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OR38 - Vital Pulp Therapy in the Dental Practice: An International Survey in Treatment Planning Decisions Among Endodontists and General Dentists

Thursday, May 4, 2023

11:00 AM – 11:15 AM CT

Location: E353B (Level 3)

Presenter(s)

Kazim Mirza, D.D.S., B.D.S.

Dr
University of the Pacific Arthur A. Dugoni School of Dentistry
Irvine, California

Disclosure information not submitted.

Co-Author(s)

Craig Dunlap, D.D.S.

Professor
University of the Pacific Arthur A. Dugoni School of Dentistry
San Francisco, California

Disclosure information not submitted.
Adham A. Azim, D.D.S., B.D.S.

Endodontic Department Chair at University of the Pacific A. Dugoni School of Dentistry
University of the Pacific Arthur A. Dugoni School of Dentistry
San Francisco, California

Disclosure(s): Endolit LLc: Ownership Interest (stocks, stock options, patent or other intellectual property or other ownership interest excluding diversified mutual funds) (Ongoing)

Objectives: Vital pulp therapy (VPT) is a well-established treatment modality that includes direct pulp capping, partial pulpotomy and full pulpotomy. The aim of this study was to determine the treatment planning decision among endodontic specialists and general dentists for VPT or root canal treatment (RCT) in different clinical scenarios.

Methods: An online survey was designed and distributed to members of the American Association of Endodontics and Endolit. Case-based scenarios were presented regarding the treatment decision to perform VPT or RCT. Variables included patient symptoms, age, pulpal exposure size, bleeding time, and root development. Chi-squared analysis was used to compare the impact of the different variables on the decision-making process. Results of the data and statistical analysis: Respondents were statistically more likely to perform RCT as the severity of symptoms increased. The age of the patient was found to be a statistically significant factor in treatment planning with an adult patient less likely to receive vital pulp therapy than a 13-year-old patient. The size of the cavity, development of the root, and bleeding time were also found to statistically significant variables (p < 0.05).

Conclusions: There is a trend towards attempting VPT on younger patients with less severe symptoms and smaller carious lesions. Despite the high success rate of VPT procedures, clinicians may still prefer RCT as a definitive treatment in many scenarios where VPT could be successful.