Development of a Core Outcome Set for Endodontics (COS-ENDO). Part 4: COS-ENDO for Studies of Vital Pulp Therapy in Permanent Teeth.

Introduction: Methodological heterogeneity and reporting bias complicate interpreting endodontic outcomes. Supported by the American Association of Endodontists (AAE) and its Foundation, this study developed the Core Outcome Set for Endodontics (COS-ENDO) to standardize reporting for studies of Nonsurgical Root Canal Treatment/Retreatment, Surgical Endodontics, Vital Pulp Therapy, Apexification, and Regenerative Endodontics. This manuscript, Part 4 of a 5-part series, focuses on COS-ENDO for Vital Pulp Therapy, while other parts address the remaining treatments.
Methods: Outcomes were identified through a scoping review and a web-based survey of AAE practicing members. In a two-round Delphi survey, clinicians, patients, and researchers rated outcomes on a 9-point scale. Ratings were assessed against consensus criteria, and a virtual meeting finalized COS-ENDO.
Results: Of the 97 invited participants to Round 1, 77 registered, and 73 (24 Academicians/Researchers, 26 Clinicians, and 23 Patients or their parents/caregivers) assessed 46 outcomes, with 17 excluded. The remaining outcomes-4 achieving consensus for inclusion and 25 lacking consensus-advanced to Round 2 for re-rating by 70 participants. This resulted in 10 outcomes achieving consensus for inclusion, and 19 lacking consensus. In the final meeting, 16 participants finalized the COS-ENDO for Vital Pulp Therapy studies, including Tooth survival, Pain, Signs of infection, Radiographic evidence of maintained periradicular health, Continued root development, Success, Functional tooth, Need for further intervention, and Adverse events/Complications.
Conclusion: COS-ENDO is an important step in standardizing outcome reporting in endodontics, ensuring consistent reporting and enhancing research utility. Further efforts are needed to establish optimal measurement methods.
Competing Interests: Conflict of interest statement The authors and the steering committee members deny any conflict of interest related to this study. We affirm that we have no financial affiliation (e.g., employment, direct payment, stock holdings, retainers, consultantships, patent licensing arrangements or honoraria), or involvement with any commercial organization with direct financial interest in the subject or materials discussed in this manuscript, nor have any such arrangements existed in the past three years.
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