Being vital or “alive” is the optimal state for a tooth’s health. The vital part of the tooth is the pulp, responsible for internal health and the tooth’s response to injury and disease. A live tooth can adeptly navigate life’s challenges, evolving over time into a stronger and more resilient structure. A procedure called a vital pulpotomy is sometimes performed to keep a damaged tooth alive.
Instances Necessitating Vital Pulpotomy
Trauma to a tooth, especially fractures that expose the pulp, places the pulp in immediate danger of dying. In such cases, a vital pulpotomy becomes an emergency procedure, offering the only course of action to save the pulp. Timing is paramount, and the treatment must be administered within a small window, mostly within 48 hours from the injury.
Another scenario prompting a vital pulpotomy is when dental professionals deliberately cut the teeth themselves, exposing the pulp. This is commonly performed during procedures like crown height reduction.
The Procedure
- Treatment of the Pulp: A vital pulpotomy involves treating the pulp and applying protective layers of material to seal and shield it from external influences.
- Pulp Amputation: A small amputation is performed on the damaged portion of the pulp.
- Application of Biocompatible Material: A special biocompatible material is applied to the surface of the pulp, sealing the opening and stimulating the pulp to initiate the creation of new tooth material.
- Layered Restoration: Over this initial layer, two more restorations (fillings) are placed to complete the sealing process, providing a surface capable of withstanding the rigors of being in the oral environment.
Monitoring and Assessment
Regular assessments, facilitated by dental radiographs, are crucial to monitor the tooth’s development. These radiographs reveal the internal development of new tooth material, indicating the survival of the pulp after exposure trauma. Continuous dental radiographs are necessary throughout the pet’s life to ensure the ongoing health of the tooth.
Potential Outcomes
Despite timely and controlled vital pulpotomies, not all pulps will survive. Sometimes, trauma, whether from fractures or height reductions, can lead to pulp death despite treatment. The failure rate for a vital pulpotomy, even when performed under controlled conditions, is approximately 5%. In the event of a failure, where the pulp dies, additional treatments will be required to address the situation.