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Review
. 2020 Apr;46(1):154-166.
doi: 10.1111/aej.12392. Epub 2019 Dec 21.

Vital pulp therapy of mature permanent teeth with irreversible pulpitis from the perspective of pulp biology

Louis M Lin  1 , Domenico Ricucci  2 , Tarek M Saoud  3 , Asgeir Sigurdsson  1 , Bill Kahler  4
Affiliations
Review

Vital pulp therapy of mature permanent teeth with irreversible pulpitis from the perspective of pulp biology

Louis M Lin et al. Aust Endod J. 2020 Apr.

Abstract

The American Association of Endodontists (AAE) Consensus Conference Recommended Diagnostic Terminology states that mature permanent teeth clinically diagnosed with irreversible pulpitis are treated with pulpectomy and root canal filling because inflamed vital pulp is not capable of healing. Histological studies have demonstrated that clinically diagnosed irreversible pulpitis does not involve the entire pulp. A recent International Endodontic Journal Editorial suggested clinical diagnosis of pulp disease should be reassessed because of the poor correlation between clinical symptoms and pulp sensibility testing and the actual histological status of the pulp. This review identified studies in a PubMed search that provide evidence for vital pulp therapy (VPT) of mature permanent teeth with irreversible pulpitis is predictable if correctly diagnosed and properly treated. A narrative review was undertaken to outline the correlation between the clinical symptoms/signs and pulp sensibility testing and the histological findings of the pulp. Treatment procedures for permanent teeth are outlined.

Keywords: irreversible pulpitis; mature permanent teeth; pulp sensibility tests; root canal therapy; vital pulp therapy.

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