Clinical outcomes of vital pulp therapy versus root canal treatment in immature permanent teeth with pulpal involvement: a meta-analysis

By
Siji Gu
Yuyun Yang
May 20, 2026
0 min

Frontiers In Pediatrics

Overview

Revise to include statistical significance and clinical implications of findings.

Background

Dental caries is a leading cause of pulpal pathology in children, necessitating effective treatment strategies. Traditional root canal treatment, while effective in managing irreversible pulpitis, often compromises the vitality of the pulp and can hinder the natural development of immature teeth. Vital pulp therapy offers a biologically conservative alternative that may preserve pulp vitality and promote continued root development.

Data Highlights

Outcome	VPT	RCT
Overall Success Odds Ratio	1.37 (95% CI: 1.06–1.78)	79%–98%
Success in Immature Teeth	3.01 (95% CI: 1.43–6.33)	N/A
Complete Pulpotomy Success	2.47 (95% CI: 1.11–5.51)	N/A
Follow-up ≥24 months	2.03 (95% CI: 1.21–3.41)	N/A

Key Findings

VPT showed significantly higher odds of overall success compared to RCT (pooled OR = 1.37).
Marked benefits of VPT were observed in immature teeth (OR = 3.01).
Complete/coronal pulpotomy had an odds ratio of 2.47 for success.
Follow-up duration of ≥24 months was associated with an odds ratio of 2.03 for VPT success.
Bioceramic-based VPT achieved near-complete success in randomized trials.

Clinical Implications

Clinicians should consider VPT as a first-line treatment for immature permanent teeth with pulpal involvement due to its favorable outcomes. The preservation of pulp vitality through VPT may enhance the potential for apexogenesis and reduce the need for more invasive procedures like RCT.

Conclusion

VPT demonstrates promising long-term outcomes compared to RCT in immature permanent teeth, although further research is needed to confirm these findings and establish definitive treatment protocols.