Beyond Tradition: Non-surgical Endodontics and Vital Pulp Therapy as a Dynamic Combination

Abstract

Symptomatic irreversible pulpitis and apical periodontitis in mature permanent teeth present challenges in their management. Traditional treatment approaches, such as root canal therapy or tooth extraction, may compromise tooth structure and oral function. This review article explores the combination of non-surgical endodontic treatment and vital pulp therapy as an alternative approach for these conditions. The purpose is to examine this combined approach's effectiveness, benefits, challenges, and limitations. The objectives include reviewing the literature, evaluating clinical outcomes, discussing potential benefits, and providing recommendations for clinical practice. The combination approach aims to preserve tooth structure, promote healing, and reduce postoperative complications. The article discusses the rationale for combining the two techniques, presents evidence supporting their efficacy, and outlines the techniques and protocols involved. Clinical outcomes, case studies, potential challenges, and comparative analysis with traditional approaches are also explored. Future directions and research recommendations highlight areas for further investigation, innovations, and the development of clinical guidelines. In conclusion, the combination of non-surgical endodontic treatment and vital pulp therapy offers a valuable strategy for managing mature permanent mandibular molars with symptomatic irreversible pulpitis and apical periodontitis. Further research and advancements are needed to refine the treatment protocol and expand the evidence base, and clinicians should stay updated to provide optimal care and improve patient outcomes.

Shear bond strength of calcium silicate-based cements to glass ionomers

“…Vital pulp treatment is frequently used by pediatric dentists to eradicate bacteria within the dentin-pulp complex, preserve pulp vitality, and create a conducive environment for apexogenesis [ 8 ]. Successful VPT necessitates stable pulpal hemodynamics and the establishment of a hermetic coronal restoration to eliminate severe inflammatory reactions [ 9 ]. The ideal biomaterial utilized in VPT should promote dentin formation by stimulating residual pulp tissue and possess the ability to resist long-term bacterial infiltration when restorative materials are applied [ 10 ].…”

Effect of Saga Leaf Extract (Abrus precatorius Linn) in Inhibiting Enterococcus faecalis Bacteria Growth as an Alternative Root Canal Irrigation Material

“…Clinically, abrin is considered an immunotoxin that can target cancer cells and can be delivered to the tumor site after combining with antitumor drugs. [1][2][3][4] At the cellular level, abrin inhibits protein synthesis, leading to cell death. Many of the features observed in abrin poisoning can be shown by abrin-induced endothelial cell damage, which leads to increased capillary permeability.…”

“…Successful root canal treatment depends on the ability to eliminate microorganisms from the root canal system and the reinfection prevention. 3,4 The most common root canal microorganisms isolated from infections are anaerobic bacteria, one of which is Enterococcus faecalis bacterium. It is considered to be the main cause of root canal abnormalities with a prevalence value of 77%.…”

“…7 An ideal irrigation material should be nontoxic, able to dissolve organic and inorganic tissues, prevent smear layers formation during root canal preparation, and have antimicrobial properties. 4 Two percent chlorhexidine (CHX) was suggested as a root canal irrigation agent because its antimicrobial effect can effectively protect the root canal after root canal treatment at that concentration. However, 2% CHX is not recommended as the first option for irrigation agents since it causes discoloration and allergic reactions when used repeatedly over a long period of time.…”