMed

89.

Kundzina R, Stangvaltaite L, Eriksen HM, Kerosuo E. Capping carious exposures in adults: a randomized controlled trial investigating mineral trioxide aggregate versus calcium hydroxide. Int Endod J. 2017;50:924–32. https://doi.org/10.1111/iej.12719.CrossRefPubMed

90.

Torabinejad M, Parirokh M. Mineral trioxide aggregate: a comprehensive literature review–part II: leakage and biocompatibility investigations. J Endod. 2010;36:190–202. https://doi.org/10.1016/j.joen.2009.09.010.CrossRefPubMed

91.

Nair PN, Duncan HF, Pitt Ford TR, Luder HU. Histological, ultrastructural and quantitative investigations on the response of healthy human pulps to experimental capping with mineral trioxide aggregate: a randomized controlled trial. Int Endod J. 2008;41(2):128–50.PubMed

92.

Accorinte Mde L, Holland R, Reis A, Bortoluzzi MC, Murata SS, Dezan E Jr, Souza V, Alessandro LD. Evaluation of mineral trioxide aggregate and calcium hydroxide cement as pulp-capping agents in human teeth. J Endod. 2008;34(1):1–6.PubMedCrossRef

93.

Asgary S, Eghbal MJ, Parirokh M, Ghanavati F, Rahimi H. A comparative study of histologic response to different pulp capping materials and a novel endodontic cement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(4):609–14. https://doi.org/10.1016/j.tripleo.2008.06.006.CrossRefPubMed

94.

Van der Sluis L, Kidd E, Gruythuysen R, Peters L. Preventive endodontics – an argument for avoiding root canal treatment. ENDO – Endodontic Practice Today. 2013;4:259–74.

95.

Matsuo T1, Nakanishi T, Shimizu H, Ebisu S. A clinical study of direct pulp capping applied to carious-exposed pulps. J Endod. 1996;22:551–6.

96.

Teixeira LS, Demarco FF, Coppola MC, Bonow MLM. Clinical and radiographic evaluation of pulpotomies performed under intrapulpal injection of anaesthetic solution. IEJ. 2001;34:440–6.

Titel: Vitale-pulpatherapie
Auteurs: Prof. dr. L. W. M. van der Sluis
Drs. M. de Groot
Drs. W. J. Wolters
Dr. X. Petridis, MSc in Endodontics
Uitgeverij: Bohn Stafleu van Loghum
Boek: Endodontologie
Print ISBN: 978-90-368-2766-9

Elektronisch ISBN: 978-90-368-2767-6

Copyright: 2022
DOI: https://doi.org/10.1007/978-90-368-2767-6_10

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