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The purpose of this study was to identify differences in usage trends for 2 specific pulpal therapy treatments in pediatric patients during an 11-year period from January 1, 2010, through December 31, 2020. Insurance data claims for children aged 2 through 12 years undergoing a pulpotomy or a pulpectomy performed by a general dentist (GD) or pediatric dentist (PD) from 2010 through 2020 were extracted from a dental data warehouse. The state where the provider was located was included in the extracted claim. Rates of undergoing a pulpotomy or pulpectomy declined from 2010 through 2020 (odds ratio [OR], 0.978 or 0.946, respectively; P <.001). PDs were more likely to perform pulpotomies than GDs (OR, 1.393; P <.001), but PDs were less likely to perform pulpectomies than GDs (OR, 0.225; P <.001). Younger patient age was a significant predictor for undergoing pulpotomy treatment for both GDs and PDs (ORs, 0.850 and 0.892, respectively; P <.001). With increasing patient age, PDs had increased odds of performing a pulpectomy (OR, 1.030; P <.001) and GDs had decreased odds of performing a pulpectomy (OR, 0.995; P =.04). When examining effects according to American Academy of Pediatric Dentistry national membership districts, the trends remained consistent with those above. The percentage of children undergoing pulpotomy and pulpectomy therapy declined from 2010 through 2020 among both GDs and PDs. These changes in pulpal therapy practice might indicate a teaching change in pulpal therapy guidelines, suggesting that less invasive pulpal therapy can be used rather than pulpotomies or pulpectomies. [ABSTRACT FROM AUTHOR]

In May 2021, the American Association of Endodontists released a Position Statement on Vital Pulp Therapy (VPT) as a conservative means by which to treat inflamed vital pulps in permanent dentition. The objective of this study was to conduct a survey to understand how U.S. dental schools are educating their students regarding VPT. This survey was administered through Qualtrics. Participation was voluntary and anonymous. 43 of 66 (65%) of the dental schools in the United States completed the survey. All schools (n = 43) indicated that students receive a didactic lecture about VPT on permanent teeth. In contrast, 14 of 43 (33%) schools teach VPT on permanent teeth as a technique exercise in the simulation/pre-clinic; 29 of 43 (67%) do not. Fifty percent of newer dental schools (0-15 years) teach VPT on permanent teeth as a simulation/pre-clinic technique exercise compared with 30% of older dental schools (16 years or older). In older schools, VPT is taught by endodontists 59% of the time, whereas the percentage of endodontists teaching in newer schools is roughly half of that (33%). A paradigm shift in endodontics has occurred due to the development and use of bioceramic dental materials. The standard of dental care is shifting in favor of more conservative treatment options. The results of the study indicate that there is a deficiency in the number of U.S. dental schools teaching VPT on permanent teeth as a simulation/pre-clinic technique exercise. [ABSTRACT FROM AUTHOR]

For children to receive needed oral health care, adequate training at both the predoctoral and postdoctoral levels of dental education is required, but previous studies have found inadequacies in predoctoral education that lead to general dentists' unwillingness to treat certain young populations. As another way of assessing predoctoral preparation, the aim of this study was to determine the perspectives of first-year residents and pediatric program directors about residents' preparedness to enter advanced education programs in pediatric dentistry. Surveys were sent to all 74 U.S. program directors and 360 first-year residents. The survey focused on procedures related to prevention, behavior management, restorative procedures, pulp therapy, sedation, and surgery, as well as treating patients funded by Medicaid and with special health care needs. Among the first-year residents, 173 surveys were returned for a 48% response rate; 61 directors returned surveys for an 82% response rate. Only half of the residents (55%) reported feeling adequately prepared for their first year in residency; less than half cited adequate preparation to place stainless steel crowns (SSCs) (42%) and perform pulpotomies (45%). Far fewer felt adequately prepared to provide treatment for children six months to three years of age, including examinations (29%), infant oral exams (27%), and children with severe caries (37%). The program directors were even less positive about the adequacy of residents' preparation. Only 17% deemed them adequately prepared to place SSCs and 13% to perform pulpotomies. Approximately half reported their first-year residents were inadequately prepared to treat very young children and children with severe caries (55% each). This study found that the perceived inadequacy of predoctoral education in pediatric dentistry was consistent at both the learner and educator levels, supporting previous studies identifying inadequacies in this area. [ABSTRACT FROM AUTHOR]

