Comparative Analysis of Vital and Nonvital Pulp Therapy Outcomes in Pediatric Endodontics
R Venkatasubramanian1, B K Ramnarayan2, Krishnanand P Satelur3
1Department of Pediatric and Preventive Dentistry, Dayananda Sagar College of Dental Sciences, Kumaraswamy Layout, Bangalore, Karnataka, India.
Background:
Pulp therapy in pediatric endodontics is crucial for maintaining primary teeth until natural exfoliation. Vital pulp therapy (VPT) and non-vital pulp therapy (NVPT) are commonly employed based on pulp status.
Materials And Methods:
A total of 80 pediatric patients (aged 4-10 years) with deep carious lesions were randomly assigned into two groups: VPT (n = 40) and NVPT (n = 40). VPT included indirect pulp capping, direct pulp capping, and pulpotomy, while NVPT involved pulpectomy followed by obturation. Success rates were assessed through clinical signs (pain, swelling, mobility) and radiographic parameters over 12 months. Statistical analysis was performed using the Chi-square test with significance set at P < 0.05.
Results:
At the 12-month follow-up, the VPT group showed an 85% success rate, while NVPT had an 80% success rate. Failure in VPT was mainly due to secondary infection and internal resorption, whereas NVPT failures were attributed to periapical pathology and root resorption. The difference in outcomes was not statistically significant (P = 0.36).
Conclusion:
Both VPT and NVPT are effective in managing deep caries in pediatric patients, with comparable success rates. VPT remains a preferable option in cases of reversible pulpitis due to its conservative nature, whereas NVPT is essential in cases of irreversible pulpitis.
