Success of Vital Pulp Therapy in Immature Permanent First Molars

Introduction: The objective of this study is to determine the factors that led to successful vital pulpotomy treatment of first permanent molars (FPMs). We hypothesize that a) immature FPM teeth have a higher success rate of Vital pulp therapy than mature teeth and b) final definitive restoration delivery within 6 months of pulp improves the success rate of pulp therapy on FPMs. Methods: A retrospective chart audit of patients aged 5-16 years who had at least one FPM that had vital pulpotomy treatment at the University of Illinois College of Dentistry (UIC COD) between January 1, 2016 and March 1st, 2023. Data was collected on patient demographics (ie. age, gender, race), the tooth treated (treatment type, root status, restoration) and follow-up visits. Successful treatment was determined by absence of symptoms or pathology at follow-up visits and no need for retreatment. Results: A total of 254 patients were treated that met the inclusion criteria: [Age-mean(SD) = 8.64(1.64)]. Fifty-four percent had immature root development at time of treatment. Pulp therapy performed included Cvek (2%), partial pulpotomy (17%), and full pulpotomy (81%). Most treated teeth (77%) were restored with Glass Ionomer (GI) on the day of treatment. Around 50% of the treated molars received SSC as final restoration with 1/3 delivered on the day of treatment. Within the subset sample population demographic (n=154), successful treatment was observed in 67% of teeth treated. No correlation was detected between the success rate of pulp therapy and root development or definitive restoration within 6 months period (p>0.05). Conclusions: The results suggest that success of pulpotomy treatment is independent of root development and type of restoration post treatment, but suggest same-day definitive restoration may be beneficial for clinics with high loss to follow up rates.