Vital pulp therapy (VP) is the treatment of the tooth pulp with the intention of keeping it alive (i.e. "vital"). This differs from root canal treatment in which the pulp, the living part of the tooth, is completely removed.
VP is restricted to specific conditions:
- For juvenile patients in which the injured tooth has not yet reached full maturity. VP is a temporary measure to buy time for the tooth, until permanent root canal treatment may be provided.
- For certain orthodontic abnormalities in which adjusting the height of the tooth is elected. When a tooth is shortened in height, the pulp is exposed and must be protected. VP protects the pulp to keep the tooth alive and functional.
- In limited cases of very recent tooth fracture, VP can be performed. Ideally VP should be reserved for patients less than 2 years of age and pulp exposures of less than 48 hours duration.
Vital pulp therapy is performed in as close to a sterile fashion as possible A superficial layer of the pulp is removed ("freshened") to remove surface bacteria and unhealthy inflamed tissue. A medicated pulp dressing is then placed directly on the newly exposed pulp to stimulate healing and provide anti-bacterial properties. Finally, a protective barrier of dental composite is placed - similar to what a dentist would fill a cavity with in people.
As with any endodontic treatment, follow-up x-rays are needed approximately 6 months after a procedure to determine successful versus unsuccessful outcome.