Vital pulp therapy for permanent molars
Received: 13 July 2017 / Accepted: 9 August 2017 / Published online: 31 August 2017
Ó Springer International Publishing AG 2017
Abstract Guidelines for vital molar therapy are presented based on best available
evidence. Often the cause for vital intervention is due to caries, but the depth of the
carious lesion is seldom mentioned in the literature, which may hamper the eval-
uation of prognosis following treatment. In this paper, the deep and extremely deep
carious lesion is deﬁned and linked to speciﬁc treatment protocols which include
both direct pulp capping, pulpotomy and less invasive carious removal procedures.
Direct pulp capping is divided into Class I: the pulp capping is made by accident; or
Class II: the capping procedure is expected and the set-up for the vital pulp therapy
includes the use of magniﬁcation and illumination. Indications are presented for
Keywords Caries Á Dentin Á Permanent teeth Á Pulp capping Á Stepwise
excavation Á Guidelines
Vital pulp therapy is initiated to preserve and maintain the pulp tissue in a healthy
state that has been compromised by caries, trauma or restorative procedures.
Before performing vital pulp therapy in a molar, two points should be considered
by the clinicians:
• How invasive a treatment needs to be in fulﬁlling the aims of preserving and
maintaining the pulp tissue in a healthy clinical condition.
• Whether the chosen modality is a permanent or temporary treatment solution.
& Lars Bjørndal
Section of Cariology and Endodontics, Department of Odontology, Faculty of Health and
Medical Sciences, Universitet of Copenhagen, Copenhagen, Denmark
Clin Dent Rev (2017) 1:9