Treatment Of Pulpitis Research Articles

Analysis of modern methods of endodontic treatment of complicated caries according to the literature

The result of endodontic treatment depends on many factors: on the level of professional training of a dentist, the material and technical equipment of the workplace, competent diagnosis and chosen treatment tactics, which is largely impossible without the use of modern scientific achievements. The article provides an overview of the current literature on the treatment of complicated caries. The methods of treatment of pulpitis and periodontitis using modern methods and tools are described, which significantly improves the effectiveness of treatment.

Introduction and interpretation of The European Society of Endodontology S3-level clinical practice guideline for treatment of pulpal and apical disease

The European Society of Endodontology published the S3-level clinical practice guideline for the treatment of pulpal and apical disease in October 2023, which provides best current therapeutic strategies supported by scientific evidences. The guideline was divided into four parts: the diagnosis and treatment of pulpitis, diagnosis and nonsurgical treatment of apical periodontitis, surgical treatment of apical periodontitis, and regenerative treatment. This article aims to introduce and interpret the guideline, and to better manage patients with pulpitis and apical periodontitis for preserving teeth over a patient's lifetime in China.

A carbon dot nanozyme hydrogel enhances pulp regeneration activity by regulating oxidative stress in dental pulpitis

Preserving pulp viability and promoting pulp regeneration in pulpitis have attracted widespread attention. Restricted by the oxidative stress microenvironment of dental pulpitis, excessive reactive oxygen and nitrogen species (RONS) trigger uncontrolled inflammation and exacerbate pulp tissue destruction. However, modulating redox homeostasis in inflamed pulp tissue to promote pulp regeneration remains a great challenge. Herein, this work proposes an effective antioxidative system (C-NZ/GelMA) consisting of carbon dot nanozymes (C-NZ) with gelatin methacryloyl (GelMA) to modulate the pulpitis microenvironment for dental pulp regeneration by utilizing the antioxidant properties of C-NZ and the mechanical support of an injectable GelMA hydrogel. This system effectively scavenges RONS to normalize intracellular redox homeostasis, relieving oxidative stress damage. Impressively, it can dramatically enhance the polarization of regenerative M2 macrophages. This study revealed that the C-NZ/GelMA hydrogel promoted pulp regeneration and dentin repair through its outstanding antioxidant, antiapoptotic, and anti-inflammatory effects, suggesting that the C-NZ/GelMA hydrogel is highly valuable for pulpitis treatment.

Novel L-(CaP-ZnP)/SA Nanocomposite Hydrogel with Dual Anti-Inflammatory and Mineralization Effects for Efficient Vital Pulp Therapy.

Vital pulp therapy (VPT) is considered a conservative treatment for preserving pulp viability in caries and trauma-induced pulpitis. However, Mineral trioxide aggregate (MTA) as the most frequently used repair material, exhibits limited efficacy under inflammatory conditions. This study introduces an innovative nanocomposite hydrogel, tailored to simultaneously target anti-inflammation and dentin mineralization, aiming to efficiently preserve vital pulp tissue. The L-(CaP-ZnP)/SA nanocomposite hydrogel was designed by combining L-Arginine modified calcium phosphate/zinc phosphate nanoparticles (L-(CaP-ZnP) NPs) with sodium alginate (SA), and was characterized with TEM, SEM, FTIR, EDX, ICP-AES, and Zeta potential. In vitro, we evaluated the cytotoxicity and anti-inflammatory properties. Human dental pulp stem cells (hDPSCs) were cultured with lipopolysaccharide (LPS) to induce an inflammatory response, and the cell odontogenic differentiation was measured and possible signaling pathways were explored by alkaline phosphatase (ALP)/alizarin red S (ARS) staining, qRT-PCR, immunofluorescence staining, and Western blotting, respectively. In vivo, a pulpitis model was utilized to explore the potential of the L-(CaP-ZnP)/SA nanocomposite hydrogel in controlling pulp inflammation and enhancing dentin mineralization by Hematoxylin and eosin (HE) staining and immunohistochemistry staining. In vitro experiments revealed that the nanocomposite hydrogel was synthesized successfully and presented desirable biocompatibility. Under inflammatory conditions, compared to MTA, the L-(CaP-ZnP)/SA nanocomposite hydrogel demonstrated superior anti-inflammatory and pro-odontogenesis effects. Furthermore, the nanocomposite hydrogel significantly augmented p38 phosphorylation, implicating the involvement of the p38 signaling pathway in pulp repair. Significantly, in a rat pulpitis model, the L-(CaP-ZnP)/SA nanocomposite hydrogel downregulated inflammatory markers while upregulating mineralization-related markers, thereby stimulating the formation of robust reparative dentin. The L-(CaP-ZnP)/SA nanocomposite hydrogel with good biocompatibility efficiently promoted inflammation resolution and enhanced dentin mineralization by activating p38 signal pathway, as a pulp-capping material, offering a promising and advanced solution for treatment of pulpitis.

