The Journal of the American Dental Association has published an appraisal of a 2011 review by Aguilar & Linsuwanont under the auspices of the American Dental Association Center for Evidence-Based Dentistry. The review looked at whether vital pulp therapy is successful in permanent teeth.
The appraiser considered that search strategy was thorough although the included articles were mainly case studies. The studies were heterogeneous and some data were missing. Success criteria were also not clearly defined. The appraiser concluded
Preliminary evidence indicates that vital pulp therapies result in maintenance of pulpal health more than 70 percent of the time regardless of the therapy used.
Comment
We briefly noted this review in 2011 (Dental Elf July 8th 2011). It is also worth noting that a 2007 Cochrane review by Miyashita et al considered pulp management for carious teeth. At that time they identified 4 randomised controlled trials concluding:-
It was disappointing that there were so few studies which could be considered as being suitable for inclusion in this review. The findings from this review do not suggest that there should be any significant change from accepted conventional practice procedures when the pulp of the carious tooth is considered. Further well designed RCTs are needed to investigate the potential of contemporary materials which may be suitable when used in the management of carious teeth.
Links
ADA-EBD Summary – Cariously exposed pulps may benefit from vital pulp therapies
Aguilar P, Linsuwanont P. Vital pulp therapy in vital permanent teeth with cariously exposed pulp: a systematic review. J Endod. 2011 May;37(5):581-7. Epub 2011 Mar 5. Review. PubMed PMID: 21496652.
Miyashita H, Worthington HV, Qualtrough A, Plasschaert A. Pulp management for caries in adults: maintaining pulp vitality. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD004484. DOI: 10.1002/14651858.CD004484.pub2.
