Bimstein E, Rotstein I
Evidence in the literature suggests to treat a permanent tooth with a complicated crown fracture as soon as possible to diminish the possibility of pain and prevent necrosis and infection of the pulp. Delay of treatment by 9 days or less may have minimal effect on the outcome of Cvek pulpotomies. While the literature indicates that pulp exposures of 4 mm or less may have a good prognosis after a Cvek pulpotomy, the prognosis in teeth with pulp exposures of more than 4 mm has not yet been clarified. Although the literature is not conclusive regarding a difference in the outcomes of Cvek pulpotomies in teeth with open or closed apices, it appears that teeth with open apices have a better prognosis. The outcome of a Cvek pulpotomy may be compromised by a luxation injury that diminishes the tooth’s blood supply and innervation. A good restoration that prevents bacterial penetration into the tooth is essential for the success of a Cvek pulpotomy. See full abstract.
JOA & EL: The calcium hydroxide partial pulpotomy developed and analyzed by the late Dr. M. Cvek has been the standard procedure for crown fractures with pulp exposures for decades. Lately this status has been challenged by other techniques such as MTA and other materials. This review article represents a very informative reference when future pulp capping or pulpotomy materials are challenged against calcium hydroxide.
Jens Ove Andreasen (JOA) & Eva Lauridsen (EL)