Pulpal response of primary and permanent teeth to various pulpotomy agents- A Systematic Review

Context: Vital pulp therapy is the treatment of choice for treating reversible pulpal injuries in both primary and permanent teeth for maintaining pulp vitality and function. Rationale of this treatment is based on the healing ability of the healthy pulp. Pulpotomy is vital pulp therapy in which a portion of vital coronal pulp tissue is removed surgically and the remaining radicular dental pulp is covered with a suitable material that protects the pulp from further injury and promotes healing.Aim: To histologically evaluate the pulpal response of teeth treated with pulpotomy..Methods and Material: The search identified 20 publications out of which 14 were excluded. Out of the 14 studies excluded, 3 were animal studies, 5 studies were on pulp capping and in 6 studies histological analysis was not done. The number of articles included were eight. The outcomes evaluated were dentin bridge formation, soft tissue changes, inflammatory changes. A detailed search was done in five databases namely Pubmed, Scopus, Cochrane, Lilacs and Science Direct.Results: Within the limitations of the study, it may be concluded that biodentine had a similar effect of dentin bridge formation like MTA and both showed less pulpal response and inflammation. Formocresol, Theracal and ferric sulfate on the other hand, caused more pulpal inflammation with almost negligible dentin bridge formation.Conclusion: MTA and Biodentine had similar results. The average follow up of various studies were 8 weeks to 6 months. In order to get more accurate results, longer follow up periods and more number of clinical trials are to be conducted.