INDIRECT PULP CAPPING
Indirect pulp capping is a conservative treatment procedure for the management of teeth with very deep caries, near exposure, wherein dental decay is gradually removed in installments and temporary filling/fillings changed after 6-weekly intervals for reparative dentin to form below the dental carious lesion so that dental decay finally can be successively, safely and completely removed before permanent filling.
This procedure is for the cases where there is a danger of exposure if caries is completely removed at the first instance.
It is usually believed by the dentists that this procedure is only of academic interest. In practice, it does not work; ultimately one has to perform root canal treatment. It is not true. If we carefully pursue the following procedure of indirect pulp capping, many teeth with very deep carious lesions can be saved from endodontic intervention.
Principle of action of “IPC”
When a tooth catches dental caries, it being bacterial in etiology, the hard tissues of tooth becomes infected. The pulp starts its defense mechanism to protect itself from the invading bacteria by forming reparative dentin below the carious lesion. If the bacterial action is more potent than the tooth defensive mechanism, the dental caries progresses to the pulp, whereas in reverse instances the caries takes longer time to reach pulp and sometimes even become arrested.
In IPC, as the dental decay is gradually cleaned in installments, the bacterial load reduces. The Ca (OH)2 inserted over the affected dentin below Kalsogen filling because of its alkalinity converts the demineralising acidic environment of the carious lesion to alkaline. This procedure promotes the formation of reparative dentin below the carious lesion, thus protecting the pulp from getting exposure when dental decay is removed after lapse of 6 weeks.