Читать книгу Endodontic Materials in Clinical Practice - Группа авторов - Страница 44

The outcome of VPT should be assessed clinically after six months and with additional radiographic assessment at one year. If symptoms dictate, the observation period should be extended annually for four years [1]. The tooth should be responsive to pulp sensibility testing, but this may be heightened or diminished during the review period. Notably, although teeth which have had a partial pulpotomy will respond positively to testing, those which have undergone full pulpotomy will be unresponsive [218]. There should be no history of pain or other symptoms, and there should be evidence of continued root formation in immature teeth radiographically, as well as absence apical periodontitis [219]. A successful outcome in mature permanent teeth with symptoms no worse than reversible pulpitis indicates that a pulp‐capping procedure using an HCSC will be successful in approximately 80–90% of cases [63, 68, 82]. However, success is likely to be affected by the location (interproximal, occlusal) [79] and depth [66] of the carries, as well as operator skill [52, 63, 69] and material used [66, 68]. Other factors have not been consistently shown to be critical in determining outcome; these include patient age [83, 85, 196] and size of exposure [53, 118]. Interestingly, recent evidence highlights the potential of full pulpotomy to be as effective as pulpectomy in teeth with signs and symptoms suggestive of irreversible pulpitis [11, 84,220–222]. That said, there is a lack of prospective controlled trials using standardized materials, irrigants, caries depth symptoms, and so on in this area; this will need to be addressed moving forward. Damaged immature teeth treated aseptically by VPT that remain vital will display continued root growth through the physiological processes of primary and ongoing secondary dentinogenesis.