Six-Month Treatment Outcomes of Vital Pulp Therapy in Adults Using Biomaterials: A Prospective Cohort Pilot Study

Abstract

Vital pulp therapy (VPT) preserves dental pulp and its functions, offering a minimally invasive alternative to root canal therapy. However, the impact of patient-related factors on success remains unclear. This study aimed to estimate the sample size for a multivariate model predicting VPT success for assessing capping material, age, sex, and pulp conditions. A prospective cohort study was conducted with the inclusion of twenty-seven adult patients with carious pulp exposure in mature permanent teeth. Treatment comprised direct pulp capping, partial pulpotomy, or complete pulpotomy with Mineral Trioxide Aggregate Plus (MTA+) or Biodentine. Success rates were evaluated at 6 months through clinical and radiographic examinations. Statistical analysis included Pearson’s Chi-square tests and logistic regression. The success rates were 64% in the Biodentine group and 92% in the MTA+ group (OR: 0.15; p = 0.108). Sex and age had no significant effect. Success declined with increasing pulp condition severity and treatment invasiveness. MTA+ had a higher incidence of discoloration, while Biodentine showed none. Sample size calculations suggested 140 participants would be needed to detect a significant effect of pulp condition. Both materials were effective, though MTA+ showed higher success based on the strict success criteria. More severe pulpitis correlated with lower success, but a larger study is needed for predictive models.