October 9, 2025 • 17 mins
A fractured canine tooth tests more than a dog’s bite—it tests our choices as clinicians. We sat down with researchers Ethan Elazegui and Dr. Elias Wolfs to reexamine vital pulp therapy with new data, honest surprises, and practical guidance you can use on your next dentistry day. The conversation starts with what holds true: an ~80% success rate keeps vital pulp therapy squarely in the toolkit as a tooth-sparing option when pulp exposure is recent and the tissue is viable. Then we challenge a common belief: younger dogs didn’t show a significant edge in outcomes, pushing us to prioritize indications and technique over age alone.
We break down what most affects success, and one factor stands out—pulp dressing extrusion. Precision during placement isn’t a nicety; it’s the difference between healing and failure. We also talk timing, including a small-sample quirk that reminds us to interpret data with care. From there, we explore material science: MTA’s respected performance versus biodentine’s faster set, strong biocompatibility, and reduced discoloration risk. Human literature suggests comparable success and better cementum repair for biodentine, a promising path for veterinary endodontics as adoption grows.
Beyond procedures and products, we highlight the power of mentorship and student peer review to raise research quality—and why that matters for everyday clinical decisions. We even look ahead to AI-driven radiograph interpretation, where large, annotated datasets could help flag subtle endodontic and periodontal changes and support more consistent decision-making in general practice.
You’ll leave with clear steps for case selection, referral thresholds, and owner communication about follow-ups—because even good cases need rechecks to catch the 1-in-5 that fail months or years later. If you care about predictable outcomes, better materials, and sharper imaging insights, this conversation is for you. Enjoy the episode, share it with a colleague who does dentistry, and if it helped your practice, subscribe and leave a quick review to help others find the show.
JAVMA article: https://doi.org/10.2460/javma.25.04.0224
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:00):
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(00:22):
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SPEAKER_02 (00:35):
This is Veterinary Vertex, a podcast in the ABMA
Journals.
In this episode, we chat aboutthe success rate of vital pulp
therapy and factors influencingoutcomes with current standards
with our guests, Ethan Alizekeand Elias Wolf.
SPEAKER_01 (00:54):
Welcome, listeners.
I'm Editor-in-Chief LisaFortier, and I'm joined by
Associate Editor Sarah Wright.
Ethan and Ilias, thank you fortaking time out of your busy
schedule today to be with us.
SPEAKER_04 (01:04):
Thank you for having us.
Yeah, thank you for having us.
We really appreciate theinvitation.
SPEAKER_02 (01:10):
Of course.
All right, let's dive right in.
So, Ilias, your JAFA articlereassesses the success rate of
vital pulp therapy in dogs andevaluates the impact of patient
age and pulp exposure durationon outcomes.
Please share with our listenersthe background on this article.
SPEAKER_04 (01:26):
Yeah, so um the literature on vital pulp therapy
um was um quote unquote a littlebit outdated.
It has been over two decades umsince the outcome had been
evaluated.
Um so we thought it was um thetime had come to um potentially
reevaluate the success rate.
And then we also had um an extrahypothesis that had not been
(01:48):
previously investigated, and wesuspected that um younger dogs
uh potentially had a betteroutcome because their apices or
the tooth apex is still open, sothat has inherently a better
blood supply and betterregenerative potential.
Um, so we wanted to look at thatdata set as well, um, versus the
(02:08):
tooth apex of older dogs that isclosed.
We we thought or hypothesizedthat um they could potentially
have a worse outcome.
SPEAKER_02 (02:17):
It's always great to see dentistry manuscripts
because like everyone needsdental care.
And I feel like we don't wedon't see that many of them,
honestly.
So it's really nice to see themin the journal.
So thank you for contributingthis work.
SPEAKER_04 (02:27):
Yeah, absolutely.
SPEAKER_02 (02:28):
And Ethan, what are the important take-home messages
from this JAGMA article?
SPEAKER_03 (02:31):
Yeah, so there's a few.
I think one of the biggesttakeaways um is that vital pulp
therapy remains a pretty viablealternative to other endodontic
therapies such as root canal,um, especially when managing
pulp exposure.
Uh, we found that VitalPulp hasabout an 80% success rate, which
aligns pretty well with previousstudies.
Um As uh I said, we hypothesizedthat younger dogs would have
(02:55):
higher vitapult therapy successrates when compared to dogs.
