Vital permanent teeth with cariously exposed pulp can be treated successfully with vital pulp therapy

pulp

This systematic review aims to illustrate the outcome of vital pulp therapy, namely direct pulp capping, partial pulpotomy, and full pulpotomy, in vital permanent teeth with cariously exposed pulp.

Electronic database MEDLINE via Ovid, PubMed, and Cochrane databases were searched. Hand searching of the reference lists of endodontic textbooks, endodontic-related journals (International Endodontic Journal, Journal of Endodontics, Oral Surgery Oral Medicine Oral Pathology Oral Radiology Endodontology, Dental Traumatology, and Australian Endodontic Journal), and relevant articles from electronic searching was conducted.

Original clinical studies of treatment of human vital permanent teeth with cariously exposed pulp where success rate from the raw data was presented or calculated having at least a six month follow-up and published in English were included.  The random effect method of weighted pooled success rate of each treatment and the 95% confidence interval were calculated using the DerSimonian-Laird method.

They found overall, the success rate was in the range of 72.9-99.4% with the success rates for the different approaches being as follows:

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They concluded that:

Vital permanent teeth with cariously exposed pulp can be treated successfully with vital pulp therapy. Current best evidence provides inconclusive information regarding factors influencing treatment outcome, and this emphasizes the need for further observational studies of high quality.

Aguilar P, Linsuwanont P. Vital pulp therapy in vital permanent teeth with cariously exposed pulp: a systematic review. J Endod. 2011 May;37(5):581-7. Epub 2011 Mar 5. PubMed PMID: 21496652

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. He is a former editor of the Evidence-Based Dentistry Journal, the chief blogger for the Dental Elf website and a past president of the British Association for the Study of Community Dentistry. He has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Retired from the NHS he is currently a part-time senior lecturer at Dundee Dental School.

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