A Prospective Analysis of the Correlation Between Postoperative Pain and Vital Pulp Therapy

Vital pulp therapy (VPT) is a viable treatment option for carious teeth with exposed pulps. To our knowledge, no study has examined the correlation between postoperative pain and the outcome of VPT on asymptomatic permanent teeth. The aim of this study was to examine whether odontogenic pain experienced after VPT on asymptomatic teeth with a carious pulp exposures is correlated with the progression of pulpal disease into a more inflamed or necrotic state. Direct pulp caps or partial pulpotomies using a tricalcium silicate (MTA Angelus, Angelus, Londrina, Brazil) were performed on asymptomatic permanent teeth using a standardized protocol. Patients were contacted at 24 h, 1 week, and 3 months following treatment and data was collected on post-operative pain and analgesic intake using a standardized questionnaire. At 6 months after treatment, an in-person clinical exam was performed which included standard vitality tests along with exposure of a periapical radiograph. Success was defined as an asymptomatic, functional tooth without any clinical or radiographic pathology. Data was analyzed using logistic regression. VPT was successful in 84.3% of patients at the 6 months timepoint. The percentage of patients that experienced pain at 24-h, 1 week, and 3-month time periods was 38, 22, and 12%, respectively. Pain at 3 months was significantly correlated with decreased outcome (p = 0.028). This data suggests that postoperative pain in the first 3 months after VPT is predictive of a poor treatment outcome.

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Decision-Making and Management of Immature Permanent Teeth with Crown Fractures in Small Animals—A Review

Journal of Veterinary Dentistry ◽

10.1177/08987564211046325 ◽

2021 ◽

pp. 089875642110463

Author(s):

Amalia Zacher ◽

Sandra Manfra Marretta

Keyword(s):

Treatment Options ◽

Mineral Trioxide Aggregate ◽

Permanent Teeth ◽

Small Animals ◽

Unique Challenge ◽

Pulp Capping ◽

Pulp Therapy ◽

Vital Pulp Therapy ◽

Pulp Vitality ◽

And Function

Immature permanent teeth with crown fractures present a unique challenge in human and animal patients. Immature permanent teeth have not yet developed completely, often presenting with thin dentin walls, incomplete apical formation, and increased crown-to-root ratios. Loss of pulp function at this stage has devastating long-term implications for these teeth. Ideally, attempts should be made to preserve pulp vitality in immature permanent teeth to allow for continued dental development. The range of treatment options for vital teeth includes odontoplasty with bonding and sealing +/− restoration, indirect pulp capping, and direct pulp capping/vital pulp therapy. These treatments have long been established in human and veterinary medicine, and cases have been reported in dogs and cats. Apexification using calcium hydroxide is a well-established treatment for nonvital immature teeth. The advent of mineral trioxide aggregate and other bioceramic materials for use in vital pulp therapy and apexification has reduced treatment sessions and improved outcomes. Recent developments in the field of regenerative endodontic therapy further expand treatment options and provide the possibility for continued development of a formerly nonvital tooth. Selecting the appropriate treatment based on the severity of tooth fracture and status of pulp vitality can avoid a lifetime of poor structure and function for the affected tooth. This article provides multiple step-by-step protocols for the management of immature permanent teeth with crown fractures in small animals.

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Wound Lavage in Studies on Vital Pulp Therapy of Permanent Teeth with Carious Exposures: A Qualitative Systematic Review

Journal of Clinical Medicine ◽

10.3390/jcm9040984 ◽

2020 ◽

Vol 9 (4) ◽

pp. 984 ◽

Cited By ~ 2

Author(s):

Amina Munir ◽

Matthias Zehnder ◽

Dan-Krister Rechenberg

Keyword(s):

Permanent Teeth ◽

Pulp Capping ◽

Recall Interval ◽

Pulp Therapy ◽

Vital Pulp Therapy ◽

Qualitative Systematic Review ◽

Significant Difference ◽

Study Characteristics ◽

Pulp Exposure ◽

Calcium Silicate Cements

The aim of this study was to systematically review pulp wound lavage in vital pulp therapy (VPT). A search was conducted in six life science databases to identify clinical trials carried out on permanent teeth with a carious pulp exposure and a recall interval of at least six months. Twenty-seven trials of low to moderate risk of bias (RoB-2 and ROBINS-I) were included. Data was extracted and analyzed regarding study characteristics and methods used for pulp wound lavage. The agent used for pulp wound lavage was specified in all included trials. Most of the identified trials (23/27) randomized the pulp capping material. Many (14/27) reported the use of sodium hypochlorite (NaOCl); ten used only saline or water. One trial was identified that compared pulp wound lavage with 2.5% (NaOCl) to saline, another compared 5% glutaraldehyde to water, both in immature molar pulpotomies. Both studies were underpowered. Neither showed a significant difference between treatments. The use of NaOCl was positively correlated to recent year of publication and use of hydraulic calcium silicate cements for pulp capping (p < 0.05). In conclusion, despite a lack of well-designed trials on pulp wound lavage in VPT, a trend towards using NaOCl for this purpose was observed.

