Vital Pulp Therapy in Irreversible Pulpitis: A Case Report Based on Literature Guidelines

Abstract

Aims: Vital pulp therapies aim to preserve the integrity of the dental element, avoiding complete removal of pulp tissue by pulpectomy. The aim of this literature review and clinical case report was to scientifically indicate a guideline, demonstrating the specificity of the different types of vital pulp therapies and when they can be indicated, as well as to emphasize the importance of diagnosis and biomaterial choice. Methodology: The PubMed, Scopus, Cochrane Library, and Grey Literature (Google Scholar) databases were accessed using the following keywords: “vital pulp therapy”; “indirect pulp capping”; “direct pulp capping”; “pulpotomy”; “partial pulpotomy”; “total pulpotomy”; “capping materials”; “biomaterials”; “MTA”; “Biodentine”; “TheraCal.” Articles were screened by reading titles and abstracts, selecting those describing, indicating or contraindicating vital pulp therapies, as well as those comparing commonly used biomaterials as capping agents. A clinical case of pulpotomy was described, using TheraCal as the capping material. Results: The study highlights the scientific relevance favoring therapies that preserve endodontic tissues, consequently preserving the tooth. It also allows the understanding of the required mechanisms of action of capping biomaterials and differences among them. The clinical case demonstrated the importance of diagnosis and the step-by-step procedure. Conclusion: It is concluded that when properly selected, pulpotomy can preserve root pulp tissue and that TheraCal proved to be a better material due to its ease of application compared to globally referenced materials.