pulp fiction: vital pulp therapy in vet dentistry
Vital pulp therapy (VPT) has been practiced for a long time, and is a very common procedure in pediatric human dentistry for fractured deciduous (baby) teeth. It can also be used in veterinary dentistry.
Teeth are roughly made up of three layers: enamel, dentin, and pulp. The innermost layer is the endodontic system, or pulp. It contains the nerves, blood vessels, and connective tissue which supply and nourish the tooth during life.
Vital pulp therapy aids in the treatment of a number of dental conditions:
1. Traumatic malocclusions
Orthodontic problems where the teeth are causing pain/trauma to the patient. Vital pulp therapy is a good alternative to removing a dog’s lower canine teeth entirely. Extraction of the lower canines is less than ideal due to the large size of these teeth and their importance in chewing and tongue retention.
Vital pulp therapy helps preserve the vitality of the pulp in fractures of immature permanent teeth (under 18 months of age). VPT was once an accepted treatment for fractures of mature teeth, but is rarely performed anymore because the success rate of standard root canal therapy is much greater for adult teeth.
3. Disarming procedures
Vital pulp therapy can be used to lower the height of canine teeth in aggressive animals (both canine and feline). Crown reduction and vital pulp therapy of the mandibular canine teeth is also effective in treating lip catching in cats following upper canine extraction.
How Vital Pulp Therapy Works
If your veterinary dentist recommends vital pulp therapy for your pet, here are the basic steps of the procedure:
1. Crown reduction is performed and a small amount of the pulp is removed.
2. A dental material called mineral trioxide aggregate (MTA) is applied to form a protective seal over the exposed pulp.
3. The tooth’s walls are cleaned with slightly moistened paper points.
4. An intermediate layer of glass ionomer (a dental cement) is placed over the MTA and light cured.
5. A bonding agent is then applied over the glass ionomer and light cured.
6. Composite restorative material is layered on top of the bonding agent and light cured.
7. The restorative is over-sealed with unfilled resin to fill any micro cracks.
Once the procedure is complete, your veterinarian will take a post-operative dental radiograph to ensure proper placement of all materials. Follow-up monitoring is a key component of this procedure, so be sure to keep all post-op appointments. An examination at 7-14 days post-operative is typical, as well as long term radiographic monitoring at 6-12 month intervals.
If any problems show up on the radiographs, your veterinarian will be able to address them either through further treatment of the pulp or extraction of the affected teeth.