Vital Pulp Treatment 2024

Vital pulp treatment in its various forms has been a subject discussed in dentistry courses for decades. However, it is only recently, in the last five years or so, that converging developments in dental material science, pulp biology and dental have made this treatment a valid, predictable and evidence- based strategy. It is not even 25 years ago that the long- term success rate of direct pulp capping was estimated as well below 50%, or a flip of coin; this poor outcome understandably has led many clinicians to view vital pulp treatment as somewhat of a second- class treatment, more like an attempt rather than as a bone fide definitive treatment. This perception is changing due to clear and compelling evidence from clinical trials supporting vital pulp therapy and it is rather exciting to see a case made for its application made in this book. Reasons to maintain a functional pulp- dentine complex are numerous and can be summarized broadly into categories: adding positive features and avoiding potentially negative elements inherent to the main comparator, i.e. root canal treatment (RCT). Vital pulp treatment or VPT retains immunocompetent tissues that effectively provide microbial clearance and protection from apical periodontitis. Moreover, in teeth with incomplete root formation, VPT promotes further dentine apposition and apical maturation. Conversely, RCT is associated with a larger damage to structural integrity, higher cost and specifically for molars with significantly higher clinical complexity. Indeed, many patients may benefit from VPT in their desire to retain the natural dentition for the long term. It is therefore very fitting and timely that Ikhlas El- Karim and Henry (Hal) Duncan, two clinicians with a strong biomedical understanding, have edited this book; it offers a compelling and comprehensive update on all aspects of VPT, from the case for the selection of the procedure, over material choices to related biology and outcomes.