A Justification for the Trend Towards Indirect Pulp Therapy

Abstract

A JUSTIFICATION FOR THE TREND TOWARDS INDIRECT PULP THERAPY By Marissa Marie Kuhnen DMD A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University. Virginia Commonwealth University, 2015 Thesis Advisor: Patrice Wunsch, DDS, MS. Director, Advanced Education in Pediatric Dentistry Associate Professor, Department of Pediatric Dentistry Purpose: The purpose of this retrospective chart review was to determine how primary molars needing vital pulp therapy have been treated in the past four years at Virginia Commonwealth University (VCU) and to determine which treatments: indirect pulp therapy (IPT), formocresol pulpotomy, and ferric sulfate pulpotomy have been successful. Methods: AxiUm records that contained the procedure codes D3120 (Pulp Cap – Indirect) or D3220 (Therapeutic Pulpotomy) were totaled by year. Visit records were queried again to identify treatment failures i.e. extractions or pulpectomy. Results: In 2010, 52% of vital pulp therapies were ferric sulfate pulpotomies and in 2014 over 90% were indirect pulp therapy. Indirect pulp therapy had a 96.2% success rate, formocresol pulpotomy had a 65.8% success rate and ferric sulfate had a 62.9% success rate at three years (P<.0001). Conclusions: Indirect pulp therapy is a successful treatment option for the primary tooth with deep caries approaching the pulp.