Vital Pulp Therapy in Irreversible Pulpitis: A Case Report Based on Literature Guidelines
Pedro Henrique Chaves de Oliveira
Department of Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
Mariana Pagliusi Justo
Department of Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
Ana Laura Ribeiro Ruiz
Department of Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
Gabriele Oliveira Amaral
Department of Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
Sinval Pereira do Amaral Júnior
Department of Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
Hyago Gon Guimarães
Department of Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
Caroline Andrade Maia
Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil.
Carina David Lujan
School of Dentistry, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil.
Tatiany Gabrielle Freire Araújo Guimarães
School of Dentistry, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil.
Francine Benetti
Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil.
Bruno Martini Guimarães
School of Dentistry, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil.
Elói Dezan Júnior
Department of Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
Carlos Roberto Emerenciano Bueno
*
Department of Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Aims: Vital pulp therapies aim to preserve the integrity of the dental element, avoiding complete removal of pulp tissue by pulpectomy. The aim of this literature review and clinical case report was to scientifically indicate a guideline, demonstrating the specificity of the different types of vital pulp therapies and when they can be indicated, as well as to emphasize the importance of diagnosis and biomaterial choice.
Methodology: The PubMed, Scopus, Cochrane Library, and Grey Literature (Google Scholar) databases were accessed using the following keywords: “vital pulp therapy”; “indirect pulp capping”; “direct pulp capping”; “pulpotomy”; “partial pulpotomy”; “total pulpotomy”; “capping materials”; “biomaterials”; “MTA”; “Biodentine”; “TheraCal.” Articles were screened by reading titles and abstracts, selecting those describing, indicating or contraindicating vital pulp therapies, as well as those comparing commonly used biomaterials as capping agents. A clinical case of pulpotomy was described, using TheraCal as the capping material.
Results: The study highlights the scientific relevance favoring therapies that preserve endodontic tissues, consequently preserving the tooth. It also allows the understanding of the required mechanisms of action of capping biomaterials and differences among them. The clinical case demonstrated the importance of diagnosis and the step-by-step procedure.
Conclusion: It is concluded that when properly selected, pulpotomy can preserve root pulp tissue and that TheraCal proved to be a better material due to its ease of application compared to globally referenced materials.
Keywords: Vital pulp therapy, pulpotomy, endodontics, MTA, Biodentine, TheraCal