Application of Hyaluronic Acid in the Treatment of Pulpitis

Hyaluronic acid, as a widely used polymer material in clinical practice, has been proven to have numerous biological functions. In dentistry, the application of hyaluronic acid also has certain advantages and can be used to treat oral diseases. However, there are still many issues that need to be explored in research. Therefore, this article aims to explore the current application status and existing problems of hyaluronic acid in pulpitis, and further test the effectiveness and safety of hyaluronic acid in the treatment of pulpitis, in order to propose a more reasonable and effective treatment plan for pulpitis.

Clinical influencing factors of vital pulp therapy on pulpitis permanent teeth with 2 calcium silicate-based materials: A randomized clinical trial.

Compared with traditional root canal therapy (RCT), vital pulp therapy (VPT) is a personalized and minimally invasive method for the treatment of pulpitis caused by dental caries. However, there are still no clear guidelines for VPT because high-quality randomized clinical trials are scarce. This prospective cohort study evaluated the clinical efficacy of VPT with the light-curable calcium silicate-based material TheraCal LC (TH) and bioceramic material iRoot BP Plus (BP) in reversible and irreversible pulpitis permanent teeth with carious exposures. 115 teeth with reversible or irreversible pulpitis caused by deep care were randomly divided into 2 groups. TheraCal LC and iRoot BP Plus were used for the pulp capping. Direct pulp capping (DPC), partial pulpotomy (PP) and full pulpotomy (FP) were performed based on observation of the exposed pulp. Postoperative discomforts were enquired and recorded via follow-up phone calls. Clinical and radiographic evaluations were performed 3, 6, and 12 months postoperatively. The overall clinical success rate in the first year was 90.4% (47/52) in both groups. The TH group required less operating time, showed lower levels of pain, and had shorter pain duration post-operative (P < .001). According to the binary logistic regression model, preoperative pain duration was significantly correlated with the prognosis of VPT (P = .011). VPT with TheraCal LC and iRoot BP Plus in pulpitis permanent carious teeth both achieved good clinical outcomes, and TheraCal LC can be easily operated for clinical use. Preoperative pain duration of the affected tooth might have a significant correlation with the prognosis of VPT.

Clinical efficacy of nano-hydroxyapatite combined with one-time root canal therapy in the treatment of pulpitis

This study investigates the clinical efficacy of nano-hydroxyapatite (nHA) combined with one-time root canal therapy in the treatment of pulpitis. A total of 92 patients diagnosed with pulpitis and treated at our hospital between September 2021 and November 2022 were selected and randomly designed into a control group filled with calcium hydroxide paste and gutta-percha (n = 46) or an observation group filled with nHA and gutta-percha (n = 46). We compare the cure rate, complication rate, and recurrence rate between the two groups. After treatment, the total effective rate of patients in the observation group was 96.70%, which was significantly higher than 86.00% in the control group. Additionally, the observation group demonstrated lower Visual Analog Scale and Oral Health Impact Profile-14 scores than those of the control group. After treatment, both groups showed reduced serum levels of various inflammatory factors compared to pretreatment values. However, the observation group displayed notably lower levels of serum tumor necrosis factor-α, interleukin-6, and high-sensitivity C-reactive protein compared to their baseline levels. Furthermore, the occlusal force, gingival sulcus bleeding index, and gingival index were significantly lower in the observation group when compared with those in the control group. The incidence of adverse reactions after 6 months of treatment was only 4.30% in the observation group, which was markedly lower than that observed in the control group (18.5%). In summary, we demonstrate the remarkable clinical efficacy of n-HA combined with one-time root canal therapy in the treatment of pulpitis, highlighting its significant potential for clinical application.

What is new in the 2023 European Society of Endodontology S3-level clinical practice guidelines?