Objective: Nearly all state Medicaid programs reimburse nondental primary care providers (PCPs) for providing preventive oral health services to young children; yet, little is known about how treatment outcomes compare with children visiting dentists. This study compared the association between the provider of preventive services (PCP, dentist, or both) with Medicaid-enrolled children before their third birthday and subsequent dental caries-related treatment (CRT) and CRT payment.Methods: We conducted a retrospective study of young children enrolled in North Carolina Medicaid during 2000 to 2006. The annual number of CRT and CRT payments per child between the ages of 3 and 5 yr were estimated with a zero-inflated negative binomial regression and a hurdle model, respectively. Models were adjusted for relevant child- and county-level characteristics and used propensity score weighting to address observed confounding.Results: We examined 41,453 children with > 1 preventive oral health visit from a PCP, dentist, or both before their third birthday. Unadjusted annual mean CRT and payments were lowest among children who had only PCP visits (CRT = 0.87, payment = $172) and higher among children with only dentist visits (CRT = 1.48, payment = $234) and both PCP and dentist visits (CRT = 1.52, payment = $273). Adjusted results indicated that children who had dentist visits (with or without PCP visits) had significantly more CRT and higher CRT payments per year during the ages of 3 and 4 yr than children who had only PCP visits. However, these differences attenuated each year after age 3 yr.Conclusions: Because of children's increased opportunity to receive multiple visits in medical offices during well-child visits, preventive oral health services provided by PCPs may lead to a greater reduction in CRT than dentist visits alone. This study supports guidelines and reimbursement policies that allow preventive dental visits based on individual needs. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify treatment options recommended by American Academy of Pediatric Dentistry (AAPD) members concerning pulp treatment in primary teeth in pediatric patients with congenital heart disease (CHD). Methods: A web-based survey was sent to all active members of the AAPD. The survey contained radiographs of pulpally involved primary teeth, a description of associated signs/symptoms, and a medical history of the patient who was positive for a type of CHD. Pediatric dentists were requested to report treatment recommendations. Results: Of the 6,590 surveys sent, 1,493 surveys (23%) were completed. Most respondents preferred to extract the tooth with the clinical presentation of irreversible pulpitis followed by distal shoe space maintenance when the patient presented with a negative medical history. By contrast, approximately half of the respondents elected to extract this tooth without space maintenance for all of the cardiac conditions. By contrast, most respondents elected to perform a pulpotomy in the case of reversible pulpitis regardless of the medical history. Indirect or direct pulp therapy were the least chosen options for both presentations. Conclusions: The presence of CHD affects treatment decisions in teeth exhibiting irreversible pulpitis with symptomatic apical periodontitis but not in teeth displaying reversible pulpitis with a normal periodontal status. [ABSTRACT FROM AUTHOR]

Many materials have been used for pulp treatment in primary teeth, but not many of them are extensively supported in the dental literature. In recent years, new materials have been introduced along with new procedures, and these will be reviewed in this article. Many of these new materials have shown promising results in the short run but can only be thoroughly evaluated after longer use and more extensive applications. There is clearly a need for long-term studies to identify the best materials for pulp treatment of primary teeth. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to repeat a 1997 survey of current pulp therapy practice. Methods: The directors of dental school predoctoral pediatric dentistry programs (N=56) and board certified pediatric dentists (N=1200) were surveyed in 2005. Results: More dental schools (83%) taught indirect pulp therapy (IPT) compared to 1997. Significantly more used glass ionomer for IPT with most dental schools and diplomates not re-entering a tooth after IPT Over 30% of schools and diplomates do direct pulp caps using glass ionamer. For pulpotomy, diluted formocresol usage decreased in dental schools (54%) while ferric sulfate significantly increased (24%) and full strength remained at 22%. Shorter placement of pulpotamy medication was noted and ZOE alone the preferred base. Pulpectomy was advocated by 85% of 2005 schools and diplomates with ZOE filler use decreasing while iodoform/calcium hydroxide filler use increasing. Conclusions: More pediatric dentists are using glass ionomer for IPT and direct pulp capping, and there was a trend away from the use of 1:5 diluted formacresol with mare using ferric sulfate for pulpotomy. For pulpectomy, most use ZOE but iodoform pastes and calcium hydroxide have increased in usage since 1997. Disagreements continue concerning when to use certain pulp therapies and some directors and diplomates did not follow the AAPD guidelines. [ABSTRACT FROM AUTHOR]

Aim: To present a scientometric analysis of the entire body of scientific publications in the field of vital pulp therapy (VPT) and analyse the research trends and popular topics., Methodology: A comprehensive literature search was conducted in the Web of Science and Scopus databases on 21 August 2020 to identify all articles related to VPT. The publications were reviewed and basic research parameters were collected, including publication year, patterns of authorship, geographical distribution of scientific productions, journals, h-index, study design and keyword analysis. Web of Science, Scopus and Google Scholar databases were used for the citation analysis of the ten top cited articles. The data were analysed using VOSviewer and visualized by tables and diagrams., Results: In total, 1197 VPT-associated items were identified from 64 countries in 176 journals. The majority of papers were published in the Journal of Endodontics. The United States of America was the leading country for number of publications, citations, h-index and collaborations. The distribution of articles based on study design was as follows: basic science (35%), clinical (27%), observational studies (26%) and review publications (12%). The most frequently occurring keywords were pulpotomy, mineral trioxide aggregate, calcium hydroxide and direct pulp capping., Conclusions: This scientometric analysis outlines the evolutionary trends and the productivity of researchers and countries in the field of vital pulp therapy. Research output is dominated by basic science articles involving innovative materials published in high impact factor dental journals., (© 2020 International Endodontic Journal. Published by John Wiley & Sons Ltd.)