Perform vital pulp therapy

Vital pulp therapy, endorsed by the American Association of Endodontists,(1) preserves pulp vitality. In cases set for root canal, pulp maintenance is viable, retaining natural structure, sensation, and response via reparative dentin. Procedures include direct/indirect pulp capping, partial/complete pulpotomy.

What you need to know


average success rate of pulpotomies after irreversible pulpitis with Biodentine

The right solution, step by step


Cavity preparation & pulpotomy

Removal of caries and inflamed pulp tissue is critical. If a pulp exposure occurs, hemorrhagic pulp tissue can be gently removed with a round diamond bur with water irrigation. It is not always necessary to perform a full pulpotomy!


Direct examination of the pulp

If the pulp appears vital and intact, and bleeding is well-controlled within 5 minutes (hemostasis) (2), vital pulp therapy can be performed.


Pulp coverage & dentin restoration

Biodentine XP may be placed in direct contact with the pulp. Bio Bulk Fill is possible – Biodentine serves as a dentin replacement material. It can be placed all the way to the occlusal surface (for up to 6 months) (3). An enamel restoration may be placed at the same appointment or a future appointment.


Follow-up and monitoring

As with all patients, follow-up is important. Check for pulp vitality (response to cold and/or electricity) at future appointments. Remember, it is not necessary to wait to place the composite or core build-up—this should be performed on the same day as the pulp exposure, to prevent contamination of the pulp.


Final enamel restoration (second session)

If the provider chooses to place the enamel restoration (such as composite or a crown) at a 2nd appointment, Biodentine can be prepped and treated like natural dentin!


Long-term follow-up

(1)AAE Position Statement on Vital Pulp Therapy. 2021 (2)AAE Position Statement on Vital Pulp Therapy. 2021 (3)Koubi et al. Clinical evaluation of the performance and safety of a new dentine substitute, Biodentine, in the restoration of posterior teeth — a prospective study. Clin Oral Investig. 2013

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