The European Society of Endodontology published in 2023, the S3-level clinical practice guidelines, which supersede the Quality Guidelines for Endodontic Treatment published in 2006. This review aims to summarize and compare the above guidelines to support their dissemination. A narrative synthesis of the main differences alongside tabulation according to the main themes. Three tables were prepared according to the following themes: diagnosis of pulpal and apical condition; treatment of pulpitis; and treatment of nonvital pulp and apical periodontitis. A compared and simplified message regarding the most recent clinical practice guidelines has been prepared. Not applicable as a narrative review.

TSG-6 Inhibits the NF-κB Signaling Pathway and Promotes the Odontogenic Differentiation of Dental Pulp Stem Cells via CD44 in an Inflammatory Environment.

In pulpitis, dentinal restorative processes are considerably associated with undifferentiated mesenchymal cells in the pulp. This study aimed to investigate strategies to improve the odonto/osteogenic differentiation of dental pulp stem cells (DPSCs) in an inflammatory environment. After pretreatment of DPSCs with 20 ng/mL tumor necrosis factor-induced protein-6 (TSG-6), DPSCs were cultured in an inflammation-inducing solution. Real-time polymerase chain reaction and Western blotting were performed to measure the expression levels of nuclear factor kappa B (NF-κB) and odonto/osteogenic differentiation markers, respectively. Cell Counting Kit-8 and 5-ethynyl-2'-deoxyuridine assays were used to assess cell proliferation and activity. Subcutaneous ectopic osteogenesis and mandibular bone cultures were performed to assess the effects of TSG-6 in vivo. The expression levels of odonto/osteogenic markers were higher in TSG-6-pre-treated DPSCs than nontreated DPSCs, whereas NF-κB-related proteins were lower after the induction of inflammation. An anti-CD44 antibody counteracted the rescue effect of TSG-6 on DPSC activity and mineralization in an inflammatory environment. Exogenous administration of TSG-6 enhanced the anti-inflammatory properties of DPSCs and partially restored their mineralization function by inhibiting NF-κB signaling. The mechanism of action of TSG-6 was attributed to its interaction with CD44. These findings reveal novel mechanisms by which DPSCs counter inflammation and provide a basis for the treatment of pulpitis.

Antimicrobial Peptide- and Dentin Matrix-Functionalized Hydrogel for Vital Pulp Therapy via Synergistic Bacteriostasis, Immunomodulation, and Dentinogenesis.

The preservation of vital pulps is crucial for maintaining the physiological functions of teeth; however, vital pulp therapy (VPT) of pulpitis teeth remains a substantial challenge due to uncontrolled infection, excessive inflammation, and limited regenerative potential. Current pulp capping agents have restricted effects in the infectious and inflammatory microenvironment. To address this, a multifunctional hydrogel (TGH/DM) with antibacterial, immunomodulatory, and mineralization-promoting effects is designed. The antimicrobial peptide (AMP) and demineralized dentin matrix are incorporated into the hydrogel, achieving sustainable delivery of AMP and a cocktail of growth factors. In vitro results show that TGH/DM could kill endodontic microbiota, ameliorate inflammatory responses of human dental pulp stem cells (hDPSCs), and prompt odontogenic differentiation of inflammatory hDPSCs via activation of peroxisome proliferator-activated receptor gamma. In vivo results suggest that TGH/DM is capable of inducing M2 phenotype transformation of macrophages in mice and fostering the regeneration of the dentin-pulp complex in inflamed pulps of beagle dogs. Overall, this study first proposes the synergistic regulation of AMP and tissue-specific extracellular matrix for the treatment of pulpitis, and the advanced hydrogel provides a facile and effective way for VPT.

Research progress in autophagy in the development of pulp inflammation and dental pulp injury reparation and regeneration

Pulpitis is an infectious disease characterized by persistent inflammation of dental pulp and severe pain of patients, root canal treatment increases the risk of tooth fracture, discoloration and reinfection. Therefore, pulp injury repair and pulp regeneration become the new targets of pulpitis treatment. Autophagy is considered as an important defense and protective mechanism, thus plays an important role in preventing the host from excessive inflammatory reaction. There are few reports on the regulative mechanisms and therapeutic strategies of autophagy on pulp inflammation progression, therefore, this paper reviewed the role of autophagy on the progression of pulpitis, also reviewed the research progress of autophagy on dental pulp injury repair and regeneration, aiming to provide theoretical support for further research and clinical application.

