Abstract
Vital pulp therapy (VPT) is a viable treatment option for carious teeth with exposed pulps. To our knowledge, no study has examined the correlation between postoperative pain and the outcome of VPT on asymptomatic permanent teeth. The aim of this study was to examine whether odontogenic pain experienced after VPT on asymptomatic teeth with a carious pulp exposures is correlated with the progression of pulpal disease into a more inflamed or necrotic state. Direct pulp caps or partial pulpotomies using a tricalcium silicate (MTA Angelus, Angelus, Londrina, Brazil) were performed on asymptomatic permanent teeth using a standardized protocol. Patients were contacted at 24 h, 1 week, and 3 months following treatment and data was collected on post-operative pain and analgesic intake using a standardized questionnaire. At 6 months after treatment, an in-person clinical exam was performed which included standard vitality tests along with exposure of a periapical radiograph. Success was defined as an asymptomatic, functional tooth without any clinical or radiographic pathology. Data was analyzed using logistic regression. VPT was successful in 84.3% of patients at the 6 months timepoint. The percentage of patients that experienced pain at 24-h, 1 week, and 3-month time periods was 38, 22, and 12%, respectively. Pain at 3 months was significantly correlated with decreased outcome (p = 0.028). This data suggests that postoperative pain in the first 3 months after VPT is predictive of a poor treatment outcome.
Highlights
Developing minimally invasive biologically based therapies is an emerging theme in dentistry
Within the specialty of endodontics, information on pain is used to make the diagnosis, and to anticipate the need for additional anesthetics and post-operative analgesics. It is rarely used a predictor for treatment outcome
This is the first pragmatic study to evaluate the relationship between post-treatment pain and treatment outcome in endodontic patients
Summary
Developing minimally invasive biologically based therapies is an emerging theme in dentistry. Pulp capping and partial pulpotomy procedures are minimally invasive and are designed to manage the bacterial contamination, stimulate formation of reparative dentin, and restore homeostasis in the pulp. The long-term goal of these procedures is the preservation of functional teeth with healthy pulps and periapical tissues. The traditional treatment for teeth with carious pulp exposures is to perform non-surgical root canal treatment. Justification for this treatment is often based on the American Association of Endodontists’ definition of asymptomatic irreversible pulpitis- “A clinical diagnosis based on subjective and objective findings indicating that the vital inflamed pulp is incapable of healing” [1].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
