Vital and Non-Vital Pulp Therapy

Question 1

Options for vital vs nonvital pulp therapy:

Answer 1

Vital pulp therapies = indirect pulp cap, direct pulp cap, partial (Cvek) pulpotomy, pulpotomy, apexogenesis

Non-vital pulp therapies = pulpectomy, root canal therapy, apexification, extraction

Question 2

material that can stimulate mesenchymal cells to differentiate into secondary odontoblasts, which will create a dentin bridge (tertiary dentin) as a barrier to protect pulp

Answer 2

calcium hydroxide

Question 3

material that stimulates cementoblasts to make hard tissue

Answer 3

MTA (mineral trioxide aggregate)

Question 4

Contents of MTA:

Answer 4

• calcium, silicon, and aluminum
• bismuth oxide (opacifier) = RO, but can leak and stain tissue

Question 5

Properties of MTA:

Answer 5

• can set in moisture
• 3h setting time
• nonresorbable and biocompatible (good sealant)
• antimicrobial

Question 6

Indirect vs direct pulp cap

Answer 6

Indirect pulp cap
- indicated for deep caries, pulp is healthy and not exposed
- dentin covering pulp lined with calcium hydroxide or RMGI

Direct pulp cap
- indicated for healthy pulp that is exposed from caries (<2mm) or trauma (within 24h)
- calcium hydroxide placed directly on top of exposed pulp, hard tissue barrier can form as early as 6 weeks