Intentional Replantation as the Treatment of Left Mandibular Second Premolar Refractory Periapical Periodontitis: A Case Report

Introduction This report aims to assess the feasibility of intentional replantation combined with concentrated growth factor(CGF) membrane treatment for refractory apical periodontitis of the left mandibular second premolar (35), with a 13-month follow-up period. Case Report A 24-year-old female patient underwent root canal treatment for pulpitis of the left mandibular second premolar 3 years ago, and her gum repeatedly swelled and drained pus after the treatment. CBCT revealed that the apical area of 35 was adjacent to mental foramina, and the cyst range was large. There could be issues of poor visual field, trauma, difficulty in apical preparation and backfilling after the apical resection. The left mandibular second premolar (35) was extracted, and the inflammatory tissues in the apical and alveolar fossa were removed, followed by the removal of apical irritants. The extracted premolar was then implanted into the alveolar fossa and fixed. Results and Prognosis After a duration of 13 months, the left mandibular second premolar 35 exhibited no clinical symptoms and was able to perform normal masticatory function. There was an absence of gum swelling, pain or mobility; cone beam computed tomography imaging revealed bone regeneration below the root apex with the absence of new lesions, root resorption, or adhesion to the alveolar bone. The periodontal ligament demonstrated healing between the root and alveolar bone, effectively controlling infection, preserving infected teeth and facilitating the formation of new attachments around them. Discussion Intentional tooth replantation has some advantages, like short operation time, less cost, less bone injury, and less limitations in terms of anatomy and location. However, clinicians should consider whether intentional replantation could be performed before dental implantation for the affected teeth with intractable periapical lesions. Nonetheless, its efficacy needs further evaluations through long-term clinical follow-ups.

Investigation of the Potential Targets and Mechanism Actions of Berberine in the Treatment of Pulpitis Based on Bioinformatics Analysis

Berberine, an active compound extracted from the Chinese herb, was reported to have an antibacterial effect and an anti-inflammatory effect and promote osteogenic differentiation of human dental pulp stem cells. However, the underlying therapeutic mechanism of berberine in pulpitis is still unknown. Here, bioinformatics analysis was performed to investigate the potential mechanism of berberine against pulpitis. First, we identified the collective targets of berberine and pulpitis from several databases using a Venny online tool. The pattern of interaction between berberine and the targeted protein was visualized by molecular docking. Moreover, we performed GSEA, Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses to obtain potential pathways. Cell experiments were performed to validate the bioinformatics analysis results. Prostaglandin-endoperoxide synthase 2 (PTGS2) was identified as the crucial antipulpitis target of berberine via the CytoHubba plugin. Docking analysis indicated that berberine could fit in the binding pocket of the PTGS2 protein. Additionally, berberine exerted its therapeutic effects against pulpitis via multiple pathways. Overall, berberine possessed therapeutic effects against pulpitis through the inactivation of toll-like receptor and NOD-like receptor signaling pathways. The present research proposes a novel approach to explore the therapeutic mechanism of natural products.

Modern methods and materials used to treat root perforation: effectiveness comparison

This study aims to experimentally compare the efficacy of different endodontic materials (iRoot BP Plus, Biodentine, MTA, Rootdent, and Trioxide) in the treatment of pulpitis and perforations on extracted tooth specimens. Additionally, the study aims to investigate the influence of iRoot BP Plus endodontic material on the regenerative processes following pulp amputation in laboratory animals. The secondary goal is to evaluate the effect of iRoot BP Plus on the restoration process in laboratory animals after pulp removal. The study presents a micropermeability analysis of the selected biomaterials performed on a sample of 50 single-rooted apical teeth in 2022. All teeth underwent endodontic treatment. Changes in molar morphology were investigated with eight laboratory animals (rabbits, 3 months old, all males) after simulated pulp removal and subsequent treatment with the iRoot BP Plus biomaterials. iRoot BP Plus appeared to be more effective in retrograde apical root filling than other biomaterials, as evidenced by its higher sealing effect. An experiment involving animal participants revealed the presence of protective adaptive mechanisms, which manifested in the form of an inflammatory process within 6 weeks after the dental pulp was removed. The connective tissue replaced the necrosis, and new capillaries began to form intensively. These dental outcomes suggest that iRoot BP Plus enables hermetical sealing in tooth restoration with good adhesion. Thus, it may have the ability to promote more active tissue regeneration after pulp removal.Graphical

