Since the 1950s, clinicians have relied on various formulations of Ca(OH)2 to stimulate dentin bridge formation. Various studies (Kozlov and Massler, 1966; Massler, 1967; Brännström, 1978; Cox et al., 1987; Snuggs et al., 1993) have demonstrated that pulp healing and dentin bridging can occur against a pH spectrum of materials. Recent studies (Akimoto et al., 1998; Cox et al., 1998, 1999; Tarim et al., 1998; Kitasako et al., 1999; Hafez et al., 2000) have reported successful pulp healing and dentin bridging using adhesives for direct capping of exposed pulps. However, others (Costa et al., 1997; Stanley and Pameijer, 1997; Pameijer, 1998; Hebling et al., 1999; Carvalho et al., 2000) have reported unsatisfactory results when exposures were direct-capped with adhesives. Biological and technical factors, or a combination of both, might be postulated to explain these differences. Recent studies have demonstrated that biological success is dependent upon proper hemorrhage control at the exposure site. This review explores the differences and common factors influencing successful dentin bridging, focusing on data derived from animal studies conducted according to ISO usage guidelines for cavity preparation and material placement. In the past, there has been concern that etching of vital dentin leads to immediate pulp death due to low pH. Recent studies have reported that acidic cements cause breakdown of only the smear layer and fail to seal the restoration interface, leading to inflammation and necrosis. A properly hybridized dentinadhesive interface provides a "bacteriometic" seal to both dentin and pulp tissues. Recent ISO usage studies have shown a high incidence of dentin bridging with adhesives following proper hemorrhage control and removal of both operative debris and biofilm at the dentin-pulp interface by agents such as NaOCl. These are important technique-sensitivity factors to be considered for pulp healing and dentin bridge formation.

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A child with asthma who needs dental treatment can be a source of concern to the pediatric dentist. Recent studies have provided a better understanding of the pathophysiology of asthma as well as the role of emotions in the expression of asthma. The goal in managing the patient with asthma is to prevent an acute asthmatic episode during the dental procedure. Suggestions are made to meet this goal. Asthma does not require alteration of routine dental practices and, most importantly, the well-managed child with asthma does not need special treatment when it comes to possible behavior problems in the dental office.

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Oro‐facial fractures, displacement of teeth and various other traumatic dental injuries may possibly be associated with damage to various aspects of the cranial nervous system. When evidence of these injuries is presented, it is the dentist's responsibility to make a thorough assessment. This paper presents a brief, yet adequate neurologic evaluation of the child patient with oro‐facial trauma which can be accomplished in five minutes. It includes a review of history, mental status, evaluation of gait, use of extremities, eye and facial movements, gag and facial sensations. When positive findings arc noted it is recommended that the patient be referred to a neurologist or an oral‐maxillofacial surgeon for further evaluation and treatment.