Management of mature permanent teeth with carious pulp exposure is currently one of the controversies in endodontics. Two different approaches are being debated: the conservative approach with vital pulp therapy (VPT) and the more invasive but reliable approach with conventional root canal treatment (RCT).
Vital pulp therapy (VPT) whether Indirect or Direct Pulp-capping, Partial or Complete Pulpotomy; has long been implemented only in immature permanent teeth, or in mature teeth with either mechanical or recent traumatic pulp exposures. However, with the better understanding of pulp biology, the increased knowledge of healing and regenerative capability of the irreversibly inflamed pulp, and the development of bioactive materials; a new treatment paradigm has developed for the management of mature permanent teeth with carious pulp exposure oriented towards preservation and tissue regeneration
Although there is current available evidence on the efficacy of VPT in managing mature permanent teeth with carious pulp exposures, however, up till now there is still a gap in the scientific knowledge among the general practitioners.
Objectives:
To introduce the audience to:
1. The current available knowledge on pulp biology and immunology.
2. Vital Pulp Therapy (Definition, techniques, and Evidence based clinical practice).
3. Recent guidelines for managing vital pulps with carious pulp exposures.
4. Factors affecting the Clinical Decision making.
5. Future perspectives.