Abstract
Over the last 12 months, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) virus has emerged as a significant global health problem with extensive repercussions for the practise of dentistry. As the principle transmission-route is via droplet-spread, aerosol-generating dental procedures (AGPs) present an exquisite challenge, which either has to be avoided or performed using strict infection-control measures, which increase the deployment of resources and cost. This new working environment necessitates the adoption of simplified, yet effective procedures that reduce intervention and minimise clinical chair time to short, single visits. Vital pulp treatment (VPT) has emerged as an attractive, technically less-complicated group of biologically-based management strategies that are aimed at maintaining pulp vitality and avoiding root canal treatment (RCT). These procedures are carried out in a strict aseptic environment using a rubber dam and have a reported high success rate, suggesting that they could be considered as effective and simple alternative therapies to relieve pain and avoid multiple visit RCT and other endodontic procedures. The relevance of promoting a simple, predictable and effective alternative to traditional, more complex dentistry has never been more compelling. In this perspective article, the latest advances in VPT are highlighted, along with an analysis of their relative success and compelling reasons why we as dentists should be adopting these treatment approaches. Thereafter, case selection, prognostic factors, techniques, limitations and future prospects of these procedures are discussed.
Highlights
Since the advent of the novel coronavirus (SARS-CoV-2, COVID-19) at the end of 2019 and subsequent global spread, the fields and Medicine and Dentistry have been thrust into an uncertain and rapidly evolving new normality
Within Dentistry there has been a focus on the generation of aerosols, so called aerosol-generating procedures (AGPs), as well as concerns relating to the length of patient appointments, emergency-only treatment and reducing the invasiveness of treatment
Endodontics has been forced to deal with this situation more than most areas of Dentistry, as Endodontic procedures invariably require the use of high-speed handpieces, deal with patients in acute pain whose treatment cannot be deferred and carry out invasive time-consuming
Summary
Since the advent of the novel coronavirus (SARS-CoV-2, COVID-19) at the end of 2019 and subsequent global spread, the fields and Medicine and Dentistry have been thrust into an uncertain and rapidly evolving new normality. The deep caries lesion (lesion extend to the inner quarter of dentine, but with a zone of hard or firm dentine between caries and the pulp) in which the pulp is not pathologically exposed, bacterial by-products diffuse through the dentinal tubules to initiate a protective inflammatory response that present clinically with mild symptoms mainly in response to thermal stimuli In this situation removal of infected dentin using selective caries removal approach and sealing the pulp with restoration (indirect pulp capping), will ensure control of inflammation and maintenance of pulp vitality [2]. Preoperative pain was suggested as a prognostic factor for pulpotomy [33], but high success has been reported for teeth with spontaneous lingering pain associated with symptomatic irreversible pulpitis [29] These contradicting findings only add to the limitations of our current diagnostic systems and suggest the need for a biomarker-based approach to pulpal diagnosis. In the authors’ opinion, the dental pulp in a tooth with symptomatic irreversible pulpitis is likely
Sign-in/Register to view highlights & summary 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 callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
