Tampon Vital Pulp Therapy in the Management of Excessive Haemorrhage in Inflamed Pulps: A Hypothesis

Current principlesin vital pulp therapy (VPT) modalities emphasise the importance of haemostasis and normal clotting in the achievement of successful treatment outcomes. However, the aforementionednotion could be challenged by the new and recent emerging evidence; suggesting that prolonged or excessive bleeding/haemorrhage (PB) in cases of intensly inflamed pulps, conventionally infamousas irreversible pulpitis (IP), may not impede the healing potential of the remaining dental pulp tissuefollowing VPTs u sing endodontic biomaterials. “Tampon VPT (tVPT)” may be considereda treatment approach for the management of stated IP cases; characterised by severe pulpal inflammation and delayed clotting process. The presentedhypothesis evaluates clinical studies, experimental research and molecular impacts on clotting within the inflamed dental pulp, so as to explore the efficacy as well as the safety of tVPT as a viable treatment option. Latest clinical investigationshave reported positive outcomes with tVPT; even in the presence of IP with PB. It has been shown that inflamed dental pulp tissues exhibit molecular impacts on the clotting cascade, which may contribute to the delayed clotting process. Nonetheless, the healing capacity of the dental pulp is not negatively affected by hyperaemia. Additionally, enhanced blood flow in the inflamed pulpal tissues may be associated with improved healing and boosted hard tissue formation. Moreover, tVPT could possibly promote pulpal healingand/or regeneration through continuing the presentation of essential nutrients, e.g.oxygen, and growth factors to the injured tissue. Furthermore, increased blood flow may facilitate the recruitment of immune and reparative cells; promoting tissue repair and encouraging the formation of dentinal bridge(s) after VPTs. Con sequently, the state-of-the -art research and their findings could support the hypothesis that tVPT may effectively manage IP cases with PB and contribute to favourable outcomes.