However, we actually didn't finduh any significant association
between patient age and outcome.
Uh lastly, um, deep pulpdressing intrusion um
significantly increases odds ofvitapult therapy failure.
So it's pretty um important whenapplying the dressing to really
(03:18):
carefully and precisely do thatin order to decrease any
likelihood of failure in thefuture.
SPEAKER_01 (03:24):
Great take homes.
Uh Ilias, you started out bysaying, you know, this isn't
new, uh, but and the literatureis a little bit outdated.
What really sparked yourinterest to look at this again?
Was it a case or an astutestudent or somebody asking a
question?
SPEAKER_04 (03:39):
Um, yeah, that's a good question.
Um, so first of all, um Eton wasa uh or still is a very keen uh
student who wanted to do aresearch project with us.
So we kicked around with a fewideas, um, and we thought that
the time had come to um lookagain at vital pulp therapy, and
(04:00):
then with the extra hypothesisof um we suspected that younger
dogs would have a betteroutcome.
Unfortunately, it turned out forour study that that was not
necessarily the case.
Um, and doing a retrospectivestudy, uh looking at radiographs
and at the uh medical records isa relatively low-hanging fruit.
So we thought that would be agood project to do with uh
(04:22):
Ethan, um, who did the lion'sshare uh of all the work from
data collection to scientificmanuscript writing.
Um, so that was a very nice andgood experience overall with
him.
SPEAKER_01 (04:33):
I'm not surprised.
That was kind of a gimme sort ofquestion.
I know you know, Ilias, but forlisteners, Ethan is actually one
of our student reviewers forJabma and AJVR.
To our knowledge, we're theonly, at least veterinary
journal, if not journals ingeneral, that take on student
reviewers and actually teachthem how to review articles for
(04:54):
scientific content, how toprovide constructive comments,
and we give them feedback.
It's actually a fantasticprogram.
Uh and Ethan, thanks for beingone of our student reviewers.
SPEAKER_04 (05:03):
Sorry.
Um, I just want to chime inbriefly that um as a junior
faculty, it's also like my firsttime taking on a student under
my wings um and coaching them inthis bad process.
And I have to say that workingwith Ethan has been an absolute
breeze, and I couldn't havehoped or wished for a better
student to work with.
So it's uh has been a reallygood experience overall.
(05:26):
Fantastic.
I really like that you guys arealso um getting students
involved from um early on intheir career.
I feel like that earlier on youcan coach them and support them
um sets them up for successlater on.
SPEAKER_01 (05:39):
Go ahead, Ethan.
Tell us about the studentreviewer pro experience.
SPEAKER_03 (05:43):
Yeah, I mean, it's been a really great experience.
Um Actostall and everyone hasreally sort of really taught me
a better way of sort ofapproaching and evaluating
scientific literature.
And I feel like I really take alot of I think it's also really
positively impacted, I guess, myresearch and sort of how I
carried out and approached umwriting and data analysis and
(06:06):
the sorts.
SPEAKER_01 (06:07):
Excellent.
That's the that's the goal.
So it's working.
Uh well, I have you, Ethan.
You uh had a little conversationwith Sarah earlier about where
some of the take-home messagesare, but every time we do an
experiment, things surprise us,which then lead to other
hypotheses and other studies.
What surprised you from the workyou did for this article?
SPEAKER_03 (06:26):
Yeah, I think you know, in our study, we actually
found that um dogs who receivedvital pulp therapy more than 24
hours following pulp exposureactually had a greater time to
failure, or in other words, ittook longer for them to fail
when compared to dogs thatreceived vital pulp within 24
(06:46):
hours.
Now, this isn't necessarily whatwe would have expected, as
previous studies have shown thatbasically the earlier vital pulp
therapy is performed followingexposure, the more likely it is
to succeed.
Conversely, if it the longer ittakes for vitapult therapy to be
performed, the higher likelihoodof uh it failing.
Um, we we have attributed thisto um basically our low sample
(07:11):
size.
We only had one dog in thatcategory.
SPEAKER_02 (07:14):
So, Ethan, what are the next steps for future
research in vital pulp therapy?
SPEAKER_03 (07:18):
Yeah, so um mineral trioxide aggregate or MTA, it's
pretty widely regarded as thesort of gold standard for pulp
dressing material in both humanand veterinary medicine.
