Outcomes of Vital-Pulp Therapy: EndoUBA Treatment Protocol.

Objectives: To evaluate the outcomes of vital-pulp therapy(VPT) in permanent teeth with pulpitis.
Methods: A prospective-longitudinal study at Buenos Aires University involved 99 patients with 159 permanent mature teeth and deep carious lesions. Informed consent was obtained. Non-restorable teeth with periapical involvement, traumatic pulpitis, or immature apices were excluded. Pulpitis diagnoses(initial, mild, moderate, severe) followed Wolters et al. 2017 guidelines. Patients assessed preoperative pain using a visual analog-scale(VAS). Treatment followed a standardized protocol with Biodentine®. Definitive restoration was performed in the same session. Symptom monitoring was conducted at 24, 48, and 72h using VAS. Clinical and radiographic follow-ups occurred at 1 and 3 months and data were recorded. Cases of indirect pulp- capping(IPC), direct pulp-capping(DPC) or pulpotomy(P) needing conventional endodontic treatment(RCT) within the 3 months were considered failures. Cases without clinical symptoms and radiographic signs were categorized as responsive or non-responsive according to positive or negative response to cold sensitivity-test. Data were statistically analyzed using Friedman-test(pairwise comparisons by Conover's method) and Chi-square-test(p<0.05).
Results: Of the 99 patients included in the study, 64 were females(65%, 95CI 55-73), and 35 were males(35%, 95CI 27-45). The age range was 8 to 78 years(median=33). Pulpitis diagnoses among the 159 cases were as follows: initial 60%(95CI 51-69), mild 33%(95CI 24-42), moderate 5%(95CI 2-11), and severe 2%(95CI 1-7). Treatments provided included IPC(36%, 95CI 27-45), DPC(53%, 95CI 44-63), P(10%, 95CI 5-17), and RCT(1%, 95CI 0-5). One week after the intervention, there was a significant pain perception reduction(p<0.05), which maintained up to 3 months. At 3 months, the percentage of successful responders (85%, 95CI 77-91) significantly exceeded(p<0.05) the percentage corresponding to the sum of successful non-responders and failures(15%, 95CI 9-23).
Conclusions: VPT has proved to be a successful and reliable treatment option, with significant reduction in pain and high rates of success at the 3-month follow-up in permanent teeth with mature apices.