Vital pulp therapy for permanent teeth

anatomy of teeth

The Journal of the American Dental Association has published an appraisal of a 2011 review by Aguilar & Linsuwanont  under the auspices of the American Dental Association Center for Evidence-Based Dentistry. The review looked at whether vital pulp therapy is successful in permanent teeth.

The appraiser considered that search strategy was thorough although the included articles were mainly case studies.  The studies were heterogeneous and some data were missing. Success criteria were also not clearly defined.  The appraiser concluded

Preliminary evidence indicates that vital pulp therapies result in maintenance of pulpal health more than 70 percent of the time regardless of the therapy used.


We briefly noted  this review in 2011 (Dental Elf July 8th 2011). It is also worth noting that a 2007 Cochrane review by Miyashita et al considered pulp management for carious teeth.  At that time they identified 4 randomised controlled trials concluding:-

 It was disappointing that there were so few studies which could be considered as being suitable for inclusion in this review. The findings from this review do not suggest that there should be any significant change from accepted conventional practice procedures when the pulp of the carious tooth is considered. Further well designed RCTs are needed to investigate the potential of contemporary materials which may be suitable when used in the management of carious teeth.


ADA-EBD Summary –  Cariously exposed pulps may benefit from vital pulp therapies

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. Review. PubMed PMID: 21496652.

Dental Elf July 8th 2011

Miyashita H, Worthington HV, Qualtrough A, Plasschaert A. Pulp management for caries in adults: maintaining pulp vitality. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD004484. DOI: 10.1002/14651858.CD004484.pub2.



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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. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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