Endodontics as a Biological Paradigm: Life-Preserving Pulp Therapy and the Transformation of Clinical Practice

The paradigm of modern endodontics is shifting: if previously a tooth with irreversible pulpitis caused by deep caries almost inevitably faced pulp extirpation, today clinicians are increasingly turning to minimally invasive techniques that preserve pulp viability. This very shift concentrates the attention of the international forum Endo Sapiens, which in October will gather endodontists and researchers in Berlin.

Biology as the foundation of clinical practice

The initiator and scientific director of Endo Sapiens, Dr. Domenico Ricci, an authoritative endodontist and scientist, sees the main disconnect between biological evidence and current practice in the fact that most clinicians, regardless of experience, focus primarily on technique, materials, and procedures. Meanwhile, what is fundamental is overlooked: normal tissue physiology, the development of pathological processes, the biological response of the pulp to microbial aggression in caries.

«We try to preserve as much healthy tissue as possible,» formulates Ricci the principle that underlies modern minimally invasive dentistry. Instead of the traditional approach (complete pulp extirpation in irreversible pulpitis), vital pulp therapy procedures are offered: direct pulp capping, partial pulpotomy, complete pulpotomy. Each of these methods allows preservation of vitality in at least part of the pulpal tissue.

Practical training with a biological foundation

At the October forum, Ricci will conduct a master class on vital pulp therapy. The main difficulty in training is the impossibility of fully reproducing the clinical situation on phantoms: a living tooth bleeds and contains living pulpal tissue. To overcome this obstacle, special models have been developed that simulate pulpal tissue and bleeding, allowing demonstration of procedures using modern bioceramics materials.

Textual resource

The two-volume textbook published by Ricci «Vital Pulp Therapy and Clinical Endodontics: A Biological Approach» (published in English, Spanish, and Russian) begins with laboratory techniques for preparation and histological examination of teeth and periapical tissues. This approach allows demonstration of tissue morphology at the cellular level, and the subsequent chapters logically transition from the biology of normal tissue to the response to caries and, finally, to the treatment of deep caries with step-by-step description of each vital pulp therapy procedure.

The forum Endo Sapiens was first held in Rome in 2022; the third edition in Paris gathered almost 600 participants from 61 countries. The independence of the program from commercial influence remains the cornerstone of the project — this is precisely what attracts clinicians seeking objective scientific information.

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