However, there is a newpromising alternative known as
biodentine, um, and it has somepretty favorable properties,
such as a faster setting time,higher cytocompatibility,
(07:40):
meaning it's just sort of saferfor cells, and also lacks this
sort of compound called bismuthoxide, which sort of delays
setting time and causesdiscoloration.
Um, and so previous humanstudies have shown that
biodentine and MPA achievepretty comparable success rates
in pulp capping and pulpotomyprocedures.
(08:01):
Um, notably, biodentine has apretty superior, I guess,
cementum repair as well as umreduced extrusion into
surrounding soft tissues.
And so that we think that thiscould really promote better
healing outcomes.
And so um it's not biodentine'snot pretty commonly used in
vetmed right now, but it'sreally a very attractive
(08:25):
candidate for future use inveterinary pulp therapy.
SPEAKER_02 (08:29):
Very cool.
Sounds like another greatproject for you and Elias
working on together.
So, Elias, AI is everywhere.
We're seeing it also pop up insome facets too of veterinary
medicine.
Do you see a role for AI in thisparticular area of research?
SPEAKER_04 (08:44):
Um, yeah, that is a good question.
And I think AI is somethingthat, as we all know, has been
rapidly evolving.
Um in the long run, I do believethat there will be a place for
it.
Um, maybe in taking a bit moreof a step back in the broader
term of AI.
I do think that with machinelearning, um, eventually we
(09:06):
could train the computer toassess dental radiographs, which
would probably pick up smalldetails better than humans in
terms of periodontal as well asendodontal disease that could
probably um help generalpractitioners as well as um
residents, boarded dentists, um,students.
(09:26):
Um, but um we need to becareful.
Um, and I think we would needhundreds, maybe thousands of
cases um to be put in into thecomputer.
Um, I don't think we're thereyet, but in the long run, I do
see that I would not besurprised if someone came up
with a software that would becommercially available to help
guide people with um clinicaldecision making.
SPEAKER_01 (09:50):
Yeah, dental RADs can be pretty difficult to
interpret.
I think we just skip them nowand go straight to CT.
SPEAKER_04 (09:56):
Right.
SPEAKER_01 (09:57):
Ethan, uh, as a four-stage veterinary school,
and as we said earlier, astudent reviewer for Jabma and
AJVR, how did all your combinedtraining or previous work help
prepare you to write thisarticle?
And not just write the article.
What words of wisdom do you havefor people like how to identify
a topic and really get it donewhile you're in veterinary
school?
SPEAKER_03 (10:15):
Yeah, that's a good question.
I think for me, uh, you know, myintroduction to research really
began in my undergrad.
Um, I think that really laid thebasic foundations.
I guess, you know, inunderstanding uh general
scientific method, hypothesistesting, and manuscript writing.
Um in vet school, I'm you know,pursuing a DVM and Wisconsin
(10:35):
actually offers a clinicianresearcher emphasis.
And so I'm pursuing that, andit's really helped me to, I
guess, integrate uh researchinto clinical practice and how
to better design and carry outuh projects.
And like you said, you know, I Ido participate in the Jabma AJVR
student peer review program, andI also participated in
(10:56):
Wisconsin's Summer ScholarsProgram.
And so they've really helped meand provide me with the tools
and really the frameworks, uh, Iguess approach research in a
more structured and confidentmanner.
So um yeah, I think togetherthose experiences have really,
you know, equipped me with youknow the technical knowledge and
the you know the skills thatwere pretty important in helping
(11:19):
develop this project.
SPEAKER_01 (11:20):
Just expand a little bit on how what advice you would
give to other veterinarystudents that are looking to get
involved in research.
How do you get it all done?
SPEAKER_03 (11:28):
Oh, yeah, I it's it's it can be challenging, you
know, or a little bitoverwhelming with you know
veterinary schedules andclasses.
Um for me, I I early onidentified dentistry as a as a
you know potential topic or afuture career path that I wanted
to go into, and I really wantedto pursue further research.
So I definitely reached out umearly on uh to see if there were
(11:52):
any small projects that I couldsort of be a part of.
And um thankfully you know,Elias had one for me and I'm
really grateful for that.
So I encourage any sort ofinterest just to reach out
there, step outside of yourcomfort zone a little bit.
SPEAKER_02 (12:07):
I did my first project when I was a third-year
veterinary student, and Iremember it was hard juggling
classwork and manuscriptwriting, and mine was like a
prospective study, so organizingthe travel and working with all
the different teams.
