VITAL PULP THERAPY OF MATURE PERMANENT TEETH WITH IRREVERSIBLE PULPITIS FROM THE PERSPECTIVE OF PULP BIOLOGY

Background: When irreversible pulpitis is detected in a tooth, root canal therapy (RCT) is commonly conducted to fully eliminate the pulp tissue, which could potentially increase the chances of vascularity loss and make the teeth more susceptible to fractures. Vital pulp therapy (VPT) is an individualized approach for treating irreversible pulpitis that aligns with the current trend of marginally aggressive endodontics. Nonetheless, there is currently a lack of well-defined criteria for determining when VPT should be recommended.

Aim: In this study, a prospective cohort design was employed to assess the results of utilizing iRoot BP Plus for vital pulp therapy (VPT) in permanent teeth of patients aged 5 to 19 years who had irreversible pulpitis due to dental caries. Additionally, the study examined the preoperative factors that influenced the prognosis of VPT.Top of Form

Methods:
A total of 65 patients, each with a single permanent tooth affected by irreversible pulpitis caused by dental caries, received vital pulp therapy using iRoot BP Plus. Generally overall participants underwent VPT following the standardized protocol. Prior to the procedure, informed consent was obtained, and teeth remained isolated using the dental dam. Skilled operators achieved VPT using iRoot BP Plus, followed by tooth restoration using either composite resin or stainless-steel crowns. Feed-back appointments were scheduled at 3, 6, and 12 months postoperatively, and subsequently on an annual basis. The success of the treatment was determined through a comprehensive assessment, combining medical and radiographic assessments.

Results: Upon completion of a follow-up period ranging from 5 to 42 months, a total of 59 teeth belonging to 65 patients were available for assessment. The subjects had a mean age of 11.76 ± 4.82 years. The complete success rate of vital pulp therapy, as determined through clinical and radiographic evaluations, was 92.3% (51 out of 65 cases). When considering an opinion period of one year or more, achievement rate remained high at 91.6% (39 out of 48 cases). Notably, none of signs or physical examination results had an important impact on the prognosis of VPT, as confirmed by a binary logistic regression model (p > 0.06).

Conclusion: Vital pulp therapy using iRoot BP Plus has demonstrated successful outcomes when utilized for the treatment of irreversible pulpitis produced through dental caries in patients ranging from 5 to 19 years of age with permanent teeth.

Keywords: Root Canal Therapy, Irreversible Pulpitis, Vital Pulp Therapy.