The results of pulpectomy in primary molars in children with negative behaviour

Relevance. A pulpectomy is a procedure predominantly performed for pulpitis treatment in single-rooted primary teeth. Data on the pulpectomy in primary molars are limited. Pulpectomy in children with negative behaviour is particularly difficult. The study aimed to determine the survival rate of primary molars after treatment of chronic pulpitis by pulpectomy in children with negative behaviour depending on the behaviour management method.Material and methods. A prospective clinical study in parallel groups involved 120 children aged 3-6 years who demonstrated negative behaviour (according to the Frankl scale) during a dental examination. Chronic fibrous pulpitis was treated by vital pulpectomy in 180 primary molars. In group 1 (60 children, 90 teeth), children underwent non-pharmacological behaviour management; in group 2, children were treated under conscious sedation (pharmacological correction of behaviour). Follow-ups after 6, 12, 18 and 24 months determined the tooth survival rate after pulpectomy.Results. The 24-month tooth survival rate after pulpectomy was 76.7% in group 1 (95% CI 67.9-85.4%), 81.1% – in group 2 (95% CI 73.0-89.2%), p &gt; 0.05.Conclusion. More than 75% of primary molars survived for 24 months after vital pulpectomy in children with negative behaviour. The results of pulpectomy with pharmacological behaviour correction were better than after non-pharmacological behaviour management; however, the detected differences were not statistically significant.

ON THE TOPIC OF ADVISABILITY OF ENDODONTIC TREATMENT OF RETAINED (PERSISTENT) PRIMARY TEETH

Treatment of complicated caries in children and adolescents has a number of features, which is determined by age-related anatomy and the limited functioning time of temporary teeth, as well as the timing of their root resorption. Today, the treatment of pulpitis of preserved temporary (persistent) teeth is of particular clinical interest. Persistent (delayed) teeth are temporary (baby) teeth that are preserved in the dentition after the physiological time of their replacement and are capable of functioning for 10 years or more. In most cases, the presence of retained temporary teeth is due to congenital edentia of permanent teeth, retention or death of their rudiments. There is no data in the literature on the features of the anatomical structure of persistent teeth and recommendations for their endodontic treatment. At the same time, in the treatment of this pathology, the methods of pulpotomy (devital amputation, impregnation method) and pulpectomy (pulp extirpation, vital method) are widely used, followed by obturation of the root canals with resorbable filling materials. Taking into account the above, we conducted a retrospective analysis of 192 orthopantomograms of patients with congenital permanent adentia and the presence of 289 persistent teeth. The anatomical features of the structure of the root canals of persistent teeth have been determined. The results of treatment of 44 preserved temporary teeth with chronic fibrous pulpitis in 27 patients of childhood and adolescence using the method of vital extirpation followed by restoration of the crown parts of the teeth using therapeutic and orthopedic methods are presented. Long-term treatment results up to 60 months were assessed. Meanwhile, the results obtained indicated the absence of signs of root resorption in persistent teeth over a long period of time from the period of their physiological change, as well as the features of the anatomical structure of root canals, similar to that of permanent teeth, and allowing endodontic treatment of preserved teeth using classical for permanent teeth pulpectomy method. The results of clinical observation and X-ray examination in the long term after treatment allow us to conclude that the approach used is highly effective, which reduced the risk of periapical complications and created conditions for the longterm functioning of persistent teeth.

Dual-Fuel Propelled Nanomotors with Two-Stage Permeation for Deep Bacterial Infection in the Treatment of Pulpitis.

Bacterial infection-induced inflammatory response could cause irreversible death of pulp tissue in the absence of timely and effective therapy. Given that, the narrow structure of root canal limits the therapeutic effects of passive diffusion-drugs, considerable attention has been drawn to the development of nanomotors, which have high tissue penetration abilities but generally face the problem of insufficient fuel concentration. To address this drawback, dual-fuel propelled nanomotors (DPNMs) by encapsulating L-arginine (L-Arg), calcium peroxide (CaO2 ) in metal-organic framework is developed. Under pathological environment, L-Arg could release nitric oxide (NO) by reacting with reactive oxygen species (ROS) to provide the driving force for movement. Remarkably, the depleted ROS could be supplemented through the reaction between CaO2 with acids abundant in the inflammatory microenvironment. Owing to high diffusivity, NO achieves further tissue penetration based on the first-stage propulsion of nanomotors, thereby removing deep-seated bacterial infection. Results indicate that the nanomotors effectively eliminate bacterial infection based on antibacterial activity of NO, thereby blocking inflammatory response and oxidative damage, forming reparative dentine layer to avoid further exposure and infection. Thus, this work provides a propagable strategy to overcome fuel shortage and facilitates the therapy of deep lesions.