Yeah, it's it was a lot, butkudos to you too, Ethan, for
crossing the finish line withthis manuscript.
SPEAKER_04 (12:23):
I just wanted to add to that that um it feels like
yesterday that Ethan knocked onmy door, and next week he's
actually giving a poster sessionat the American Veterinary
Dental Forum uh with his paperthat is published.
So that is quite an achievement.
SPEAKER_02 (12:39):
Amazing.
Congratulations, Ethan.
That's wonderful.
SPEAKER_04 (12:41):
Thank you.
SPEAKER_02 (12:42):
Okay, we want photos too, by the way.
So you can put them on socialmedia to show off how awesome
our student reviewers are.
So this next set of questions isgoing to be really important for
our listeners.
You shared really greatinformation today about vital
pulp therapy.
So we want to share with ourlisteners now what's the one
thing that's really gonna changethe way that they practice.
So, Elias, what is one piece ofinformation the veterinarian
(13:03):
should know about the successrate of vital pulp therapy in
dogs?
SPEAKER_04 (13:08):
Um, it remains a viable treatment uh for
relatively acutely fracturedteeth for which referral to a
veterinist is recommended.
SPEAKER_02 (13:20):
Very well said.
And then Ethan, on the otherside of the relationship, what's
one thing clients should knowabout this topic?
SPEAKER_03 (13:27):
Yeah, I think one important thing is that vital
pulp therapy isn't necessarily aone-and-done treatment.
At least in our study, we foundthat one in five teeth may
eventually fail, sometimesmonths or even years after the
initial procedure.
So that's why follow-up examsare pretty important.
I think it's recommended thatrechecks occur every six months
(13:48):
for the first year or two andthen annually thereafter, of
course, sooner if there's anyconcerns.
And so really keeping up withthose visits helps to catch
problems early and gives um yourpet the best chance the best
chance for long-term success.
SPEAKER_01 (14:02):
One in five doesn't seem to be that bad from what I
remember in large animal andhorse teeth at least.
I think it's more like 50% endup with some other thing that
goes wrong.
Thank you guys again.
Uh always, always fun to learnmore things about dentistry,
which I still don't think welearn enough of in veterinary
school.
As we wind down, we'd like toask just a little bit of a fun
(14:25):
question.
So, Elias, if you could have asuperpower, what would it be and
why?
SPEAKER_04 (14:30):
Yeah, um, another great question.
I had to think about it for asecond, and eventually I thought
about it, would be really niceto be able to teleport yourself.
Uh, because one of the thingsthat lately has been bugging me
is the increasingly expensivecost of flying to conferences as
(14:52):
well as courses or areas whereyou can give a talk or um an a
CE event.
Um, and on top of that, withmissed connections, um, I do
believe it would be really niceto just be able to move from
point A to point B in um in ablink of a second.
I agree.
SPEAKER_01 (15:12):
Yeah, and then think of how much more time you'd have
for fun.
SPEAKER_04 (15:15):
Exactly.
SPEAKER_01 (15:16):
All that commuting time, all that stuff, that that
would be an amazing, not justcost savings, but time.
SPEAKER_04 (15:22):
Yep, cost savings and time.
I love that.
SPEAKER_01 (15:26):
Ethan, uh Sarah and I have a bit of a hypothesis for
the the answer to the next thisnext question.
So I think I know what youranswer will be.
But uh when you complete apuzzle, do you begin with the
middle interior and completesome form of theme, or do you do
the exterior border piecesfirst?
SPEAKER_03 (15:44):
Uh I I tend to start with the border pieces and I try
to work all the way around.
But you know, as I do go, I if Icome across any like middle
pieces that sort of seem to fitlike a pattern or an area, I
tend to sort of roughly placethem where they might belong.
But yeah, that border definitelygives me a better framework to
work with and makes it a littlebit more manageable.
SPEAKER_01 (16:05):
Doesn't surprise me, but I would hypothesize that was
your answer.
And uh our uh our um assessmentso far is that people that tend
to do surgery are the exteriorborder pieces and inter purely
internists or educational folksare more the ones that do the uh
middle interior.
Whoever knew you could evenstart it.
(16:26):
One of my daughters does themiddle interior.
Dives me crazy.
I'm like, well, you don't havethe you don't have the framework
yet.
SPEAKER_04 (16:33):
Yeah, when I read the question, I had also no idea
that people would do theinterior first.
