Vital Pulp Therapy

This procedure is performed to keep the root canal system of a tooth with direct pulp exposure alive. It is a common practice for fractured teeth in human children, however is rarely performed for fractures in veterinary patients.

This procedure is performed to keep the root canal system of a tooth with direct pulp exposure alive. It is a common practice for fractured teeth in human children, however is rarely performed for fractures in veterinary patients.

The main indication for this procedure in veterinary patients is following crown reduction (lowering the height of the crown of the tooth).  This is typically due to an orthodontic condition (malocclusion) which is causing a tooth to cause trauma to either another tooth or the oral soft tissues.  This is most common in cases of overbites, where the lower canines will contact the palate and cause painful ulcers and may even create a hole into the nasal cavity.  In addition, certain oral surgeries may result in self-trauma, including:

  • extraction of the upper canine tooth (especially in cats)
  • a major oral cancer surgery
  • A misaligned jaw fracture

For these reasons we try to avoid extractions of upper canines in cats.  In addition, having a veterinary dentist perform jaw fracture fixation reduces the risk of post-operative malocclusion.  Finally, when this trauma is a unavoidable result of the planned surgery, a veterinary dentist will generally perform the procedure during the same anesthesia as the surgery.

When properly performed on teeth which were intact prior to crown reduction, this procedure has an excellent (nearing 100%) long term success rate. 

This procedure was once commonly performed for fractured teeth in dogs and cats.  However recent studies (including one by Dr. Niemiec) has shown that the long term success rate for this procedure is poor, especially if it not performed within a day or two.  Root canal therapy has an excellent long term success rate and therefore is recommended in almost cases of tooth fracture with direct nerve (or root canal) exposure.  The exception to this is in young patients.  This is because in young pets (under 12-18 months depending on breed) the tooth is not yet mature enough to accept a root canal.  In these cases, this procedure can be performed in order to allow the tooth to mature to the point of accepting a root canal in the future.

The vital pulp therapy procedure consists of removing a small amount of the nerve (generally 5-7 mm) with a sterile headpiece.  Following this, the living root canal is medicated with a product called mineral trioxide aggregate (MTA). This medicant stimulates the tooth to lay down a protective layer of tooth structure called dentin.  Following this, a layer of a restorative called glass ionomer is placed on top of the MTA to seal the tooth from the oral cavity, thus protecting the root canal from oral bacteria.  Finally, a composite restoration (white filling) is added on top to provide an esthetic and strong restoration.

Contact Us

Are you concerned about your pet's dental condition or injury?

We have locations in California, Las Vegas and the Gulf Coast, and look forward to helping schedule your pet's appointment. 

Find a Location