2023, Vol. 27 ›› Issue (3): 427-433

Application of biological materials in vital pulp therapy

Wang Ziyang, Zuo Enjun   

Abstract: BACKGROUND: Studies have shown that the retention rate of endodontically treated teeth (especially molars) is significantly lower than that of vital teeth. The hazard ratios for loss were 7.4:1. With the progress of the concept of tissue regeneration and the development of biological materials, people are searching for new endodontic treatments to increase the retention rates.
OBJECTIVE: To review the clinical effect, application status and research prospect of various biological materials in order to help clinicians choose a better method in vital pulp therapy.
METHODS: Based on Chinese search terms “vital pulp therapy, calcium hydroxide, MTA, iRoot BP Plus, Biodentine, TheraCal LC, BioAggregate”, the authors searched and matched relevant documents in CNKI and Wanfang database. With the English search terms “vital pulp therapy, MTA, iRoot BP Plus, Biodentine, TheraCal LC, BioAggregate”, the authors searched for relevant literature in PubMed database. The retrieval time was from January 2011 to November 2021. After reading title, abstract and full-text selection of literature, 56 articles were finally included for review.
RESULTS AND CONCLUSION: (1) In minimally invasive endodontics, in addition to pursuing the integrity of residual dental hard tissues, healthy dental pulp should be retained as far as possible. Preservation of vital pulp is important to both immature permanent teeth and mature permanent teeth. It can help to improve prognosis and increase the retention rates. (2) Calcium hydroxide is the longest-used pulp capping agent in clinic. Its effect is stable and the price is low, but it cannot seal the pulp tightly. There are tunnel-like defects in the dentin bridge of the patients, and the prognosis is poor. (3) The biocompatibility of mineral trioxide aggregates is better than that of calcium hydroxide, with good sealing properties, which can effectively control inflammation. There are problems such as high price, long coagulation time, and possible discoloration of the crown. (4) In recent years, new biomaterials such as iRoot BP Plus, Biodentine, TheraCal LC, and BioAggregate have gradually entered the clinic, showing bright prospects. Further clinical research is still needed. However, no matter what pulp capping material is used, accurate selection of indications is the key to successful preservation of healthy pulp tissue.
Key words: vital pulp therapy, pulp capping agent, biological materials, minimally invasive endodontics, calcium hydroxide, MTA, iRoot BP Plus, Biodentine, TheraCal LC, BioAggregate