Contemporary Perspectives on Vital Pulp Therapy: Views From the Endodontists and Pediatric Dentists

Article title: Contemporary Perspectives on Vital Pulp Therapy: Views From the Endodontists and Pediatric Dentists

Author(s): Seale & Glickman.

Journal: Pediatric Dentistry

Year. Volume (number). Page #’s: 2008. 30:3. 261-267.

Major topic: Pulp Therapy Perspectives by Specialists

Overview of method of research: Conference Paper

Purpose:
To compare the attitudes of endodontists and pediatric dentists at a pulp therapy symposium sponsored by both the American Academy of Endodontists (AAE) and AAPD regarding opinions of vital pulp therapies.

Methods:
Pre and post symposium surveys were administered and completed via a real-time electronic audience response system (ARS). There were three main areas of interest: pulp therapy for cariously involved primary teeth, indirect pulp treatment (IPT) of carious young permanent teeth and the future of regenerative/revascularization of teeth. The pretest was 8 questions and the posttest was 20 questions and the responses were analyzed. This was the first attempt to bring these specialties together in such a manner.
This identical article was also published in the Journal of Endodontics in 2008.

Findings:
Responses of 79 endodontists and 231 pediatric dentists were used for analysis. The pretest showed that 80% of pediatric dentists strongly agreed that formocresol is an acceptable primary tooth pulpotomy agent versus 29% of endodontists. Only 5 % of pediatric dentists agreed with a statement identifying formocresol as presenting documented danger to the patient yet 15% of the endodontists agreed. 78% and 76% of pediatric dentists and endodontists respectively agreed that formo would be replaced as a pulpotomy agent due to its controversy about its potential dangers not because of its actual danger to patients.
When asked their pulpotomy agent of choice, MTA was the overwhelming top choice by both types of specialists.
Significantly more pediatric dentists (94%) than endodontists (69%) agreed that indirect pulp capping is an acceptable and contemporary technique for cariously involved young permanent teeth. Both specialists’ posttest responses significantly differed regarding symptoms of irreversible pulpitis being a contraindication to IPT from their pretest responses. 31% and 26% agreed to this statement at first, but after the symposium only 7 or 8% agreed.
47% of pediatric dentists and 58% of endodontists chose IPT as the best treatment for a reversibly inflamed primary molar with a large carious lesion encroaching the pulp. 74% of pediatric dentists and 70% of endodontists strongly agreed that IPT is successful as pulpotomy in primary teeth with reversible pulpitis.

Key points/Summary:
Practitioners in both specialties seem to agree that formocresol will eventually be replaced as a primary tooth pulpotomy medicament, MTA is by far the material of choice to take its place, IPT in primary dentition may be a replacement for pulpotomy, IPT is also an acceptable therapy for cariously involved young permanent teeth with open apices, and that pulp revascularization and regeneration are potential therapies to be utilized in the future.

Assessment of Article:
Very interesting comparison of the 2 specialties, but it would have been nice if they gave the same survey both before and after the symposium in order to draw better conclusions.