Two-year results of vital pulp therapy in permanent molars with irreversible pulpitis: an ongoing multicenter randomized clinical trial

Abstract

Vital pulp therapy with CEM is a cost-effective and reliable biological technique for endodontic treatment of permanent molar teeth with irreversible pulpitis and can be recommended for general clinical practice.

A Review of Criteria for the Evaluation of Pulpotomy Outcomes in Mature Permanent Teeth

“…Finally, 31 articles were included: 15 case reports or case series (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), 9 cohort studies (15,(31)(32)(33)(34)(35)(36)(37)(38), and 3 clinical trials and 4 randomized clinical trials (39)(40)(41)(42)(43)(44)(45).…”

“…The third group of publications gathered follow-up studies aiming to verify whether pulpotomy could be an alternative to RCT in a public health perspective (15,(34)(35)(36)(37)(38)(42)(43)(44)(45).…”

“…In the first group, the outcomes after the use of different pulp capping materials were compared (18,31,39,43), whereas other studies described the outcome of pulpotomy realized with a single material (16, 17, 22-24, 28, 30, 40, 44, 45). Different types of material were tested including bioactive materials such as calcium hydroxide with or without corticosteroid medications (18,31,32,39,40), materials such as calcium-enriched mixture cement (18,23,43,44), mineral trioxide aggregate (16-18, 24, 30, 43), and Biodentine (Septodont, SaintMaur-des-Foss es, France) (28). Certain authors tested a biological matrix platelet-rich fibrin membrane obtained after centrifugation of the patients' own withdrawn blood (25,29).…”

Analysis of reasons for retreatment and extraction of endodontically treated teeth: A transversal study

“…Several factors related to endodontic technique can result in the need for a new intervention of endodontically treated teeth, including the ability and knowledge of the professional who performed the primary endodontic treatment. Epidemiological studies have shown a higher percentage of failure [20,21] when the root canal therapy is performed by general clinicians, when compared to treatments that were performed by specialists, which have a success rate of up to 94% [2]. Moreover, the quality of coronal restorations can also contribute to failure of endodontic therapy [16], which is in accordance with the findings of the present study, where the failure or fracture of coronal restoration retained by composite resin, amalgam, prosthetic crown, or provisional material represented a significant percentage of cases that were indicated for new root canal treatment.…”

Mineral Trioxide Aggregate and Evidence-Based Practice

“…When irreversible pulpitis is clinically diagnosed, the common school of thought recommends removal of entire vital pulp, despite containing competent stem cells with proliferative potential [ 121 ]. In the light of recent evidences and in order to gain a better understanding of pulp healing capability, the infl ammatory process and pathogenesis of the dental pulp need to be reconsidered, particularly in cases of irreversible pulpitis [ 14 ]; such a modern approach can lead to preservation of the dental pulp in mature permanent teeth and, thus by healing of the diseased pulp, can have a positive impact on improving the tooth survival rate as well as patients' quality of life. Current dental educational system defends the correlation between spontaneous pain or lingering pain in response to cold stimuli and the existence of irreversible pulpitis that necessitates the complex/expensive process of root canal therapy.…”