Pulp preservation
Pulp exposure risk, symptoms and restorability guide caries management and vital pulp therapy. The seal and follow-up are central.
Understand
Vital pulp therapy aims to preserve a healthy or recoverable pulp. Symptoms, exposure circumstances, contamination and the ability to seal the tooth shape prognosis.
Assess
Differentiate reversible from irreversible disease using history, tests and imaging, while recognising imperfect tests. Check whether caries removal can be staged or selective without compromising the seal.
Apply
Use appropriate asepsis, a suitable biocompatible material and a durable coronal restoration. Explain that follow-up is essential and further treatment may still be needed.
Key distinctions
Pulpal inflammation exists on a continuum, while clinical categories simplify decisions. Pain history and tests estimate rather than directly reveal histology. A vital pulp treatment succeeds only if contamination is controlled and the restoration seals. The patient needs a clear plan for symptoms that recur and radiographic review when indicated.
Think through a case
A deep lesion is treated conservatively and sealed, but the patient develops spontaneous lingering pain months later. Reassessment may change the pulpal diagnosis.
The distinction to remember
Do not promise pulp preservation will always avoid root canal treatment; explain uncertainty and follow-up at consent.
Test your recall
Why does a good coronal seal matter?
Show answer
It limits bacterial leakage and supports pulpal recovery.