I thought that the framework wassomething that um was something
everyone did.
SPEAKER_02 (16:44):
No, it's a fun one.
We I say it's every episode, butreally do gotta compile those
answers.
So I think it would beinteresting.
But thank you so much, Ethan andElias, for being here today and
for also sharing your nephewstreaming and the script too
with Jabma.
SPEAKER_04 (16:55):
Thank you so much.
Yeah, thank you for having us.
SPEAKER_02 (16:57):
And to our listeners, you can read Ethan
and Elias' article in Jabma.
I'm Sarah Wright with LisaFordier.
Be on the lookout for nextweek's episode.
And don't forget to leave us arating and review on Apple
Podcasts or whatever platformyou listen to.
From the makers of FET recommended Green East
Dental Fruits, comes an easy wayto support your dog's wellness.
Green East Smartest Dentals DryFood delivers complete balanced
nutritionists withscience-backed recipes.
Green East Supplement, developedby a team of PhD animal
nutritionists, offers options tohelp support healthy joints,
(00:22):
digestion, and more.
Whether it's mealtime ormobility support, GreenEats
helps you care for your dog fromthe inside out.
Learn more at greeneats.com.
SPEAKER_02 (00:35):
This is Veterinary Vertex, a podcast in the ABMA
Journals.
In this episode, we chat aboutthe success rate of vital pulp
therapy and factors influencingoutcomes with current standards
with our guests, Ethan Alizekeand Elias Wolf.
SPEAKER_01 (00:54):
Welcome, listeners.
I'm Editor-in-Chief LisaFortier, and I'm joined by
Associate Editor Sarah Wright.
Ethan and Ilias, thank you fortaking time out of your busy
schedule today to be with us.
SPEAKER_04 (01:04):
Thank you for having us.
Yeah, thank you for having us.
We really appreciate theinvitation.
SPEAKER_02 (01:10):
Of course.
All right, let's dive right in.
So, Ilias, your JAFA articlereassesses the success rate of
vital pulp therapy in dogs andevaluates the impact of patient
age and pulp exposure durationon outcomes.
Please share with our listenersthe background on this article.
SPEAKER_04 (01:26):
Yeah, so um the literature on vital pulp therapy
um was um quote unquote a littlebit outdated.
It has been over two decades umsince the outcome had been
evaluated.
Um so we thought it was um thetime had come to um potentially
reevaluate the success rate.
And then we also had um an extrahypothesis that had not been
(01:48):
previously investigated, and wesuspected that um younger dogs
uh potentially had a betteroutcome because their apices or
the tooth apex is still open, sothat has inherently a better
blood supply and betterregenerative potential.
Um, so we wanted to look at thatdata set as well, um, versus the
(02:08):
tooth apex of older dogs that isclosed.
We we thought or hypothesizedthat um they could potentially
have a worse outcome.
SPEAKER_02 (02:17):
It's always great to see dentistry manuscripts
because like everyone needsdental care.
And I feel like we don't wedon't see that many of them,
honestly.
So it's really nice to see themin the journal.
So thank you for contributingthis work.
SPEAKER_04 (02:27):
Yeah, absolutely.
SPEAKER_02 (02:28):
And Ethan, what are the important take-home messages
from this JAGMA article?
SPEAKER_03 (02:31):
Yeah, so there's a few.
I think one of the biggesttakeaways um is that vital pulp
therapy remains a pretty viablealternative to other endodontic
therapies such as root canal,um, especially when managing
pulp exposure.
Uh, we found that VitalPulp hasabout an 80% success rate, which
aligns pretty well with previousstudies.
Um As uh I said, we hypothesizedthat younger dogs would have
(02:55):
higher vitapult therapy successrates when compared to dogs.
However, we actually didn't finduh any significant association
between patient age and outcome.
Uh lastly, um, deep pulpdressing intrusion um
significantly increases odds ofvitapult therapy failure.
So it's pretty um important whenapplying the dressing to really
(03:18):
carefully and precisely do thatin order to decrease any
likelihood of failure in thefuture.
SPEAKER_01 (03:24):
Great take homes.
Uh Ilias, you started out bysaying, you know, this isn't
new, uh, but and the literatureis a little bit outdated.
What really sparked yourinterest to look at this again?
Was it a case or an astutestudent or somebody asking a
question?
SPEAKER_04 (03:39):
Um, yeah, that's a good question.
