Permanent Teeth With Pulp Exposure Benefit From Vital Pulp Therapy

Objectives: Cariously pulp exposure is a common clinical problem. Although AAE and ESE put forward the strategy of vital pulp therapy(VPT), the clinical application of VPT is still controversial. The purpose of this prospective study was to evaluate the efficacy of VPT under dental operating microscope(DOM) in the treatment of permanent teeth with cariously pulp exposure.
Methods: In the present nonrandomized clinical trial, patients with carious pulp exposure (n=94 )for vital pulp therapy were included. After signing the informed consent, the standard VPT procedure was performed under DOM. IRoot BP Plus covered the pulp when the tissue in the exposed area meets the following conditions: healthy dentin around perforations; fresh pulp wound, filled with uniform bright red blood, without yellow liquefaction area or dark ischemia area; no dentin debris; 1% sodium hypochlorite solution can stop bleeding within 2 minutes. The cavity was immediately filled with light cure glass ionomer or composite resin. Patients were evaluated clinically and radiologically by 2 examiners at 3 months, 6 months, 12 months and 24 months. Univariate analysis and binary logistic regression were used to analyze the relationship between treatment outcome and related factors.
Results: The age ranged from 10 to 61 (mean= 21.5±8.7) years old. The survival rate of 3 months, 6 months, 12 months and 24 months were 100%, 97.3%, 90.7% and 80.8%, respectively. The overal success rate was 92.6%. Age, sex and the size of pulp exposure had no significant effect on the outcome(P>0.05). The number of pulp exposure affect the success rate, the success rate of tooth with two pulp perforations is significantly lower than that of one(P<0.05).
Conclusions: Combined with dental operating microscope, the application of iRoot BP Plus in vital pulp therapy is a treatment option worthy of promotion for cariously exposed pulp of permanent teeth.