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Dentist-related factors influencing the use of vital pulp therapy: a survey among dental practitioners in China

Journal of International Medical Research ◽

10.1177/0300060519843406 ◽

2019 ◽

Vol 47 (6) ◽

pp. 2381-2393

Author(s):

Mengjie Li ◽

Xiaoli Hu ◽

Xiaolan Li ◽

Shuxiang Lei ◽

Ming Cai ◽

...

Keyword(s):

Mineral Trioxide Aggregate ◽

Permanent Teeth ◽

Direct Pulp Capping ◽

Online Questionnaire ◽

Related Factors ◽

Pulp Capping ◽

Factors Associated ◽

Pulp Therapy ◽

Vital Pulp Therapy ◽

Dental Practitioners

Objective To evaluate dentist-related factors associated with the use of vital pulp therapy (VPT) for the treatment of pulp exposures in permanent teeth. Methods This survey-based study sent an online questionnaire to collect data on the demographics of the respondents, the use of VPT and the choice of materials for VPT, to all members of the Society of Endodontology of Guangdong, China. Results A total 183 of 380 members responded (48.2%). The majority (89.6%; 164 of 183) had performed direct pulp capping (DPC) while 55.2% (101 of 183) had performed partial pulpotomy (PP) at least once. The most-cited reason for not performing VPT was unfamiliarity with the technique. Mineral trioxide aggregate was the most commonly used material for both DPC (67.1%; 110 of 164) and PP (73.3%; 74 of 101). Endodontists, compared with general practitioners, preferred to perform DPC and chose calcium silicate materials (CSMs) for VPT (odds ratios 5.81 and 8.07, respectively). DPC and CSMs for VPT were also favoured more by respondents who had practised for > 5 years. Senior respondents were more likely to use PP. Conclusions Speciality, years of practise and age of dentists influenced the decision making and the choice of materials for VPT. Continuing education is essential to promote the clinical use of VPT.

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The knowledge about vital pulp therapy of permanent teeth among Saudi internship dentists and dental students

Saudi Endodontic Journal ◽

10.4103/sej.sej_84_19 ◽

2020 ◽

Vol 10 (2) ◽

pp. 83

Author(s):

Mazen Doumani ◽

ShahadTalea Almutairi ◽

NaifTami Talal Alshammari ◽

AsmaNaeem Alshami ◽

AbdulazizSaeed Alharbi ◽

...

Keyword(s):

Dental Students ◽

Permanent Teeth ◽

Pulp Therapy ◽

Vital Pulp Therapy

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Decision Analysis for Vital Pulp Therapy in Mature Permanent Teeth

Indian Journal of Public Health Research & Development ◽

10.37506/ijphrd.v11i4.4466 ◽

2020 ◽

Keyword(s):

Decision Analysis ◽

Permanent Teeth ◽

Pulp Therapy ◽

Vital Pulp Therapy

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Knowledge and practice of vital pulp therapy in young permanent teeth among general dental practitioners in Kerman, Iran

International Journal of Dental Research ◽

10.14419/ijdr.v6i1.9199 ◽

2018 ◽

Vol 6 (1) ◽

pp. 29

Author(s):

Lida Pishbin ◽

Fatemeh Sadat Sajadi ◽

Maryam Mahmoudi ◽

Hassan Shahabinejad

Keyword(s):

Material Selection ◽

Permanent Teeth ◽

Average Score ◽

Cross Sectional ◽

Pulp Capping ◽

Pulp Therapy ◽

Vital Pulp Therapy ◽

Dental Practitioners ◽

Knowledge And Practice ◽

The University

The dental pulp is the living tissue of the tooth and its vitality is essential for long-term tooth survival. The vitality or non-vitality of the pulp as well as the presence or absences of a radicular pathology determine the type of pulp therapy. The knowledge of the dentist is important in selecting and carrying out a proper complete treatment. Therefore, this study was conducted to assess general dental practitioner`s (GDP) knowledge of indication, methods and prognosis of vital pulp therapy (VPT) for young permanent teeth (YPT).Method A total of 160 GDPs from dental clinics and offices in Kerman participated in this descriptive cross-sectional study. Data were collected using an initial questionnaire consisted of 15 items examining the knowledge and practice of indication, methods and prognosis of VPT for YPT among GDPs. The participants were asked to choose from the provided answers.Result of 160 questionnaires 154 were used for final evaluation.The overall obtained average score of the total items of the questionnaire was 4.53 ± 3.56. There was not any significant correlation between the knowledge of indication, examination, diagnosis, patients selection, effective factors in success of treatment and gender, number of the years since graduation and the university where the degree was obtained for VPT among GDPs. While knowledge of selecting the right materials for pulp-capping was significantly correlated with the number of the years since graduation and the university where the degree was obtained.Conclusion Although GDPs' level of knowledge in regard to VPT is not favorable, the time since graduation and place of education influenced the suitable material selection for pulp capping. Hence, GDPs, who perform pulp therapy , need to keep themselves updated with these procedures.

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