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Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2026, vol. 32, issue2
Subject Area: Dental Medicine
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DOI: 10.5272/jimab.2026322.6893
Published online: 05 June 2026
Cases report
J of IMAB. 2026 Apr-Jun;32(2):6893-6900
ASSESSING PULP EXPOSURE AND DENTIN FOR SELECTING VITAL PULP THERAPY: A CLINICAL CASE SERIES
Janet Kirilova1
, Dimitar Yovchev2,
1) Department of Conservative Dentistry, Faculty of Dental Medicine, Medical University, Sofia, Bulgaria.
2) Department of Imaging and Oral Diagnostics, Faculty of Dental Medicine, Medical University, Sofia, Bulgaria.
ABSTRACT:
Material and Method: Twenty-four patients with a diagnosis of reversible pulpitis or asymptomatic irreversible pulpitis were treated. The treated teeth were 16 molars, seven premolars, and one incisor. The chosen treatment method was direct pulp capping. All patients signed informed consent.
Results: Depending on the diagnosis, success is reported for the application of direct pulp capping in patients diagnosed with reversible pulpitis at 90.9% success (10/11), and in patients diagnosed with asymptomatic irreversible pulpitis: 76.9% success (10/13). Size of the pulp exposure. A decreasing success rate is observed with increasing exposure size: <1 mm: 100% (11/11); 1–1.5 mm: 75% (3/4); 1.5–2.5 mm: 66.7% (6/9).
Conclusion: Detailed assessment of the pulpal communication and adjacent dentine is critical for selecting the appropriate treatment. Examination under magnification enables objective evaluation of tissue changes. The autologous platelet concentrates A-PRF+ combined with a calcium-silicate cement performed well, particularly in small communications with clean, sound peripheral dentine. When hemostasis is difficult or necrosis is suspected, pulpotomy or pulpectomy is preferable.
Keywords: vital pulp therapy, direct pulp capping; autologous platelet concentrates, A- PRF, pulp communication, chemical-mechanical removing of infected dentin, ozone,
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Please cite this article as: Kirilova J, Yovchev D. Assessing Pulp Exposure and Dentin for Selecting Vital Pulp Therapy: A Clinical Case Series. J of IMAB. 2026 Apr-Jun;32(2):6893-6900. [Crossref - 10.5272/jimab.2026322.6893]
Correspondence to: Janet Kirilova, Department of Conservative Dentistry, Faculty of Dental Medicine, Medical University, Sofia; 1, Georgi Sofiiski Str., Sofia, Bulgaria; E-mail: janetkirilova@gmail.com
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Received: 22 October 2025
Published online: 05 June 2026