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Preserving pulp vitality: part two - vital pulp therapies

British Dental Journal volume 230, pages 148–155 (2021)Cite this article

Abstract

Vital pulp therapies (VPTs) aim to preserve the vitality of the pulp. The European Society of Endodontology have begun a campaign to raise awareness on the efficacy of VPTs following on from the publication of their 2019 position statement, aimed at both specialists and general dental practitioners. This review examines the current evidence surrounding VPTs and provides a rational approach to the management of the exposed pulp with the aid of case studies. Success lies in accurate diagnosis and case selection, along with well-executed treatment and appropriate follow-up protocols. The introduction of calcium silicate cements has made these treatments more predictable.

Key points

  • There is sufficient evidence to recommend calcium silicate cements ahead of calcium hydroxide for all vital pulp therapies, but consideration must be given to potential discolouration in material selection.

  • The main driver for a decision between different vital pulp therapies is the visual appearance of the pulp and the ability to control haemorrhage.

  • Following careful case selection, teeth receiving vital pulp therapies with calcium silicate cements have a good prognosis, equal to pulpectomy and root canal treatment, which still remains an option in the event of failure.

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Acknowledgements

Thank you to Luca Moranzoni and Jonathan Cowie for supplying the pictures of the clinical cases.

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Authors and Affiliations

  1. Restorative Dentistry (Endodontics), Newcastle Dental Hospital, Richardson Road, NE2 4AZ, Newcastle upon Tyne, UK

    David Edwards

  2. Restorative Dentistry, School of Dental Sciences, Framlington Place, NE2 4BW, Newcastle upon Tyne, UK

    Simon Stone & Oliver Bailey

  3. School of Dentistry, University of Birmingham, UK

    Phillip Tomson

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Correspondence to David Edwards.

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Edwards, D., Stone, S., Bailey, O. et al. Preserving pulp vitality: part two - vital pulp therapies. Br Dent J 230, 148–155 (2021). https://doi.org/10.1038/s41415-020-2599-y

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