[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Dentistry](https://durgical.com/en/dentistry/) › [Endodontics](https://durgical.com/en/dentistry/areas/endodontics/) › Vital pulp therapy: pulp capping and pulpotomy # Vital pulp therapy: pulp capping and pulpotomy - Procedure A pulp that is still alive can often be saved, in part or whole, instead of a full root canal. The keys: clean pulp, bleeding controlled, a perfect seal. Updated Nov 12, 2026 ## Key points - Indirect cap, direct cap, partial and full pulpotomy. - Haemostasis tells you the pulp is healthy. - Calcium silicate cement and a perfect seal. ## What it is Vital pulp therapy keeps the pulp, or the healthy part of it, alive. It ranges from leaving dentine over the pulp (indirect capping), to covering a small exposure (direct capping), to removing the inflamed top of the pulp (partial pulpotomy) or the whole pulp chamber (full pulpotomy). Calcium silicate cements have made these treatments more predictable, and pulpotomy is now also used for some mature teeth with irreversible pulpitis. ## Indications and contraindications - Indicated for a vital pulp: reversible pulpitis, a small exposure during caries removal or trauma, and selected cases of irreversible pulpitis (pulpotomy). - Not suitable for necrotic pulps, pulps that will not stop bleeding, or teeth that cannot be restored and sealed. - Stopping the bleeding within a few minutes of irrigation with sodium hypochlorite suggests the remaining pulp is healthy. - Rubber dam isolation is essential: saliva contamination of an exposed pulp worsens the outcome. - Young teeth with open apices respond best: keeping the pulp alive lets the root keep growing. ## How it is done - Confirm a vital pulp (history, cold test) and a restorable tooth; give anaesthesia and place a rubber dam. - Remove caries, selectively over the pulp; disinfect the cavity. - If the pulp is exposed, remove the inflamed tissue to the depth needed (cap, partial or full pulpotomy). - Control bleeding with sodium hypochlorite on a pellet; if it will not stop, go deeper or move to root canal treatment. - Cover the pulp with a calcium silicate cement, then seal with a liner and a definitive restoration. - Review symptoms, vitality and the radiograph over the following months and years. ## Complications and pitfalls - Failure shows as pain, loss of vitality or apical radiolucency, and then needs root canal treatment. - Calcium hydroxide works but dissolves and leaves tunnel defects in the dentine bridge; calcium silicates seal better. - Some calcium silicate cements can stain the tooth grey, which matters in front teeth. ## Next step / Initial management - Deep caries in a vital tooth without lingering pain: selective removal and sealed restoration, or vital pulp therapy if exposed. - Pain that lingers or a pulp that will not stop bleeding: refer to the dentist or endodontist for pulpotomy or root canal treatment. - Follow-up: cold test and radiograph at the review visits. ## Test yourself Think of the answer, then tap the question to see it. ## What does it suggest if a pulp exposure stops bleeding within a few minutes? That the remaining pulp tissue is likely healthy enough to be kept. ## What is a partial pulpotomy? Removal of the superficial inflamed pulp under an exposure, leaving the rest of the coronal and root pulp alive. ## Why are young teeth with open apices good candidates? Their pulps heal well, and keeping them alive lets the root keep developing. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/dentistry/vital-pulp-therapy-pulp-capping-and-pulpotomy/) ## Connections ## Related 4 - [Liners, bases and protecting the pulp](https://durgical.com/en/dentistry/liners-bases-and-protecting-the-pulp/) - [Pulpitis: reversible or irreversible](https://durgical.com/en/dentistry/pulpitis-reversible-or-irreversible/) - [Endodontic diagnosis: naming pulp and apical disease](https://durgical.com/en/dentistry/endodontic-diagnosis-naming-pulp-and-apical-disease/) - [Immature teeth: apexification and regenerative endodontics](https://durgical.com/en/dentistry/immature-teeth-apexification-and-regenerative-endodontics/) ## Related conditions 1 - [Dental caries](https://durgical.com/en/conditions/dental-caries/) [← All of dentistry](https://durgical.com/en/dentistry/) Educational content; it does not replace assessment by a dentist or doctor and is not a clinical instruction. For facial or neck swelling with difficulty swallowing or breathing, a knocked-out tooth or bleeding that will not stop, go to an emergency department at once. Sources: [Current and future options for dental pulp therapy](https://pmc.ncbi.nlm.nih.gov/articles/PMC6354285/) (Japanese Dental Science Review (PMC open access), 2019); [Dental Materials: Biodentine, a Calcium Silicate Bioactive](https://www.ncbi.nlm.nih.gov/books/NBK599506/) (StatPearls Publishing (NCBI Bookshelf), 2024); [Biological Characteristics and Odontogenic Differentiation Effects of Calcium Silicate-Based Pulp Capping Materials](https://pmc.ncbi.nlm.nih.gov/articles/PMC8399810/) (Materials (Basel) (PMC open access), 2021); [Guiding Caries Removal Through Biological Principles: A Narrative Review on Selective Caries Tissue Preservation](https://pmc.ncbi.nlm.nih.gov/articles/PMC13351430/) (International Dental Journal (PMC open access), 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/dentistry/vital-pulp-therapy-pulp-capping-and-pulpotomy/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/dentistry/vital-pulp-therapy-pulp-capping-and-pulpotomy/