Vital Pulp Therapy for Permanent Dentition Using Calcium Enriched Mixture Cement: A Review Article

It is difficult and sometimes impossible to predict the degree of damage and prognosis of tooth vitality after a carious dental pulp exposure. This predicament is exacerbated by the fact that clinical signs and symptoms do not correlate closely with the histopathological status of the pulp. As clinicians, we are keen to be conservative to maintain pulp vitality; however we must also remove all the infected tissue. Vital pulp therapy (VPT) aims to remove infected dentin, and bacteria, and at the same time to maintain pulp vitality by using a biocompatible material to seal off the pulp and restore the tooth’s strength and function. In the past, calcium hydroxide was used as a biocompatible pulp capping/pulpotomy agent. This has now been generally replaced with either MTA or Calcium Enriched Mixture (CEM) cement. These new biomaterials have good sealability and regenerative abilities, even superior to the traditional material used for VPT; for example, they can induce the production of greater and better quality reparative dentine. CEM cement has been clinically assessed for different VPT treatments such as direct pulp capping and pulpotomy treatments and therefore, its use for different VPT treatments is recommended.