IADR Abstract Archives
Vital Pulp Therapy in Carious Pulp Exposed Permanent Teeth: Review
Objectives: There has been increased evidence indicating rather high success rates of vital pulp therapies and these procedures are suggested as possible alternative treatments for permanent teeth with carious pulp exposure. This umbrella review aimed to provide an overview of existing systematic reviews regarding the outcomes of vital pulp therapy, specifically direct pulp capping, partial pulpotomy, and full pulpotomy, in carious pulp exposed permanent human teeth.
Methods: The review process was registered in PROSPERO (CRD42020156694). The specific PICO questions were: Population - permanent human teeth with carious pulp exposure; Intervention - direct pulp capping with pulp capping materials; Comparators - partial pulpotomy and full pulpotomy; Outcomes success rate and prognostic factors. PubMed, Ovid, and Cochrane databases were searched in conjunction with hand searching. Grey literature was searched too. The searches were last conducted on May 5, 2020. Study selection, data extraction and study appraisal (AMSTAR 2 criteria) were performed independently by two authors. A consensus was reached through discussion when disagreements arose.
Results: Six articles fulfilled the inclusion criteria. Higher and more predictable success rates of ≥ 2 years were observed for partial pulpotomy and full pulpotomy in carious pulp exposed permanent human teeth as compared to direct pulp capping. Possible prognostic factors (pre-operative pulp status, pulp capping material and apex closure) yielded conflicting results. Restorative material, periapical status at baseline, final irrigation solution, age and study type did not seem to affect the treatment outcome.
Conclusions: This is the first umbrella review of vital pulp therapy in permanent human teeth with carious pulp exposure. Based on the current evidence, vital pulp therapy (partial pulpotomy and full pulpotomy in particular) is a reliable treatment option for permanent teeth with carious pulp exposure and could be considered as an alternative for root canal treatment. However, more high-quality studies are required to corroborate this finding.
Methods: The review process was registered in PROSPERO (CRD42020156694). The specific PICO questions were: Population - permanent human teeth with carious pulp exposure; Intervention - direct pulp capping with pulp capping materials; Comparators - partial pulpotomy and full pulpotomy; Outcomes success rate and prognostic factors. PubMed, Ovid, and Cochrane databases were searched in conjunction with hand searching. Grey literature was searched too. The searches were last conducted on May 5, 2020. Study selection, data extraction and study appraisal (AMSTAR 2 criteria) were performed independently by two authors. A consensus was reached through discussion when disagreements arose.
Results: Six articles fulfilled the inclusion criteria. Higher and more predictable success rates of ≥ 2 years were observed for partial pulpotomy and full pulpotomy in carious pulp exposed permanent human teeth as compared to direct pulp capping. Possible prognostic factors (pre-operative pulp status, pulp capping material and apex closure) yielded conflicting results. Restorative material, periapical status at baseline, final irrigation solution, age and study type did not seem to affect the treatment outcome.
Conclusions: This is the first umbrella review of vital pulp therapy in permanent human teeth with carious pulp exposure. Based on the current evidence, vital pulp therapy (partial pulpotomy and full pulpotomy in particular) is a reliable treatment option for permanent teeth with carious pulp exposure and could be considered as an alternative for root canal treatment. However, more high-quality studies are required to corroborate this finding.