Long-Term Clinical Outcomes of Bioceramic-Based Vital Pulp Therapy in Mature Permanent Teeth: A Prospective Study

Abstract

Vital pulp therapy (VPT) has emerged as a conservative and biologically oriented alternative to root canal treatment for preserving pulp vitality, even in mature permanent teeth. The introduction of bioceramic-based materials has enhanced the predictability of VPT by combining excellent biocompatibility, sealing ability, and bioactivity. This prospective study aims to evaluate the long-term clinical and radiographic outcomes of bioceramic-based VPT in mature permanent teeth over a 3–5 year follow-up period. A total of 80 mature teeth diagnosed with reversible pulpitis or mechanical/caries-induced pulp exposure were treated using mineral trioxide aggregate (MTA) and Biodentine under standardized protocols. Clinical assessments included the absence of spontaneous pain, swelling, tenderness, or sinus tract formation, while radiographic evaluations focused on dentin bridge formation and periapical health.

Preliminary findings indicate a high clinical success rate, with more than 90% of treated teeth maintaining vitality and functional integrity at the 3-year mark. Radiographic results revealed consistent dentin bridge formation and stable periapical conditions across both material groups. Biodentine demonstrated faster initial healing, while MTA exhibited superior long-term radiographic stability. These outcomes reinforce the efficacy of bioceramic materials in promoting sustained pulp healing and dentinogenesis in mature permanent teeth.

The study concludes that bioceramic-based materials provide predictable, long-term success in vital pulp therapy, representing a reliable clinical choice for preserving natural dentition. Ongoing follow-up and multicenter studies are essential to confirm their long-term clinical durability and optimize treatment protocols in contemporary endodontic practice.