Recommendations

Document Overview

Design and created by Guideline Central in participation with the American Academy of Pediatric Dentistry.

Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions

American Academy of Pediatric Dentistry

Publication Date: Oct 1, 2017

Page Last Updated: May 6, 2026

GRADE Strength of Recommendations and Implications

Grade	Quality of Evidence
High	We are very confident that the true effect lies close to that of the estimate of the effect.
Moderate	We are moderately confident in the effect estimate. The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low	Our confidence in the effect estimate is limited. The true effect may be substantially different from the estimate of the effect.
Very low	We have very little confidence in the effect estimate. The true effect is likely to be substantially different from the estimate of effect.

Grade	Strength of Recommendation
Strong	For the Patient	For the Clinician
Strong	Most individuals in this situation would want the recommended course of action and only a small proportion would not.	Most individuals in this situation would want the recommended course of action and only a small proportion would not. The majority of individuals in this situation would want the suggested course of action, but many would not.
Conditional (weak)	The majority of individuals in this situation would want the suggested course of action, but many would not.	Different choices will be appropriate for different patients. Decision aids may well be useful in helping individuals making decisions consistent with their values and preferences. Clinicians should expect to spend more time with patients when working toward a decision.

Document Overview

Document Title: Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions

Authoring Society: American Academy of Pediatric Dentistry

Document Publication Date: Oct 1, 2017

Page Last Reviewed/Updated: May 6, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: www.aapd.org/globalassets/media/policies_guidelines/g_vpt.pdf

Source Citation: PEDIATRIC DENTISTRY V 39 / NO 5 SEP / OCT 17

Supplemental Implementation Resources

Quick-Reference Guide

Document Scope, Criteria, and Use Cases

Document Objectives: For the purpose of this guideline, various interventions for vital pulp therapy were evaluated, including indirect pulp treatment using calcium hydroxide and alternates such as bonding agents/liners; direct pulp cap using calcium hydroxide and alternates such as bonding agents, mineral trioxide aggregate (MTA),or formocresol; and pulpotomies using formocresol, MTA, ferric sulfate (FS), sodium hypochlorite (NaOCl), lasers, calcium hydroxide, or tricalcium silicate. In addition to the reported adverse events, the evidence on outcome moderators such as type of final restorations and use of rubber dam was reviewed for this guideline.

Scope: Management, Treatment

Diseases/Conditions (MeSH)

D010377 - Pediatric Dentistry

D003813 - Dentistry

D003149 - Community Dentistry

D003785 - Dental Pulp Capping

D003782 - Dental Pulp

D005566 - Formocresols

D010372 - Pediatrics

D005566 - Formocresols

D003782 - Dental Pulp

D003785 - Dental Pulp Capping

D003149 - Community Dentistry

D003813 - Dentistry

D010377 - Pediatric Dentistry

Keywords: dental procedure, pediatrics, pulp therapy

Target Patient Population: Children with deep caries lesions

Inclusion Criteria: Female, Male, Adolescent, Child

Health Care Settings: Childcare Center, Outpatient

Intended Users: Dental - Other, Dentist, Nurse, Nurse Practitioner, Pediatric Dentistry, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Number of Source Documents: 64

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: No

Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions

Recommendations

In vital primary teeth with deep caries lesions requiring pulp therapy, is one particular therapy (IPT, DPC, pulpotomy) more successful than others?

In vital primary teeth treated with indirect pulp treatment (IPT) due to deep caries lesions, does the choice of medicament affect success?

In vital primary teeth with deep caries lesions treated with DPC due to pulp exposure (one mm or less) encountered during carious dentin removal, does the choice of medicament affect success?

In vital primary teeth with deep caries lesions treated with pulpotomy due to pulp exposure during caries removal, does the choice of medicament or technique affect success?

GRADE Strength of Recommendations and Implications

Document Overview

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology