Vital pulp therapies versus conventional endodontics for the treatment of mature teeth with pulp inflammation: A systematic review

Abstract

Introduction: To compare the effectiveness of vital pulp therapies (pulpotomy and direct pulp capping) with that of conventional endodontics for the treatment of mature teeth with pulp inflammation and to analyze which pulp capping material is more effective for the treatment of mature teeth with pulp inflammation. Materials and Methods: A bibliographic search of electronic databases (PUBMED, COCHRANE LIBRARY, SCOPUS, ScienceDirect, and SciELo) was conducted. The inclusion criteria were comparative studies in patients who underwent conventional endodontic and vital pulp therapy in mature teeth with pulp inflammation and comparative studies comparing Mineral Trioxide Aggregate (MTA) versus calcium hydroxide as direct pulp capping materials in mature teeth with pulp inflammation. Risk of bias was assessed using RoB2 or ROBINS-I. Results: Eight clinical trials were included, all of which had a high risk of bias. The data analysis showed that pulpotomy has similar clinical success rates to conventional endodontics. No studies comparing conventional endodontics versus direct pulp capping were found. MTA has better clinical results than calcium hydroxide as a direct pulp capping material. Conclusion: Vital pulp therapies are a valid alternative for the treatment of mature teeth with pulp inflammation. There is a need for more clinical trials with longer follow-up time and which consider other variables related to the characteristics of the patient and the tooth.