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    Case Study Vital Pulp Therapy

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    chen daniel
    The document discusses vital pulp therapy for cariously exposed permanent teeth and its limitations. It outlines that in mature permanent teeth, pulpectomy and root canal treatment is usually preferred over vital pulp therapy. For young permanent teeth with incomplete root development, pulpotomy may be attempted to encourage continued root development, but it does not have long term success comparable to root canal treatment. Major limitations of vital pulp therapy include unpredictability, lack of long term success, and difficulty accurately diagnosing a pulp's ability to repair.

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    Case Study Vital Pulp Therapy

    Uploaded by

    chen daniel
    12 views1 page
    The document discusses vital pulp therapy for cariously exposed permanent teeth and its limitations. It outlines that in mature permanent teeth, pulpectomy and root canal treatment is usually preferred over vital pulp therapy. For young permanent teeth with incomplete root development, pulpotomy may be attempted to encourage continued root development, but it does not have long term success comparable to root canal treatment. Major limitations of vital pulp therapy include unpredictability, lack of long term success, and difficulty accurately diagnosing a pulp's ability to repair.

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    The document discusses vital pulp therapy for cariously exposed permanent teeth and its limitations. It outlines that in mature permanent teeth, pulpectomy and root canal treatment is usually preferred over vital pulp therapy. For young permanent teeth with incomplete root development, pulpotomy may be attempted to encourage continued root development, but it does not have long term success comparable to root canal treatment. Major limitations of vital pulp therapy include unpredictability, lack of long term success, and difficulty accurately diagnosing a pulp's ability to repair.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    12 views1 page

    Case Study Vital Pulp Therapy

    Uploaded by

    chen daniel
    The document discusses vital pulp therapy for cariously exposed permanent teeth and its limitations. It outlines that in mature permanent teeth, pulpectomy and root canal treatment is usually preferred over vital pulp therapy. For young permanent teeth with incomplete root development, pulpotomy may be attempted to encourage continued root development, but it does not have long term success comparable to root canal treatment. Major limitations of vital pulp therapy include unpredictability, lack of long term success, and difficulty accurately diagnosing a pulp's ability to repair.

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    of 1

    Clinical Review

    By Dr Jeff Ward BDS, Postgraduate, Endodontics, School of Dental Science, The University of
    Melbourne, 71 1 Elizabeth Street, Melbourne, Victoria, 3000.

    Vital Pulp Therapy In Cariously


    Exposed Permanent Teeth And
    Its Limitations
    Abstract permanent teeth, pulpectomy and obturation of the root canal
    system is usually the treatment of choice.
    Vital pulp therapy for cariously exposed permanent In young permanent teeth, pulpotomy is classically undertaken
    teeth remains one of the most controversial areas in to promote apexogenesis (5). Apexogenesis refers to a vital pulp
    dentistry. Because a vital, functioning pulp is capable therapy procedure performed to encourage physiological develop-
    of initiating several defence mechanisms to protect ment and formation of the root end (6). The objective is to pro-
    the body from bacterial invasion, it is beneficial to mote root development and apical closure. An open, divergent
    preserve the vitality and health of an exposed pulp apex presents the challenge of producing an apical stop or
    rather than replace it with a root filling material constriction for placement of a hermetically sealed root canal filling
    (6). Because the pulp is necessary for the formation of dentine, the
    following pulp exposure. There is no consensus on
    loss of vitality in young permanent teeth before completion of root
    the survival rate of formerly cariously exposed pulps.
    formation leaves a thin, weak root that is prone to fracture and
    Observation time, judgement criteria,
    difficult to treat endodontically (7). The prognosis for permanent
    pulpotomy/pulp capping technique and, most retention is limited when compared with fully developed teeth.
    importantly, pulpal status at the time of treatment, Every effort must be made to maintain the vitality of the pulp in
    vary to a great extent amongst studies. teeth with incomplete apices to achieve root development. Once
    In mature teeth, a pulp exposed by caries is usually root development is achieved and apices have closed, root canal
    treatment is completed. The need for root canal treatment was
    removed and the root canals are cleaned, shaped and
    based on the premise that possible necrosis, continued calcification
    filled. Amongst the methods for preservation of a
    or internal resorption will occur following pulpotomy. Recent
    cariously exposed pulp, partial pulpotomy has yielded
    studies have proposed that as long as a hermetic seal is ensured,
    a markedly high success rate in young teeth. Major root canal treatment is not needed following pulpotomy (8).
    limitations in the success of vital pulp therapy in Partial pulpotomy aimed at preserving pulpal vitality has been
    cariously exposed permanent teeth exist. The lack of shown to be successful in traumatically exposed permanent teeth
    predictability and long-term success greatly influence (9). This treatment regimen has been applied and showed some
    decision-making. The decision-making itself is success in the treatment of cariously exposed young permanent
    unreliable primarily due to the difficulty of accurately molars ( 10, I I ). The excellent blood supply of a young permanent
    diagnosing the ability of the pulp to repair. tooth with incompletely formed roots may contribute towards this
    success (7). In contrast, the decreased resistance of the aged pulp
    While there are indications for vital pulp therapy in may become significant when one considers that the vascular
    young permanent molars, it must be remembered reaction to inflammation is considered a protective mechanism of
    that ultimately, none of these procedures enjoy the the pulp against invading factors ( 12). From the clinical point of view,
    long-term success of complete root canal therapy. the vitality of the dental pulp of an aged person appears to be
    weaker than that of a young person ( I 2).
    Considerable literature emphasises the negative aspects of vital
    Introduction pulp therapy and discourages its practice. Many clinicians and
    The treatment of the cariously exposed permanent tooth should researchers continue to condemn vital pulp therapy for the same
    result in arrestingthe carious process and keepingthe vital pulp free reasons reported in the literature 80 years ago, despite the
    of inflammation ( I ) The aim of vital pulp therapy is to preserve the advances made in pulp biology ( I 3).
    vitality and function of the coronal or remaining radicular pulp tissue The immediate and long-term success of root canal therapy is
    (2) Carious lesions involving the pulp, if not treated will lead to well known, but clinicians are less certain of the success of vital pulp
    pulpal necrosis and often involvement of the periradicular tissues, therapy. Cvek ( 9 ) reported a 96% success rate for partial
    with pain and discomfort for the patient (3) The treatment of the pulpotomy in traumatically fractured teeth with an open apex that
    cariously exposed pulp is dependent upon the maturity of the were healthy before trauma. Barthel et al (14) in comparison,
    tooth In deciduous teeth, treatment is aimed at removing the found a success rate of only 13% ten years after capping cariously
    infected, coronal pulp and fixing or mummifying the radicular pulpal exposed, asymptomatic, vital pulps. Whilst observation time,
    tissue, thereby preserving the tooth, not the pulp (4) In mature pulpotomy technique and judgement criteria vary between studies,

    AUSTMLIAN ENDODONTIC JOURNALVOLUME 28 No. I APRIL 2002 29

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