The Dental Pulp Cap and Pulpotomy: Healing Procedures or Just Plain Magic?

Abstract

Mesenchymal stem cells in the dental pulp are multi-potent progenitors with the ability to differentiate into many different cell types including odontoblasts that function in the formation of reparative (secondary) dentin. However, reparative dentin is a two-edged sword to the pulp; it is necessary to ‘wall-off’ a pulp exposure or pulpotomy, but at the same time, it compresses the pulp in its finite living space causing inflammatory and necrotic changes. Unlike vital pulp therapy, root canal treatment is like a tombstone for a tooth’s retention in the mouth. The root canal tooth loses both vitality and function. Lost are the dental defense mechanisms of proprioception, sensitivity, anti-desiccation, and the buffering/dampening quality of a vital, living, bodily organ. Examination of the histological status of pulpal tissue can reveal the inflammatory status of the pulp, but microscopic findings cannot be directly correlated to clinical status or healing potential. Vital pulp therapy is a conservative approach to tooth retention and dental life; it is easier, more concise, and less expensive than root canal treatment.

Keywords: Vital pulp therapy, pulp cap, pulpotomy, calcium hydroxide, mineral trioxide aggregate (MTA)

Cite this Article:

Paul J. Flaer_, Ana Maria Mejia, Seng Kyu Choi, et al. The Dental Pulp Cap and Pulpotomy: Healing Procedures or Just Plain Magic? Research and Reviews: Journal of Dentistry (RRJoD). 2015; 6(1): 8–13p