Journal of Prevention and Treatment for Stomatological Diseases ›› 2021, Vol. 29 ›› Issue (7): 433-441.doi: 10.12016/j.issn.2096-1456.2021.07.001

• Expert Forum • Previous Articles     Next Articles

Vital pulp therapy of pulp inflammation of permanent teeth

WU Buling1,2(),LUO Yifei2,3,XU Wenan1,TONG Zhongchun4   

  1. 1. Department of Cariology and Endodontics, Shenzhen Stomatology Hospital (Pingshan), Southern Medical University, Shenzhen 518118, China
    2. College of Stomatology, Southern Medical University, Guangzhou 510515, China
    3. Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
    4. Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, China
  • Received:2020-09-05 Revised:2020-11-12 Online:2021-07-20 Published:2021-04-19
  • Contact: Buling WU
  • Supported by:
    National Natural Science Foundation of China(81870755);National Natural Science Foundation of China(81970930)


Vital pulp therapy aims to maintain healthy pulp tissue as much as possible to improve the long-term survival of teeth. It has limited indications and uncertain curative effects. The pathological changes in inflamed pulp are the histological basis for the determination of treatment strategies and the treatment outcome; however, pulp sensitivity testing cannot reflect the actual histological status of the pulp. With the development of basic and clinical research on vital pulp therapy, the innovation of modern diagnostic and therapeutic technology and capping material, vital pulp therapy can be used as a treatment of teeth on which it was previously thought pulpectomy was necessary. Based on the evidence-based literature, this paper analyzes and summarizes the pathological changes of pulpitis and clinical research on the treatment of pulpitis. Vital pulp therapy can be a treatment for mature teeth with carious exposure and symptoms of irreversible pulpitis if comprehensive applications, including laser Doppler flowmetry, tissue oxygen monitoring, magnetic resonance imaging and microscopy, are used to determine the degree of pulp retention and if infection control and the use of biocompatible capping material are emphasized. In the future, it will be necessary to improve the success rate of vital pulp therapy for the treatment of pulpitis through research on the mechanism of pulp repair and regeneration, the precise diagnosis of pulpitis, and the development of pulp capping materials.

Key words: pulpitis, permanent teeth, vital pulp therapy, direct pulp capping, pulpotomy, indication, prognosis, defease reaction, repair reaction, laser doppler flowmetry, tissue oxygen monitor, magnetic resonance imaging, pulp capping material

CLC Number: 

  • R78

Figure 1

Partial pulpotomy in the 16 tooth with carious exposure a: a radiograph showed that the deep caries lesion of tooth 16 was close to the pulp horn; b: after caries excavation, exposure of the pulp horn was identified; c: after anesthesia, rubber dam isolation and thorough caries excavation; d: pulp wound after removal of infected tissue and hemostasis with sodium hypochlorite; e: the wound was capped with iRoot BP, flowable resin was used as cavity liner and the cavity was restored with resin composite; f: a radiograph taken 3 months after treatment showed the cavity restored with resin composite and normal periapical conditions"

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