Abstract: PURPOSE: To explore the efficacy of pulp capping in the preservation of vital pulp in young permanent teeth and to analyze the factors influencing treatment failure. METHODS: A total of 284 patients who underwent pulp preservation surgery for young permanent teeth at the Affiliated Hospital of Army Medical University Cadet School from August 2023 to November 2024 were selected. The patients were divided into direct pulp capping group (142 cases) and indirect pulp capping group (142 cases) based on the pulp exposure status during operation. The postoperative treatment effects and adverse reactions/complications of the two groups were compared, and univariate and multivariate logistic regression analyses were used to investigate the influencing factors of treatment failure. RESULTS: The success rates of pulp preservation treatment for young permanent teeth in the direct pulp capping group and the indirect pulp capping group were 88.03% (125/142) and 90.14% (128/142), respectively. The overall treatment success rate was 89.08% (253/284), with a treatment failure rate of 10.92% (31/284). The incidence rates of adverse reactions/complications in the young permanent teeth pulp preservation treatment between the direct pulp capping group and the indirect pulp capping group were 9.15% (13/142) and 7.75% (11/142) respectively. Comparison of age, sex, damaged site, whether there was significant bleeding from the pulp, patient compliance, whether root development was complete, and postoperative oral hygiene between patients with successful treatment and those with failure showed no significant differences (P>0.05). The percentage of caries-derived pulp exposure, the percentage of moderate-to-severe pulp infection, and the percentage of pulp capping agents that did not fit tightly to the pulp were higher in patients with treatment failure than in patients with treatment success (P<0.05). Caries-derived pulp exposure, moderate-to-severe pulp infection, and lack of tight fit between the capping agent and the pulp were all factors influencing the failure of pulp capping in the treatment of living pulp preservation in young permanent teeth, as analyzed by a multifactorial logistic regression model (P<0.05). CONCLUSIONS: Pulp capping is efficacious in the treatment of living pulp preservation in young permanent teeth. Caries-derived pulp exposure, moderate-to-severe pulp infection, and lack of a tight fit between the capping agent and the pulp are influential factors affecting the failure of pulp capping.

Key words: Direct pulp capping, Indirect pulp capping, Live pulp preservation in young permanent teeth, Caries-derived pulp exposure, Pulp infection