Short-Term Efficacy of Vitapex Paste in Single-Visit Root Canal Treatment for Acute Irreversible Pulpitis: A Retrospective Cohort Study.

BACKGROUND

The selection of root canal obturation material is critical for the successful management of acute irreversible pulpitis. Vitapex, an iodoform-calcium hydroxide-based paste, possesses recognized antimicrobial and biocompatible properties. However, comprehensive evidence comparing its efficacy in single-visit root canal treatment against the conventional gutta-percha/zinc oxide-eugenol (ZOE) sealer combination remains relatively limited.

OBJECTIVE

To compare the clinical efficacy of Vitapex paste versus gutta-percha/ZOE sealer in single-visit root canal treatment for acute irreversible pulpitis.

METHODS

In this single-center retrospective cohort study, clinical data from 112 patients with acute irreversible pulpitis who underwent single-visit root canal therapy between April 2022 and August 2024 were analyzed. Patients were allocated into two groups based on the obturation material: the Vitapex group (n=56), obturated with Vitapex paste, and the gutta-percha/ZOE group (n=56), obturated using the cold lateral compaction technique with gutta-percha points and ZOE sealer. Key outcome measures included time to pain relief, time to swelling resolution, time to return to normal masticatory function, Visual Analogue Scale (VAS) scores, bite force, chewing efficiency, levels of inflammatory factors (hs-CRP, IL-6, TNF-α), periodontal health indices (Bleeding Index-BI, Plaque Index-PLI, Probing Depth-PD), and the incidence of adverse reactions.

RESULTS

The Vitapex group showed significantly shorter recovery times for pain relief, swelling resolution, and return to normal function (all P<0.001), significantly lower VAS scores at 1 and 4 weeks (P<0.05), and greater improvements in masticatory function at 4 weeks (P<0.05). Inflammatory markers and periodontal health indices improved more significantly with Vitapex (all P<0.001). The adverse reaction rate was lower with Vitapex (5.4% vs 12.5%), though not statistically significant (P=0.325).

CONCLUSION

Vitapex demonstrates superior outcomes in single-visit treatment for irreversible pulpitis, offering faster recovery, better pain control, improved function, and reduced inflammation compared to gutta-percha/ZOE, making it a valuable clinical alternative.