Abstract
The aim of this study was to systematically review pulp wound lavage in vital pulp therapy (VPT). A search was conducted in six life science databases to identify clinical trials carried out on permanent teeth with a carious pulp exposure and a recall interval of at least six months. Twenty-seven trials of low to moderate risk of bias (RoB-2 and ROBINS-I) were included. Data was extracted and analyzed regarding study characteristics and methods used for pulp wound lavage. The agent used for pulp wound lavage was specified in all included trials. Most of the identified trials (23/27) randomized the pulp capping material. Many (14/27) reported the use of sodium hypochlorite (NaOCl); ten used only saline or water. One trial was identified that compared pulp wound lavage with 2.5% (NaOCl) to saline, another compared 5% glutaraldehyde to water, both in immature molar pulpotomies. Both studies were underpowered. Neither showed a significant difference between treatments. The use of NaOCl was positively correlated to recent year of publication and use of hydraulic calcium silicate cements for pulp capping (p < 0.05). In conclusion, despite a lack of well-designed trials on pulp wound lavage in VPT, a trend towards using NaOCl for this purpose was observed.
Highlights
Vital pulp therapy (VPT) is the treatment of the exposed pulp of a tooth with the aim of keeping it healthy and free from infection
The reviewed question was: “what is the influence of topical disinfectants on pulp survival in the vital pulp therapy of permanent teeth with a carious pulp exposure?” Based on the PICO format the search was carried out for clinical trials on permanent human teeth with a carious pulp exposure (P) that received vital pulp therapy (I), compared different treatment protocols (C) and reported the pulp survival after intervention with a minimal recall interval of 6 months (O)
There is a history of glutaraldehyde usage in antiseptic solutions [56] and despite the fact that it is still contained in some dentine bonding agents [57], the high toxicity and mutagenic potential of this chemical would preclude it from the application proposed by Waly (1995) [47]
Summary
Vital pulp therapy (VPT) is the treatment of the exposed pulp of a tooth with the aim of keeping it healthy and free from infection This is done in teeth that have been damaged by caries, trauma or restorative procedures [1,2]. The different types of VPT can be categorized into indirect and direct pulp capping, partial pulpotomy and full (coronal or pulp chamber) pulpotomy This is done according to the extent of pulp exposure, perceived stage of bacterial infiltration and damage to the dental pulp [3]. Neither clinical signs and symptoms nor results of the currently available diagnostic tests correlate to the histological state of the exposed pulp [11] This is the main conundrum in the clinical management of exposed pulps after caries excavation
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.
