Retrospective Clinical Evaluation of Vital Pulp Therapy With CaSiO₄ Materials

Objectives: Objectives: To investigate efficiency of one visit direct vital pulp therapy (VPT) utilizing CaSiO₄ materials.
Methods: Methods: Charts of patients with VPT of carious exposures of permanent teeth with normal radiographic periapical area or an exposed pulp as a result of trauma, were reviewed. 130 patients treated with VPT (pulp capping, partial pulpotomy or pulpotomy) procedures were identified. 41 met inclusion criteria and returned for post-op evaluation. Treatment included local anesthetic, dental dam isolation, caries removal using sterile burs and excavators. Exposed pulps of trauma cases were removed to a depth of approximately 2mm. Preparations were cleansed with 3% NaOCl for hemorrhage control. ProRoot MTA white, Endosequence Root Repair Material, or Biodentine were prepared according to manufacturers’ directions and placed directly over the exposure. Glass ionomer(Fuji Lining LC) base covered the CaSiO₄ material. Most final restorations consisted of bonded composite. Pulpal and periapical status were evaluated at recall. Successful treatment outcome was assessed as no radiographic/adjacent soft tissue pathology, no pain to percussion/biting, no subsequent endodontic treatment, and positive response to cold. Failure included subsequently extracted or endodontically treated teeth, spontaneous pain, radiographic/ soft tissue pathology, pain to percussion/biting, or no response to cold. Nonparametric statistical analysis, Fisher’s exact and Wilcoxon rank sum tests, were utilized at p<0.05. 10 factors such as age, gender, procedure and material used were evaluated for association with success/failure.
Results: Results: A total of 41 procedures were available for recall. 36 were successful and 5 failed, resulting in a success rate of 88%. The average recall interval for the 36 successful procedures was 2 years. Five procedures failed after an average of 24 days. None of the factors examined were statistically associated with success/failure.
Conclusions: Conclusions: This study supports previous reports of long-term success for CaSiO₄ materials for VPT. Single VPT is a viable treatment option when indicated.