(TC12) Preserving Pulp Vitality with Biodentine in Permanent Mature Posterior Tooth: Case Series Report

Abstract: Vital pulp therapy (VPT) is designed to preserve the vitality of pulp tissue when it is affected by trauma, a carious lesion, or an iatrogenic procedure. This case series aims to evaluate factors that influence the outcome of VPT. Three patients, diagnosed with reversible pulpitis and with a mean age of 26, were included. After achieving good isolation with a rubber dam, dental caries was carefully removed, and the pulp tissue was exposed. The inflamed coronal pulp tissue was removed with high-speed instruments. Hemostasis was achieved by placing a cotton pellet moistened with 5% NaOCl for 5 minutes, and biodentine was placed in the pulp chamber. After a selective etch, the proximal cavities were restored with composite resin. Previous studies indicate that direct pulp capping or partial pulpotomy can serve as a therapeutic procedure for mature permanent teeth with deep caries. As more tissue was jeopardized by bacteria, shallow pulpotomy was performed with instruments. Although the sizes of exposed coronal pulp tissue varied, the degree of bleeding and the time to achieve hemorrhage control were more closely related to a higher success rate. Given NaOCl's antimicrobial effect and biofilm removal capabilities, it was deemed an appropriate hemostatic agent at the pulpal wound site. Reasons for selecting biodentine include its bioactivity to promote reparative dentin formation, faster setting time, higher compressive strength, and lower risk of discoloration. During the 3-6 month periodic follow-up, clinical and radiographic evaluations showed no symptoms or signs; the restored teeth also showed a normal response to electric pulp testing (EPT) and cold tests. Thus, preservation of pulp vitality with biodentine was successful, and longer observation period was required