One of my favorite things to teach in my online course “E-school” is MTA Vital Pulp Therapy. I believe that every dentist should know how to do this. It is such a service for your patients! It works really well on pediatric patients, but did you know that it can work for your adult patients, too?
I want to show you a classic example of when MTA Vital Pulp Therapy works best.
MTA Vital Pulp Therapy Saves the Day: A Tooth Story
This patient is young, only 12 years old, and has decay into the pulp, with no real symptoms. Her tooth responded normally to cold, with no lingering pain and had no pain to percussion. To me, this is the ideal patient for MTA Vital Pulp Therapy.
A root canal is the last thing I want to do because I want to keep that pulp alive. Why? The National Boards had a question about this:
Q: What is the function of the pulp?
A: To lay down dentin.
The pulp is responsible for forming the root and completing the closure of those apices!
I started by numbing her up, then I removed the temporary filling and right underneath, the pulp was exposed.
I obtained hemostasis with a cotton pellet soaked in sodium hypochlorite and placed my MTA right on top of the pulp.
I covered the MTA with Vitrebond (you can use TheraCal, too, whatever you’ve got).
Then restore as usual and take a final radiograph like you see here:
For me, follow up is key for cases like these. She just came back for her 1 month check up in this next image:
Now, I know that I am not going to see much change in the root, but I want to make sure that she doesn’t have any symptoms. She still felt cold, which I want, and she has no pain to percussion.
From this point forward, follow up is the key. You want to continue to monitor for symptoms, root formation and a vital pulp at every recall. So make sure you are always performing a cold test at these follow ups. It’s SO important.
MTA Vital Pulp Therapy Is for Adult Patients, Too.
Did you know that MTA vital pulp therapy can also be used for adult teeth? Here’s when you know when to consider it:
Do you ever have that adult patient come in, where they have deep decay and no preoperative symptoms? But then you start to excavate that decay, and you expose that pulp? Bummer, right?
Well, do you have to condemn that tooth to a root canal and crown? Or could an MTA vital pulp therapy be the right treatment choice for them? Most people try to do an indirect pulp cap in these situations when they start to approach the pulp, but MTA directly on the pulp, in my opinion, is the better option.
MTA is so biocompatible that it works wonders in a situation like this—yes, even on adult teeth. The goal is to make sure all the decay (AKA the bacteria) has been removed. Only then will you have a successful treatment.
So throw away that dycal and start getting some experience with this type of procedure. It will definitely help your patients, plus you’ll be able to make more revenue for your practice with an additional procedure.
(Reminder: there are some limitations for this procedure. If your patient has preoperative symptoms, it probably won’t work, and they’ll most likely need a root canal. So make sure you properly inform your patient of all the potential consequences. Communication is always key! Patients really appreciate it when you make sure they’re informed.)
If you want to learn more about MTA Vital Pulp Therapy and how to incorporate it into your practice, check out E-School, where I go over it in great detail so you can provide this procedure successfully in your practice. It is so easy to do!!