Pulp protection in today clinical practice: what about the role of materials?

Vital Pulp Protection and Therapy (VPPT) is the treatment that maintains pulp tissue in a healthy and functional state, whenever the dentin-pulp complex has been compromised by caries, trauma or restorative procedures. Pulp vitality and function is not essential for mature tooth survival. Mature permanent teeth without a vital pulp can survive for a long time after a successful endodontic treatment. However, the maintenance of pulp vitality in both mature and developing teeth provides beneits. ฀n immature permanent teeth the vital pulp plays a central role for continuation of root development and strengthening of the root canal walls. Furthermore, with living pulp the capacity of the dentin-pulp complex of mature permanent teeth to repair dentin defects and to retain the damaged complex as a functional unit, is maintained (Bergenholtz 2005). The objective of VPPT is to minimize reversible inlammatory reactions, to allow pulp tissue healing and to protect it from exogenous stimuli. It is well recognized that the damaged dentin-pulp complex requires protection from thermal conduction, chemical injury from the overlying restorative materials and further bacterial invasion from dentinal caries or oral bacteria leakage. It must be clariied here that protection from thermal conduction depends mainly on the conductivity of the main restoration and is beyond the aim of the present article. In order to assess the therapeutic validity of the currently used techniques and materials in vital pulp protection, the biology of dentin-pulp complex is briely reviewed.