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What is Vital Pulp Therapy?

 

Vital pulp therapy (VPT) is a treatment that aims to preserve and maintain tooth structure as an alternative to extraction or root canal therapy. Through the use of sterile instruments, vital pulp therapy removes a small amount of pulpal tissue, followed by placement of a pulp dressing, cement and restoration. VPT allows the tooth to remain alive and mature as an alternative to extraction. This procedure is commonly referred to as pulp cap placement. 

 

Figure 1. Mandibular canine tooth treated with vital pulp therapy

 

When is A Pulp Cap Placement Necessary? 

 

In veterinary dentistry, the most common uses of vital pulp therapy include acute trauma of teeth with pulp exposure, teeth with near pulp exposure, and select malocclusions. Tooth trauma is unfortunately common in companion dogs and is often the result of inappropriate chew toys or aggressive chewing behavior. 

In many cases, a broken tooth has pulp exposure. If the trauma is recent (less than a 24-hour duration), vital pulp therapy may be elected to allow the tooth to remain alive. This is particularly important in young patients that may have immature teeth.

Near exposure occurs when the pulp is not actively exposed. There is still a very thin layer of dentin covering the pulp, however, the tooth is very susceptible to irreversible pulpitis.

Vital pulp therapy is additionally used as an orthodontic procedure in cases of linguoverted (tipped towards the inside of the mouth) mandibular canines. If the lower canines contact the hard palate, this is painful and may cause oronasal fistula formation.

Oronasal fistulas are abnormal communications between the oral cavity and nasal passages that lead to chronic upper respiratory infections. By performing crown reduction and vital pulp therapy on the mandibular canines, a pain-free occlusion is attained without losing these functionally important teeth through extraction. Treatment of the pulp is necessary to protect the exposed pulpal tissue and to ensure the tooth remains vital (alive). 

 

                    

Figure 2. Linguoverted (tipped inward) mandibular canine tooth                            Figure 3. Palatal trauma from painful occlusion

 

What To Expect After Pulp Capping

 

Patients who receive vital pulp therapy should have a follow-up, anesthetized exam in 6 months to ensure the procedure remains successful. Vital pulp therapy is successful in most cases with a greater than 90% success rate. It is an excellent option for preserving tooth structure and, more importantly, function.

 

Board Certified Veterinary Dentist in Colorado Springs

 

At Animal Dental Care and Oral Surgery, we believe every dog and cat is entitled to a pain-free and functional bite. Vital pulp therapy is one of the many ways we can help our patients attain this. If your furry companion is in need of a dental procedure or an annual cleaning (COHAT), give us a call today! 



Photo by Tommy Lucena Villar on Unsplash (8/28/2020)

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