(TC40) Successes and Failures of Vital Pulp Therapy Treatment in an Undergraduate General Dentistry Clinic

Vital pulp therapy (VPT) has been the principal treatment option for immature permanent teeth to maintain pulpal function and vitality during apical development. However, the 2021 AAE Position Paper now advocates performing an advanced VPT protocol in selected cases on mature permanent teeth.
Successful accomplishment of VPT depends on several factors: (1) making accurate pulpal and apical diagnoses – an Endodontic Diagnosis flow chart has been created and will be displayed (2) visualizing the development and spread of pulpal inflammation – histologic slides and classic literature will be depicted (3) understanding how the development of new dental biomaterials is the driving force of the advanced VPT protocol – properties of bioceramics will be discussed and (4) following a precise advanced VPT clinical protocol – the importance of each step will be discussed.
Four cases treated in an Undergraduate General Dentistry Clinic: Two treatments, one performed by an Endodontist and the other supervised VPT by a case-based calibrated General Dentist, were successful due to the removal of inflamed pulpal tissue and the application of a calcium silicate cement. The two other treatments, by two different uncalibrated General Dentists, most likely failed due to the lack avascular and inflamed pulp tissue removal and/or use of inferior pulp capping materials.
The outcome differences in these cases support: (1) employing advanced dental biomaterials and techniques to maintain continued pulp vitality and (2) the need for a formal VPT calibration program of general dentistry faculty members.