Ways of Maintaining Pulp Vitality: Narrative Literature Review

Background: Dental caries and traumatic injuries pose significant challenges to preserving the vitality of the dental pulp, with implications for tooth survival and overall oral health. Traditional approaches to managing these conditions have evolved, reflecting advancements in dental materials and a better understanding of pulp biology. Objective: This review aims to elucidate the effectiveness and implications of various vital pulp therapy techniques—indirect pulp capping, direct pulp capping, and pulpotomy—in preserving pulp vitality amidst dental caries and traumatic injuries. Methods: A comprehensive literature search was conducted across both physical libraries and online databases, including PubMed and Google Scholar, focusing on peer-reviewed articles that discuss vital pulp therapy techniques and the materials used. A total of 32 articles were selected based on predefined inclusion and exclusion criteria. Results: The review identifies indirect pulp capping, particularly the stepwise approach, as the most conservative method, offering significant benefits in terms of promoting natural healing processes and reducing the risk of pulp exposure. Direct pulp capping, utilizing materials such as Mineral Trioxide Aggregate (MTA) and Biodentin, demonstrates a high success rate in forming a protective barrier over exposed pulp tissue, thus preserving pulp vitality. Pulpotomy, indicated for more severe cases, also shows promising results in maintaining the vitality of the remaining pulp tissue, with materials like MTA and Biodentin playing pivotal roles. The evolution of dental materials, including bioactive silicates and resin-based MTA, has significantly contributed to the success of these therapies. Conclusion: Vital pulp therapies, leveraging contemporary materials and techniques, offer effective strategies for preserving pulp vitality in teeth affected by caries or traumatic injuries. The choice of technique and material is crucial, with indirect pulp capping, direct pulp capping, and pulpotomy each serving distinct clinical scenarios. These therapies not only support the structural integrity and health of the tooth but also align with the principles of minimally invasive dentistry.