Um, so first of all, um Eton wasa uh or still is a very keen uh
student who wanted to do aresearch project with us.
So we kicked around with a fewideas, um, and we thought that
the time had come to um lookagain at vital pulp therapy, and
(04:00):
then with the extra hypothesisof um we suspected that younger
dogs would have a betteroutcome.
Unfortunately, it turned out forour study that that was not
necessarily the case.
Um, and doing a retrospectivestudy, uh looking at radiographs
and at the uh medical records isa relatively low-hanging fruit.
So we thought that would be agood project to do with uh
(04:22):
Ethan, um, who did the lion'sshare uh of all the work from
data collection to scientificmanuscript writing.
Um, so that was a very nice andgood experience overall with
him.
SPEAKER_01 (04:33):
I'm not surprised.
That was kind of a gimme sort ofquestion.
I know you know, Ilias, but forlisteners, Ethan is actually one
of our student reviewers forJabma and AJVR.
To our knowledge, we're theonly, at least veterinary
journal, if not journals ingeneral, that take on student
reviewers and actually teachthem how to review articles for
(04:54):
scientific content, how toprovide constructive comments,
and we give them feedback.
It's actually a fantasticprogram.
Uh and Ethan, thanks for beingone of our student reviewers.
SPEAKER_04 (05:03):
Sorry.
Um, I just want to chime inbriefly that um as a junior
faculty, it's also like my firsttime taking on a student under
my wings um and coaching them inthis bad process.
And I have to say that workingwith Ethan has been an absolute
breeze, and I couldn't havehoped or wished for a better
student to work with.
So it's uh has been a reallygood experience overall.
(05:26):
Fantastic.
I really like that you guys arealso um getting students
involved from um early on intheir career.
I feel like that earlier on youcan coach them and support them
um sets them up for successlater on.
SPEAKER_01 (05:39):
Go ahead, Ethan.
Tell us about the studentreviewer pro experience.
SPEAKER_03 (05:43):
Yeah, I mean, it's been a really great experience.
Um Actostall and everyone hasreally sort of really taught me
a better way of sort ofapproaching and evaluating
scientific literature.
And I feel like I really take alot of I think it's also really
positively impacted, I guess, myresearch and sort of how I
carried out and approached umwriting and data analysis and
(06:06):
the sorts.
SPEAKER_01 (06:07):
Excellent.
That's the that's the goal.
So it's working.
Uh well, I have you, Ethan.
You uh had a little conversationwith Sarah earlier about where
some of the take-home messagesare, but every time we do an
experiment, things surprise us,which then lead to other
hypotheses and other studies.
What surprised you from the workyou did for this article?
SPEAKER_03 (06:26):
Yeah, I think you know, in our study, we actually
found that um dogs who receivedvital pulp therapy more than 24
hours following pulp exposureactually had a greater time to
failure, or in other words, ittook longer for them to fail
when compared to dogs thatreceived vital pulp within 24
(06:46):
hours.
Now, this isn't necessarily whatwe would have expected, as
previous studies have shown thatbasically the earlier vital pulp
therapy is performed followingexposure, the more likely it is
to succeed.
Conversely, if it the longer ittakes for vitapult therapy to be
performed, the higher likelihoodof uh it failing.
Um, we we have attributed thisto um basically our low sample
(07:11):
size.
We only had one dog in thatcategory.
SPEAKER_02 (07:14):
So, Ethan, what are the next steps for future
research in vital pulp therapy?
SPEAKER_03 (07:18):
Yeah, so um mineral trioxide aggregate or MTA, it's
pretty widely regarded as thesort of gold standard for pulp
dressing material in both humanand veterinary medicine.
However, there is a newpromising alternative known as
biodentine, um, and it has somepretty favorable properties,
such as a faster setting time,higher cytocompatibility,
(07:40):
meaning it's just sort of saferfor cells, and also lacks this
sort of compound called bismuthoxide, which sort of delays
setting time and causesdiscoloration.
Um, and so previous humanstudies have shown that
biodentine and MPA achievepretty comparable success rates
in pulp capping and pulpotomyprocedures.
(08:01):
Um, notably, biodentine has apretty superior, I guess,
cementum repair as well as umreduced extrusion into
surrounding soft tissues.
And so that we think that thiscould really promote better
healing outcomes.
And so um it's not biodentine'snot pretty commonly used in
vetmed right now, but it'sreally a very attractive
(08:25):
candidate for future use inveterinary pulp therapy.
