Vital pulp therapy in dogs: 190 cases (2001–2011)

Niina Luotonen Anident Veterinary Clinic, Lamminpääntie 43, FI-01490 Veikkola, Finland.

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 DVM
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Helena Kuntsi-Vaattovaara Anident Veterinary Clinic, Lamminpääntie 43, FI-01490 Veikkola, Finland.

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Eva Sarkiala-Kessel Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, FI-00014 Helsinki, Finland.

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 DVM, PhD
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Jouni J. T. Junnila 4Pharma Ltd, Ahventie 4, FI-02170 Espoo, Finland.

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Outi Laitinen-Vapaavuori Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, FI-00014 Helsinki, Finland.

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Frank J. M. Verstraete Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

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Abstract

Objective—To evaluate factors associated with the outcome of vital pulp therapy (VPT) in dogs.

Design—Retrospective study.

Sample—190 teeth in 138 dogs.

Procedures—Medical records were reviewed; radiographs obtained before, immediately after, and during the last available follow-up examination for VPT were evaluated. Treatment was categorized as successful (with radiographic evidence of continued secondary dentin production, continued root formation in immature teeth, and absence of clinical and radiographic signs of apical periodontitis and internal or external inflammatory root resorption), having no evidence of failure (with signs for success fulfilled except the width of the apical periodontal ligament space, which could be wider than but no more than double the width of the periodontal ligament space in other areas), or failed (with radiographic evidence of pulp necrosis, apical periodontitis, or inflammatory root resorption). Associations between diagnostic or treatment-related variables and outcome were assessed with multinomial logistic regression.

Results—Overall, treatment was classified as successful for 162 of 190 (85%) teeth, including 23 (12%) teeth with no evidence of failure, and as having failed for 28 (15%) teeth. The overall success rate was 137 of 149 (92%) for teeth treated with mineral trioxide aggregate alone and 21 of 36 (58%) for teeth treated with Ca(OH)2 alone. Use of Ca(OH)2 and deep penetration of dressing material into the vital pulp were each significantly associated with increased odds of treatment failure.

Conclusions and Clinical Relevance—Results indicated that VPT with mineral trioxide aggregate was an effective option for use in crown reduction to treat malocclusion and for treatment of recent crown fractures in immature or mature permanent teeth.

Abstract

Objective—To evaluate factors associated with the outcome of vital pulp therapy (VPT) in dogs.

Design—Retrospective study.

Sample—190 teeth in 138 dogs.

Procedures—Medical records were reviewed; radiographs obtained before, immediately after, and during the last available follow-up examination for VPT were evaluated. Treatment was categorized as successful (with radiographic evidence of continued secondary dentin production, continued root formation in immature teeth, and absence of clinical and radiographic signs of apical periodontitis and internal or external inflammatory root resorption), having no evidence of failure (with signs for success fulfilled except the width of the apical periodontal ligament space, which could be wider than but no more than double the width of the periodontal ligament space in other areas), or failed (with radiographic evidence of pulp necrosis, apical periodontitis, or inflammatory root resorption). Associations between diagnostic or treatment-related variables and outcome were assessed with multinomial logistic regression.

Results—Overall, treatment was classified as successful for 162 of 190 (85%) teeth, including 23 (12%) teeth with no evidence of failure, and as having failed for 28 (15%) teeth. The overall success rate was 137 of 149 (92%) for teeth treated with mineral trioxide aggregate alone and 21 of 36 (58%) for teeth treated with Ca(OH)2 alone. Use of Ca(OH)2 and deep penetration of dressing material into the vital pulp were each significantly associated with increased odds of treatment failure.

Conclusions and Clinical Relevance—Results indicated that VPT with mineral trioxide aggregate was an effective option for use in crown reduction to treat malocclusion and for treatment of recent crown fractures in immature or mature permanent teeth.

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