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

2020 ◽  
Vol 9 (4) ◽  
pp. 984 ◽  
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.

scholarly journals Acemannan Used as an Implantable Biomaterial for Vital Pulp Therapy of Immature Permanent Teeth Induced Continued Root Formation

Pharmaceutics ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 644
Author(s):  
Tien Thuy Vu ◽  
Minh Truong Nguyen ◽  
Polkit Sangvanich ◽  
Quang Ngoc Nguyen ◽  
Pasutha Thunyakitpisal
Keyword(s):  
Root Formation ◽  
Treatment Success ◽  
Permanent Teeth ◽  
Pulp Tissue ◽  
Pulp Therapy ◽  
Exposure Site ◽  
Vital Pulp Therapy ◽  
Significant Difference ◽  
Pulp Exposure

Direct pulp-capping, a vital pulp therapy, is used to protect and preserve pulp vitality by applying a biomaterial on the pulp exposure site. Acemannan, a polysaccharide extracted from Aloe vera, induces osteodentin-bridge formation to cover the exposure site in vivo. We evaluated the effect of acemannan sponges on partial pulpotomized permanent teeth with caries or accident-induced pulp exposure (n = 50). After removing infected dentin and inflamed pulp tissue, the teeth were randomly divided into acemannan or control (mineral trioxide aggregate (MTA) groups (n = 25). The teeth were examined immediately after treatment (baseline) and at 6- and 12-month follow-ups for clinical and cone beam computed tomography (CBCT) examination. The three-dimensional tooth length and root apex area were simulated to determine treatment success. We found that the overall success rate in the acemannan and MTA groups from baseline to 12-month follow-up was 90.91% and 95.65%, respectively, with no significant difference between the two groups (p > 0.05). In the success teeth in both groups, the root length increased, and the apex area significantly decreased (p < 0.05), indicating continued root formation. Our results suggest that acemannan is a promising low-cost biomaterial for partial pulpotomy treatment for immature permanent teeth requiring vital pulp therapy.

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

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.

scholarly journals Minimal Intervention in Dentistry: A Literature Review on Biodentine as a Bioactive Pulp Capping Material

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Naji Ziad Arandi ◽  
Mohammad Thabet
Keyword(s):  
Decision Making Process ◽  
Direct Pulp Capping ◽  
Minimal Intervention ◽  
Bioactive Material ◽  
Pulp Capping ◽  
Pulp Therapy ◽  
Minimally Invasive Dentistry ◽  
Vital Pulp Therapy ◽  
Alternative Approach ◽  
Pulp Exposure

Root canal treatment has been the treatment of choice for carious pulp exposures. In the perspective of minimally invasive dentistry and preventive endodontics, a direct pulp capping procedure with a reliable bioactive material may be considered an alternative approach provided that the pulp status is favorable. However, the treatment of pulp exposure by pulp capping is still a controversial issue with no clear literature available on this topic, leaving the concerned practitioner more confused than satisfied. Biodentine is a relatively new bioactive material explored for vital pulp therapy procedures. This article discusses its role in direct pulp capping procedures. A thorough literature search of the database was done using PubMed, Google Scholar, and Scopus using the keywords preventive endodontics, calcium silicate cement, direct pulp capping, Biodentine, and vital pulp therapy. Reference mining of the articles that were identified was used to locate other papers and enrich the findings. No limits were imposed on the year of publication, but only articles in English were considered. This paper is aimed at reviewing the current literature on Biodentine as a direct pulp capping material. The review will provide a better understanding of Biodentine’s properties and can aid in the decision-making process for maintaining the vitality of exposed dental pulp with minimal intervention.

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

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.

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

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.

Apexogenesis

1990 ◽  
Vol 7 (3) ◽  
pp. 12-13 ◽  
Author(s):  
Chris J. Visser
Keyword(s):  
Root Canal ◽  
Root Canal Treatment ◽  
Permanent Teeth ◽  
Canal System ◽  
Tooth Formation ◽  
Pulp Therapy ◽  
Biological Approach ◽  
Immature Teeth ◽  
Vital Pulp Therapy ◽  
Pulp Exposure

The permanent teeth erupt while undergoing tooth formation and root lengthening. These immature teeth are more vulnerable to pulp exposure. Faced with the necessity for root canal treatment, and taking into account the unlikely possibility of successful obturation of an immature canal system, it is recommended that these developing teeth be treated by a biological approach. When the vital pulp of a tooth is exposed and the pulp is not irreversibly inflamed and apical development and closure is incomplete apexogenesis procedures are recommended. Vital pulp therapy techniques are described.

scholarly journals Vital Pulp Therapy in Permanent Teeth with Irreversible Pulpitis Caused by Caries: A Prospective Cohort Study

2021 ◽  
Vol 11 (11) ◽  
pp. 1125
Author(s):  
Xiaoxu Guan ◽  
Yi Zhou ◽  
Qingxia Yang ◽  
Tianer Zhu ◽  
Xuepeng Chen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Success Rate ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Permanent Teeth ◽  
Old Patients ◽  
Pulp Therapy ◽  
Vital Pulp Therapy ◽  
Significant Difference ◽  
Irreversible Pulpitis

