Defense Date


Document Type


Degree Name

Master of Science in Dentistry



First Advisor

Garry Myers

Second Advisor

Duane Schafer

Third Advisor

Caroline Carrico


Introduction: The purpose of vital pulp therapy is to maintain pulp viability by eliminating bacteria from the dentin-pulp complex and to establish an environment in which apexogenesis can occur. The aim of this retrospective cohort study was to evaluate the clinical and radiographic outcomes of vital pulp therapy on immature permanent teeth using different calcium silicate-based materials. Methods: This study was carried out in the Virginia Commonwealth University Graduate Endodontics department in Richmond, Virginia. Vital pulp therapy cases performed by graduate endodontic residents were retrospectively searched and charts were reviewed to determine inclusion into this study. All cases selected for this study were vital pulp therapy treatments performed on immature permanent teeth using a calcium silicate-based material. The treatment outcomes were assessed clinically and radiographically at a minimum of 6 months post-treatment. Six examiners (3 endodontists and 3 endodontic residents) were selected to assess the pre- and post-treatment radiographs. The examiners were calibrated and used 3 different radiographic assessment categories (Orstavik’s PAI, a root development category, and a final assessment category) to assess periapical healing and treatment outcome. Results: A total of 823 vital pulp therapy treatment notes were identified, 209 charts were reviewed as potential candidates for the study, and 51 met the inclusion criteria and were included in this study. The study showed an overall success rate of 89%. The failures noted were subsequently treated with either conventional root canal therapy or regenerative endodontic procedures. Dental sensitivity to cold reported by patients reduced over time, radiographic outcomes showed an increase in apical dentin deposition, and all immature teeth showed continued root formation. Conclusions: Vital pulp therapy on immature permanent teeth using calcium silicate-based materials is a viable treatment option for treating teeth affected by traumatic or carious exposures of a vital pulp. Funding Source: Foundation for Endodontics.


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