(TC33) Bioactive Scaffold for Vital Pulp Therapy: Does It Help Rebuild the Pulp?

Abstract: Vital pulp therapy (VPT) is considered an effective and conservative treatment option for both immature and mature teeth with irreversible pulpitis, as stated in the 2021 American Association of Endodontists position statement on VPT. Often full pulpotomy followed by the placement of calcium silicate cement is recommended in mature permanent teeth with irreversible pulpitis to ensure complete removal of inflamed/infected pulp tissue and preservation of vitality. From a biological perspective, however, a strategy to efficiently regenerate vital tissue from existing pulp is more desirable than the mere preservation of the pulp tissue. Such a regenerative strategy may also enhance the outcomes of VPT in mature teeth with irreversible pulpitis. An amnion-chorion membrane (ACM) (BioXclude; Snoasis Medical, Golden, CO) widely used for the treatment of connective tissue defects can be suggested as a potential scaffold material for the regeneration of vital pulp tissue in fully pulpotomized mature teeth because it contains a variety of biological molecules including extracellular matrix proteins, growth factors, anti-inflammatory cytokines, and tissue inhibitors of matrix metalloproteinases to suppress inflammation and promote wound healing. The purpose of this table clinic is to present a tissue engineering strategy using the ACM for VPT. Clinical cases will be used to illustrate how this bioactive ACM can be utilized during VPT for mature teeth with irreversible pulpitis and how it may lead to pulp regeneration at follow-ups. With this knowledge, clinicians will be able to apply this bioactive scaffold to enhance regeneration of the pulp-dentin complex in VPT.