Efficient Treatment of Pulpitis via Transplantation of Human Pluripotent Stem Cell-Derived Pericytes Partially through LTBP1-Mediated T Cell Suppression.

Dental pulp pericytes are reported to have the capacity to generate odontoblasts and express multiple cytokines and chemokines that regulate the local immune microenvironment, thus participating in the repair of dental pulp injury in vivo. However, it has not yet been reported whether the transplantation of exogenous pericytes can effectively treat pulpitis, and the underlying molecular mechanism remains unknown. In this study, using a lineage-tracing mouse model, we showed that most dental pulp pericytes are derived from cranial neural crest. Then, we demonstrated that the ablation of pericytes could induce a pulpitis-like phenotype in uninfected dental pulp in mice, and we showed that the significant loss of pericytes occurs during pupal inflammation, implying that the transplantation of pericytes may help to restore dental pulp homeostasis during pulpitis. Subsequently, we successfully generated pericytes with immunomodulatory activity from human pluripotent stem cells through the intermediate stage of the cranial neural crest with a high level of efficiency. Most strikingly, for the first time we showed that, compared with the untreated pulpitis group, the transplantation of hPSC-derived pericytes could substantially inhibit vascular permeability (the extravascular deposition of fibrinogen, ** p < 0.01), alleviate pulpal inflammation (TCR+ cell infiltration, * p < 0.05), and promote the regeneration of dentin (** p < 0.01) in the mouse model of pulpitis. In addition, we discovered that the knockdown of latent transforming growth factor beta binding protein 1 (LTBP1) remarkably suppressed the immunoregulation ability of pericytes in vitro and compromised their in vivo regenerative potential in pulpitis. These results indicate that the transplantation of pericytes could efficiently rescue the aberrant phenotype of pulpal inflammation, which may be partially due to LTBP1-mediated T cell suppression.

Clinical case of preservation of teeth vitality during treatment of initial pulpitis

Diagnosis and treatment of pulp disease is one of the leading and widespread problems in dentistry. Clinicians are often faced with a dilemma when treating vital teeth with deep carious lesions and the development of reversible inflammation in the pulp tissue: whether to perform minimally invasive treatment to maintain pulp viability or to perform vital extirpation to prevent pulp necrosis, its further infection and prevention of apical periodontitis. To date, researchers and clinicians report that clinical recovery of the pulp with viable new bioactive materials is observed in 90% of cases provided that the inflammatory process in the pulp is diagnosed in the stage of reversibility. This article presents a clinical case of initial pulpitis treatment of teeth 1.5, 1.6 with the pulp-preserving method: direct pulp capping with bioactive cement Biodentine (Septodont). In the dynamics of observation after 1, 6, 12, 18 months teeth were asymptomatic and a favorable prognosis of the therapy was observed.

The results of vital pulp therapy for primary molars in children with negative behaviour

Relevance. Сhildren's negative behaviour may affect pulpitis treatment results. The study aimed to study the vital pulp therapy effectiveness for chronic fibrous pulpitis treatment in primary molars of children with negative behaviour.Material and methods. The study involved 60 children aged 3-6 years with negative behaviour (according to the Frankl scale). Before the treatment, the children had non-pharmacological psychological behaviour management. One hundred and twenty primary molars were treated for pulpitis using the biological method. Follow-ups assessed the condition of the fillings and the presence/absence of clinical and radiographic signs of complications after 6, 12, 18 and 24 months. Tooth survival rate determined the effectiveness of pulpitis treatment.Results. The after-pulpitis-treatment complication rate where tooth extraction was necessary amounted to 15.0% after six months and 1.7% after 12 months (p&lt;0.001); there were no complications after 18 and 24 months. During the first 12 months, 4.1% of cases required retreatment of pulpitis by pulpotomy. The retreatment rate due to filling defects was 20.8% after six months, and it then significantly decreased to 1.0-3.3% (p &lt; 0,001). The tooth survival rate after pulpitis treatment was 83.3% after 24 months. There were no statistically significant differences between the pulpitis treatment results based on the children’s age, the localization of the carious cavities, and direct or indirect pulp capping.Conclusion. The biological method of chronic fibrous pulpitis treatment in primary molars of children aged 3-6 years with negative behaviour had high 24-month effectiveness at an outpatient dental appointment (with preliminary psychological behaviour management). Most complications developed during the first six months after the treatment, to which dental filling defects contributed.