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 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 Vital Pulp Therapy in Permanent Mature Posterior Teeth with Symptomatic Irreversible Pulpitis: A Systematic Review of Treatment Outcomes

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 573
Author(s):  
João Miguel Santos ◽  
Joana F. Pereira ◽  
Andréa Marques ◽  
Diana B. Sequeira ◽  
Shimon Friedman
Keyword(s):  
Systematic Review ◽  
Root Canal ◽  
Small Sample ◽  
Risk Of Bias ◽  
Root Canal Treatment ◽  
Cochrane Library ◽  
Posterior Teeth ◽  
Pulp Therapy ◽  
Vital Pulp Therapy ◽  
Irreversible Pulpitis

Background and Objectives: Symptomatic irreversible pulpitis in permanent mature teeth is a common indication for nonsurgical root canal treatment (NSRCT), but contemporary studies have reported on vital pulp therapy (VPT) applied in such teeth as a less invasive treatment. This systematic review assessed the outcomes of VPT, including partial and full pulpotomy performed with hydraulic calcium silicate cements (HCSCs) in permanent mature posterior teeth diagnosed with symptomatic irreversible pulpitis. Materials and Methods: The PRISMA guidelines were followed. The search strategy included PubMed®, EMBASE, Cochrane library and grey literature electronic databases. The quality assessment of the identified studies followed the Cochrane Collaboration Risk of Bias, ROBINS-I and Newcastle–Ottawa Scale tools. Results: The search of primary databases identified 142 articles, of which 9 randomized controlled trials and 3 prospective cohort studies were selected for review. The risk-of-bias was assessed as ‘high’ or ‘serious’, ‘fair’, and ‘low’ for three, seven and two articles, respectively. One to five years after VPT using HCSCs, the success rates mostly ranged from 78 to 90%. Based on two articles, the outcomes of the VPT and NSRCT were comparable at one and five years. Despite the necessity for the intra-operative pulp assessment in VPT procedures, the majority of the studies did not fully report on this step or on the time needed to achieve hemostasis. Small sample sizes, of under 23 teeth, were reported in three studies. Conclusions: The reviewed 12 articles reported favorable outcomes of the VPT performed with HCSCs in permanent mature posterior teeth with symptomatic irreversible pulpitis, with radiographic success in the range of 81 to 90%. Two articles suggested comparable outcomes of the VPT and root canal treatment. Universal case selection and outcome criteria needs to be established for VPT when considered as an alternative to NSRCT. This evidence supports the need for further research comparing longer-term outcomes of both of the treatment modalities.

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 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.

Self-etching adhesives: possible new pulp capping agents to vital pulp therapy

2011 ◽  
Vol 5 (1) ◽  
pp. 77-79 ◽  
Author(s):  
Chun Cui ◽  
Xiu-Neng Zhou ◽  
Wei-Min Chen
Keyword(s):  
Capping Agents ◽  
Pulp Capping ◽  
Pulp Therapy ◽  
Vital Pulp Therapy

Dentin Regeneration in Vital Pulp Therapy: Design Principales

2001 ◽  
Vol 15 (1) ◽  
pp. 96-100 ◽  
Author(s):  
D. Tziafas ◽  
G. Belibasakis ◽  
A. Veis ◽  
S. Papadimitriou
Keyword(s):  
Artificial Substrates ◽  
Tissue Architecture ◽  
Pulp Capping ◽  
Pulp Therapy ◽  
Vital Pulp Therapy ◽  
Reparative Dentin ◽  
Dentin Formation ◽  
Direct Induction ◽  
Reparative Dentin Formation ◽  
Dentin Regeneration

The nature and specificity of the mechanisms by which the amputated dentin-pulp interface is therapeutically healed determine the properties of the barrier at this site and play a critical role in the outcome of vital pulp therapy. Healing of the dentin-pulp complex proceeds either by natural repair-which results in defensive hard-tissue formation, or therapeutically regulated dentin regeneration, which aims to reconstitute the normal tissue architecture at the pulp periphery. Progress in biomedical research opens new directions for the design of biologically effective pulp therapies. Application of biocompatible and biodegradable carrier vehicles for local delivery of signaling molecules in pulp-capping situations showed induction of fibrodentin/reparative dentin formation, but often at the expense of underlying pulp tissue. An alternative pre-clinical model aiming to reconstitute normal tissue architecture directly at the dentin-pulp interface should be designed on the basis of the direct induction of odontoblast-like cell differentiation and reparative dentin formation at the pulp-capping material interface. Experimental data clearly showed that pulpal cells can differentiate directly into odontoblast-like cells in association with specific extracellular matrices (dentinal or fibrodentinal matrix) or TGFβ1-containing artificial substrates. Dentin-induced dentinogenesis can be used as a master plan for the achievement of new therapeutic opportunities. In the present study, several short-term experimental studies on dog teeth for potential direct induction of odontoblast-like cell differentiation at the surface of rhTGFβ1-containing artificial substrates (Millipore filters, hydroxyapatite granules, calcium hydroxide, pure titanium) failed to induce any specific reparative dentinogenic effects.

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.

scholarly journals In Vitro Cytotoxicity Evaluation of Four Vital Pulp Therapy Materials on L929 Fibroblasts

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Aniket S. Wadajkar ◽  
Chul Ahn ◽  
Kytai T. Nguyen ◽  
Qiang Zhu ◽  
Takashi Komabayashi
Keyword(s):  
Culture Medium ◽  
In Vitro Cytotoxicity ◽  
Direct Pulp Capping ◽  
Average Standard Deviation ◽  
Pulp Therapy ◽  
Clinical Investigations ◽  
Time Period ◽  
Vital Pulp Therapy

The aim of this study was to evaluate cytotoxicity of direct pulp capping materials such as Dycal, Life, ProRoot MTA, and Super-Bond C&B on L929 fibroblasts. Freshly mixed or set materials were prepared and eluted by incubation with cell culture medium for working time period (fresh) or for 6 hours (set). The cells were exposed to media containing elutes for 24 hours, after which the cell survival was evaluated by MTS assays. In freshly mixed materials, average ± standard deviation % cell viabilities were 40.2 ± 14.0%, 43.7 ± 16.0%, 72.9 ± 12.7%, and 66.0 ± 13.6% for Dycal, Life, ProRoot MTA, and Super-Bond C&B, respectively. There was no statistical difference in cell viabilities among material groups, whereas in set materials, the cell viabilities were 48.7 ± 14.8%, 37.2 ± 10.6%, 46.7 ± 15.2%, and 100 ± 21.9% for Dycal, Life, ProRoot MTA, and Super-Bond C&B, respectively. Super-Bond C&B showed more cell viabilities than the other three material groups P< 0.05. The four vital pulp therapy materials had similar cytotoxicity when the materials were fresh. Super-Bond C&B was less cytotoxic than Dycal, Life, and ProRoot MTA after the materials were set, which suggests the use of SB-C&B in future in vivo clinical investigations.

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