| Abstract [eng] |
Relevance of the problem: Tendencies in a shift of clinicians’ preferences from an invasive to conservative treatment approach of pulpal conditions were observed due to negative effects of traditional root canal treatment, including changes in tooth structure, biomechanical behaviour and fracture resistance, advanced comprehension of dental pulp’s healing capabilities and introduction of hydraulic calcium silicate-based cements. Accurate diagnosis and preservation of pulp vitality are of major significance concerning prevention of inadequate treatment procedure, maintenance of biomechanical properties and fracture resistance of teeth. Therefore, analysis regarding clinical effectiveness of both, vital pulp therapy and root canal treatment, is required to evaluate the role of preventive endodontic therapies in mature teeth and their importance in avoiding root canal treatment, as an alternative if amenability of the pulp is ensured. Aim and Objectives: The purpose is to conduct a literature review on the currently available studies evaluating preventive methods in endodontics taking their comparison to root canal treatment into consideration and highlighting their importance in avoiding root canal treatment in mature teeth. Materials and Methods: A systematic literature search was conducted applying identified Medical Subject Headings (MeSH terms) and text-words in the medical database PubMed restricting language to English and German and publication year to 10 years. Following exclusion of duplicates, a two-phase strategy was employed as initially only title and abstract of articles were screened excluding unsuitable studies, followed by appraisal of full text of articles with regards to exclusion and inclusion criteria. Results: In total, 43 studies were considered eligible and included in this review. Adapted approaches or treatment protocols of vital pulp therapy methods presented higher success rates than conventional methods. However, outcome of vital pulp therapy can be affected by various patient, intra- and postoperative factors. Compared to calcium hydroxide, the gold standard, application of hydraulic calcium silicate-based cements in vital pulp therapy entailed more favourable outcomes. Comparable clinical effectiveness of vital pulp therapy and root canal treatment was observed. Conclusion: Higher or comparable success rates to root canal treatment suggest vital pulp therapy as an advantageous alternative treatment modality in mature teeth. However, root canal treatment is the only available approach when the pulp is not amenable to vital pulp therapy, or the latter presented a negative outcome. Keywords: Pulpotomy, Dental pulp capping, Root Canal Therapy, Pulp Capping and Pulpectomy Agents, Vital pulp therapy, Mature teeth. |