SPEAKER_02 (08:29):
Very cool.
Sounds like another greatproject for you and Elias
working on together.
So, Elias, AI is everywhere.
We're seeing it also pop up insome facets too of veterinary
medicine.
Do you see a role for AI in thisparticular area of research?
SPEAKER_04 (08:44):
Um, yeah, that is a good question.
And I think AI is somethingthat, as we all know, has been
rapidly evolving.
Um in the long run, I do believethat there will be a place for
it.
Um, maybe in taking a bit moreof a step back in the broader
term of AI.
I do think that with machinelearning, um, eventually we
(09:06):
could train the computer toassess dental radiographs, which
would probably pick up smalldetails better than humans in
terms of periodontal as well asendodontal disease that could
probably um help generalpractitioners as well as um
residents, boarded dentists, um,students.
(09:26):
Um, but um we need to becareful.
Um, and I think we would needhundreds, maybe thousands of
cases um to be put in into thecomputer.
Um, I don't think we're thereyet, but in the long run, I do
see that I would not besurprised if someone came up
with a software that would becommercially available to help
guide people with um clinicaldecision making.
SPEAKER_01 (09:50):
Yeah, dental RADs can be pretty difficult to
interpret.
I think we just skip them nowand go straight to CT.
SPEAKER_04 (09:56):
Right.
SPEAKER_01 (09:57):
Ethan, uh, as a four-stage veterinary school,
and as we said earlier, astudent reviewer for Jabma and
AJVR, how did all your combinedtraining or previous work help
prepare you to write thisarticle?
And not just write the article.
What words of wisdom do you havefor people like how to identify
a topic and really get it donewhile you're in veterinary
school?
SPEAKER_03 (10:15):
Yeah, that's a good question.
I think for me, uh, you know, myintroduction to research really
began in my undergrad.
Um, I think that really laid thebasic foundations.
I guess, you know, inunderstanding uh general
scientific method, hypothesistesting, and manuscript writing.
Um in vet school, I'm you know,pursuing a DVM and Wisconsin
(10:35):
actually offers a clinicianresearcher emphasis.
And so I'm pursuing that, andit's really helped me to, I
guess, integrate uh researchinto clinical practice and how
to better design and carry outuh projects.
And like you said, you know, I Ido participate in the Jabma AJVR
student peer review program, andI also participated in
(10:56):
Wisconsin's Summer ScholarsProgram.
And so they've really helped meand provide me with the tools
and really the frameworks, uh, Iguess approach research in a
more structured and confidentmanner.
So um yeah, I think togetherthose experiences have really,
you know, equipped me with youknow the technical knowledge and
the you know the skills thatwere pretty important in helping
(11:19):
develop this project.
SPEAKER_01 (11:20):
Just expand a little bit on how what advice you would
give to other veterinarystudents that are looking to get
involved in research.
How do you get it all done?
SPEAKER_03 (11:28):
Oh, yeah, I it's it's it can be challenging, you
know, or a little bitoverwhelming with you know
veterinary schedules andclasses.
Um for me, I I early onidentified dentistry as a as a
you know potential topic or afuture career path that I wanted
to go into, and I really wantedto pursue further research.
So I definitely reached out umearly on uh to see if there were
(11:52):
any small projects that I couldsort of be a part of.
And um thankfully you know,Elias had one for me and I'm
really grateful for that.
So I encourage any sort ofinterest just to reach out
there, step outside of yourcomfort zone a little bit.
SPEAKER_02 (12:07):
I did my first project when I was a third-year
veterinary student, and Iremember it was hard juggling
classwork and manuscriptwriting, and mine was like a
prospective study, so organizingthe travel and working with all
the different teams.
Yeah, it's it was a lot, butkudos to you too, Ethan, for
crossing the finish line withthis manuscript.
SPEAKER_04 (12:23):
I just wanted to add to that that um it feels like
yesterday that Ethan knocked onmy door, and next week he's
actually giving a poster sessionat the American Veterinary
Dental Forum uh with his paperthat is published.
So that is quite an achievement.
SPEAKER_02 (12:39):
Amazing.
Congratulations, Ethan.
That's wonderful.
SPEAKER_04 (12:41):
Thank you.
SPEAKER_02 (12:42):
Okay, we want photos too, by the way.
So you can put them on socialmedia to show off how awesome
our student reviewers are.
So this next set of questions isgoing to be really important for
our listeners.
