Vital Pulp Therapy in Permanent Teeth with Irreversible Pulpitis Caused by Caries: A Prospective Cohort Study

Background: When a tooth is diagnosed with irreversible pulpitis, root canal therapy (RCT) is generally performed to completely remove pulp tissue, which might lead to a higher risk of loss of vascularity, and teeth being more prone to fracture. Vital pulp therapy (VPT) is a personalized method of t...

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Autores principales:	Xiaoxu Guan, Yi Zhou, Qingxia Yang, Tianer Zhu, Xuepeng Chen, Shuli Deng, Denghui Zhang
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	vital pulp therapy irreversible pulpitis iRoot BP Plus personalized treatment caries Medicine R
Acceso en línea:	https://doaj.org/article/0f172c1db66f45eb99d25c466256f46c
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spelling	oai:doaj.org-article:0f172c1db66f45eb99d25c466256f46c2021-11-25T18:07:23ZVital Pulp Therapy in Permanent Teeth with Irreversible Pulpitis Caused by Caries: A Prospective Cohort Study10.3390/jpm111111252075-4426https://doaj.org/article/0f172c1db66f45eb99d25c466256f46c2021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4426/11/11/1125https://doaj.org/toc/2075-4426Background: When a tooth is diagnosed with irreversible pulpitis, root canal therapy (RCT) is generally performed to completely remove pulp tissue, which might lead to a higher risk of loss of vascularity, and teeth being more prone to fracture. Vital pulp therapy (VPT) is a personalized method of treating irreversible pulpitis, which conforms to the trend of minimally invasive endodontics. The remaining vital pulp could promote the physiological development of the roots of young permanent teeth with incomplete apical foramen. However, clear guidelines for VPT indication are still missing. Objective: This prospective cohort study evaluated the outcomes of vital pulp therapy (VPT) using iRoot BP Plus (Innovative Bioceramix Inc, Vancouver, BC, Canada) in permanent teeth of 6- to 20-year-old patients with irreversible pulpitis caused by caries and analyzed the preoperative factors affecting VPT prognosis. Methods: Fifty-nine permanent teeth in 59 patients with irreversible pulpitis caused by caries were treated with VPT using iRoot BP Plus. All patients received VPT under a standardized protocol. After informed consent, teeth were isolated with a dental dam, then operators performed VPT with iRoot BP Plus and restored the teeth with composite resin or stainless steel crown. Patients were postoperatively recalled after 3, 6 and 12 months and then recalled annually. Successful cases were defined as successful in both clinical and radiographic evaluations. A statistical analysis was performed using the Fisher exact test, and the level of significant difference was <i>p</i> < 0.05. Results: After 6–36 months of follow-up, a total of 57 teeth from 57 patients were accessible for evaluation. The mean age of subjects was 11.75 ± 3.81 years. The overall clinical and radiographic success rate of VPT was 91.2% (52/57). With an observation time of one year or more, the success rate was 90.5% (38/42). All the symptoms and physical examination findings showed no significant effect on VPT prognosis (<i>p</i> > 0.05) using a binary logistic regression model. Conclusions: Permanent teeth in 6- to 20-year-old patients diagnosed as irreversible pulpitis caused by caries can be successfully treated with VPT using iRoot BP Plus.Xiaoxu GuanYi ZhouQingxia YangTianer ZhuXuepeng ChenShuli DengDenghui ZhangMDPI AGarticlevital pulp therapyirreversible pulpitisiRoot BP Pluspersonalized treatmentcariesMedicineRENJournal of Personalized Medicine, Vol 11, Iss 1125, p 1125 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	vital pulp therapy irreversible pulpitis iRoot BP Plus personalized treatment caries Medicine R
spellingShingle	vital pulp therapy irreversible pulpitis iRoot BP Plus personalized treatment caries Medicine R Xiaoxu Guan Yi Zhou Qingxia Yang Tianer Zhu Xuepeng Chen Shuli Deng Denghui Zhang Vital Pulp Therapy in Permanent Teeth with Irreversible Pulpitis Caused by Caries: A Prospective Cohort Study
description	Background: When a tooth is diagnosed with irreversible pulpitis, root canal therapy (RCT) is generally performed to completely remove pulp tissue, which might lead to a higher risk of loss of vascularity, and teeth being more prone to fracture. Vital pulp therapy (VPT) is a personalized method of treating irreversible pulpitis, which conforms to the trend of minimally invasive endodontics. The remaining vital pulp could promote the physiological development of the roots of young permanent teeth with incomplete apical foramen. However, clear guidelines for VPT indication are still missing. Objective: This prospective cohort study evaluated the outcomes of vital pulp therapy (VPT) using iRoot BP Plus (Innovative Bioceramix Inc, Vancouver, BC, Canada) in permanent teeth of 6- to 20-year-old patients with irreversible pulpitis caused by caries and analyzed the preoperative factors affecting VPT prognosis. Methods: Fifty-nine permanent teeth in 59 patients with irreversible pulpitis caused by caries were treated with VPT using iRoot BP Plus. All patients received VPT under a standardized protocol. After informed consent, teeth were isolated with a dental dam, then operators performed VPT with iRoot BP Plus and restored the teeth with composite resin or stainless steel crown. Patients were postoperatively recalled after 3, 6 and 12 months and then recalled annually. Successful cases were defined as successful in both clinical and radiographic evaluations. A statistical analysis was performed using the Fisher exact test, and the level of significant difference was <i>p</i> < 0.05. Results: After 6–36 months of follow-up, a total of 57 teeth from 57 patients were accessible for evaluation. The mean age of subjects was 11.75 ± 3.81 years. The overall clinical and radiographic success rate of VPT was 91.2% (52/57). With an observation time of one year or more, the success rate was 90.5% (38/42). All the symptoms and physical examination findings showed no significant effect on VPT prognosis (<i>p</i> > 0.05) using a binary logistic regression model. Conclusions: Permanent teeth in 6- to 20-year-old patients diagnosed as irreversible pulpitis caused by caries can be successfully treated with VPT using iRoot BP Plus.
format	article
author	Xiaoxu Guan Yi Zhou Qingxia Yang Tianer Zhu Xuepeng Chen Shuli Deng Denghui Zhang
author_facet	Xiaoxu Guan Yi Zhou Qingxia Yang Tianer Zhu Xuepeng Chen Shuli Deng Denghui Zhang
author_sort	Xiaoxu Guan
title	Vital Pulp Therapy in Permanent Teeth with Irreversible Pulpitis Caused by Caries: A Prospective Cohort Study
title_short	Vital Pulp Therapy in Permanent Teeth with Irreversible Pulpitis Caused by Caries: A Prospective Cohort Study
title_full	Vital Pulp Therapy in Permanent Teeth with Irreversible Pulpitis Caused by Caries: A Prospective Cohort Study
title_fullStr	Vital Pulp Therapy in Permanent Teeth with Irreversible Pulpitis Caused by Caries: A Prospective Cohort Study
title_full_unstemmed	Vital Pulp Therapy in Permanent Teeth with Irreversible Pulpitis Caused by Caries: A Prospective Cohort Study
title_sort	vital pulp therapy in permanent teeth with irreversible pulpitis caused by caries: a prospective cohort study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/0f172c1db66f45eb99d25c466256f46c
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Vital Pulp Therapy in Permanent Teeth with Irreversible Pulpitis Caused by Caries: A Prospective Cohort Study

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