Consensus-Based Recommendations on Pulp Therapies in Primary and Permanent Teeth: IAPD Porto Forum
Vineet Dhar1, Ikhlas El-Karim2, James A Coll1
1Department of Orthodontics and Pediatric Dentistry, University of Maryland, School of Dentistry, Baltimore, Maryland, USA.
International Journal of Paediatric Dentistry
|February 2, 2026
Summary
New dental guidelines prioritize pulp preservation using minimally invasive techniques. Experts recommend selective caries removal and calcium silicate cements for vital pulp therapy in children and adults.
Area of Science:
- Dentistry
- Endodontics
- Pediatric Dentistry
Background:
- Pulp biology understanding has evolved, favoring preservation over traditional treatments.
- Current diagnostic terms and protocols need updates to reflect pulp's healing potential.
Purpose of the Study:
- Develop consensus-based recommendations for pulp therapies in primary and permanent teeth.
- Update diagnostic terminology and treatment protocols for pulp management.
Main Methods:
- Systematic literature reviews and Delphi surveys with international specialists.
- Recommendations required >70% consensus, categorized by evidence level (RCTs, observational, expert opinion).
Main Results:
- 38 evidence-based recommendations on pulp inflammation, diagnosis, caries excavation, pulpitis management, and dental trauma.
- Emphasis on selective caries removal, calcium silicate cements for vital pulp therapy, and conservative irreversible pulpitis management.
Conclusions:
- Consensus provides evidence-based guidance for minimally invasive, biologically driven pulp preservation.
- Recommendations support tiered approaches for managing pulpal diseases in primary and permanent teeth.
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