Background: When a tooth is diagnosed with irreversible pulpitis, root canal therapy (RCT) is generally performed to completely remove pulp tissue, which might lead to a higher risk of loss of vascularity, and teeth being more prone to fracture. Vital pulp therapy (VPT) is a personalized method of treating irreversible pulpitis, which conforms to the trend of minimally invasive endodontics. The remaining vital pulp could promote the physiological development of the roots of young permanent teeth with incomplete apical foramen. However, clear guidelines for VPT indication are still missing. Objective: This prospective cohort study evaluated the outcomes of vital pulp therapy (VPT) using iRoot BP Plus (Innovative Bioceramix Inc, Vancouver, BC, Canada) in permanent teeth of 6- to 20-year-old patients with irreversible pulpitis caused by caries and analyzed the preoperative factors affecting VPT prognosis. Methods: Fifty-nine permanent teeth in 59 patients with irreversible pulpitis caused by caries were treated with VPT using iRoot BP Plus. All patients received VPT under a standardized protocol. After informed consent, teeth were isolated with a dental dam, then operators performed VPT with iRoot BP Plus and restored the teeth with composite resin or stainless steel crown. Patients were postoperatively recalled after 3, 6 and 12 months and then recalled annually. Successful cases were defined as successful in both clinical and radiographic evaluations. A statistical analysis was performed using the Fisher exact test, and the level of significant difference was p < 0.05. Results: After 6–36 months of follow-up, a total of 57 teeth from 57 patients were accessible for evaluation. The mean age of subjects was 11.75 ± 3.81 years. The overall clinical and radiographic success rate of VPT was 91.2% (52/57). With an observation time of one year or more, the success rate was 90.5% (38/42). All the symptoms and physical examination findings showed no significant effect on VPT prognosis (p > 0.05) using a binary logistic regression model. Conclusions: Permanent teeth in 6- to 20-year-old patients diagnosed as irreversible pulpitis caused by caries can be successfully treated with VPT using iRoot BP Plus.

scholarly journals Partial pulpotomy without age restriction: a retrospective assessment of permanent teeth with carious pulp exposure

2021 ◽  
Author(s):  
Florin Eggmann ◽  
Thomas J. W. Gasser ◽  
Hanjo Hecker ◽  
Mauro Amato ◽  
Roland Weiger ◽  
...  
Keyword(s):  
Survival Rates ◽  
Age Groups ◽  
Permanent Teeth ◽  
Eligibility Criteria ◽  
Presumptive Diagnosis ◽  
Tooth Discoloration ◽  
Significant Difference ◽  
Pulp Exposure ◽  
The Mean

Abstract Objectives This study aimed to retrospectively evaluate clinical and radiographic outcomes of partial pulpotomy performed in permanent teeth with carious pulp exposure. Materials and methods Records of patients undergoing treatment at an undergraduate dental clinic between 2010 and 2019 were screened for partial pulpotomies in teeth with a presumptive diagnosis of normal pulp or reversible pulpitis. The follow-up had to be ≥ 1 year. Patient data were retrieved and analyzed using Mantel-Cox chi square tests and Kaplan–Meier statistics. The level of significance was set at α = 0.05. Results Partial pulpotomy was performed in 111 cases, of which 64 (58%) fulfilled the eligibility criteria. At the time of partial pulpotomy, the mean age was 37.3 (± 13.5) years (age range 18–85). The mean observation period was 3.1 (± 2.0) years. Two early failures (3.1%) and five late failures (7.7%) were recorded. The overall success rate of maintaining pulp vitality was 89.1%, with 98.4% tooth survival. The cumulative pulp survival rates of partial pulpotomy in patients aged < 30 years, between 30 and 40 years, and > 40 years were 100%, 75.5%, and 90.5%, respectively, with no significant difference between the age groups (p = 0.225). At follow-up, narrowing of the pulp canal space and tooth discoloration were observed in 10.9% and 3.1% of cases, respectively. Conclusions Across age groups, partial pulpotomy achieved favorable short and medium-term outcomes in teeth with carious pulp exposure. Clinical relevance Adequate case selection provided, partial pulpotomy is a viable operative approach to treat permanent teeth with deep carious lesions irrespective of patients’ age.

Vital Pulp Therapy Current Trends and Future Perspectives

2021 ◽  
Author(s):  
Iris Slutzky-Goldberg
Keyword(s):  
Root Development ◽  
Future Perspectives ◽  
Direct Pulp Capping ◽  
Pulp Capping ◽  
Pulp Therapy ◽  
Immature Teeth ◽  
Current Trends ◽  
Vital Pulp Therapy ◽  
Irreversible Pulpitis

Vital pulp therapy (VPT), including direct pulp capping, partial and cervical Pulpotomy, was suggested for the treatment of young teeth, with reversible or irreversible pulpitis [1]. Maintaining the vitality of immature teeth enables continued root development, maturogenesis, and a better prognosis

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

2021 ◽  
Vol 2 ◽  
Author(s):  
Mark Shallal-Ayzin ◽  
Tam Trinh ◽  
William Yeung ◽  
Peter Z. Tawil ◽  
Carol L. Haggerty ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Permanent Teeth ◽  
Pulp Therapy ◽  
Standardized Protocol ◽  
Vital Pulp Therapy ◽  
Post Operative Pain ◽  
Experienced Pain ◽  
Functional Tooth ◽  
Poor Treatment ◽  
Poor Treatment Outcome

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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