You shared really greatinformation today about vital
pulp therapy.
So we want to share with ourlisteners now what's the one
thing that's really gonna changethe way that they practice.
So, Elias, what is one piece ofinformation the veterinarian
(13:03):
should know about the successrate of vital pulp therapy in
dogs?
SPEAKER_04 (13:08):
Um, it remains a viable treatment uh for
relatively acutely fracturedteeth for which referral to a
veterinist is recommended.
SPEAKER_02 (13:20):
Very well said.
And then Ethan, on the otherside of the relationship, what's
one thing clients should knowabout this topic?
SPEAKER_03 (13:27):
Yeah, I think one important thing is that vital
pulp therapy isn't necessarily aone-and-done treatment.
At least in our study, we foundthat one in five teeth may
eventually fail, sometimesmonths or even years after the
initial procedure.
So that's why follow-up examsare pretty important.
I think it's recommended thatrechecks occur every six months
(13:48):
for the first year or two andthen annually thereafter, of
course, sooner if there's anyconcerns.
And so really keeping up withthose visits helps to catch
problems early and gives um yourpet the best chance the best
chance for long-term success.
SPEAKER_01 (14:02):
One in five doesn't seem to be that bad from what I
remember in large animal andhorse teeth at least.
I think it's more like 50% endup with some other thing that
goes wrong.
Thank you guys again.
Uh always, always fun to learnmore things about dentistry,
which I still don't think welearn enough of in veterinary
school.
As we wind down, we'd like toask just a little bit of a fun
(14:25):
question.
So, Elias, if you could have asuperpower, what would it be and
why?
SPEAKER_04 (14:30):
Yeah, um, another great question.
I had to think about it for asecond, and eventually I thought
about it, would be really niceto be able to teleport yourself.
Uh, because one of the thingsthat lately has been bugging me
is the increasingly expensivecost of flying to conferences as
(14:52):
well as courses or areas whereyou can give a talk or um an a
CE event.
Um, and on top of that, withmissed connections, um, I do
believe it would be really niceto just be able to move from
point A to point B in um in ablink of a second.
I agree.
SPEAKER_01 (15:12):
Yeah, and then think of how much more time you'd have
for fun.
SPEAKER_04 (15:15):
Exactly.
SPEAKER_01 (15:16):
All that commuting time, all that stuff, that that
would be an amazing, not justcost savings, but time.
SPEAKER_04 (15:22):
Yep, cost savings and time.
I love that.
SPEAKER_01 (15:26):
Ethan, uh Sarah and I have a bit of a hypothesis for
the the answer to the next thisnext question.
So I think I know what youranswer will be.
But uh when you complete apuzzle, do you begin with the
middle interior and completesome form of theme, or do you do
the exterior border piecesfirst?
SPEAKER_03 (15:44):
Uh I I tend to start with the border pieces and I try
to work all the way around.
But you know, as I do go, I if Icome across any like middle
pieces that sort of seem to fitlike a pattern or an area, I
tend to sort of roughly placethem where they might belong.
But yeah, that border definitelygives me a better framework to
work with and makes it a littlebit more manageable.
SPEAKER_01 (16:05):
Doesn't surprise me, but I would hypothesize that was
your answer.
And uh our uh our um assessmentso far is that people that tend
to do surgery are the exteriorborder pieces and inter purely
internists or educational folksare more the ones that do the uh
middle interior.
Whoever knew you could evenstart it.
(16:26):
One of my daughters does themiddle interior.
Dives me crazy.
I'm like, well, you don't havethe you don't have the framework
yet.
SPEAKER_04 (16:33):
Yeah, when I read the question, I had also no idea
that people would do theinterior first.
I thought that the framework wassomething that um was something
everyone did.
SPEAKER_02 (16:44):
No, it's a fun one.
We I say it's every episode, butreally do gotta compile those
answers.
So I think it would beinteresting.
But thank you so much, Ethan andElias, for being here today and
for also sharing your nephewstreaming and the script too
with Jabma.
SPEAKER_04 (16:55):
Thank you so much.
Yeah, thank you for having us.
SPEAKER_02 (16:57):
And to our listeners, you can read Ethan
and Elias' article in Jabma.
I'm Sarah Wright with LisaFordier.
Be on the lookout for nextweek's episode.
And don't forget to leave us arating and review on Apple
Podcasts or whatever platformyou listen to.
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