Apical Curettage Procedure
Apical Curettage Procedure is a specialized dental service provided by the board-certified specialists at Aloha Dental Specialty Center in Beaverton, OR. Preserving the living nerve in your tooth with bioactive materials — avoiding root canal treatment when the pulp can be saved.
Vital Pulp Therapy: Saving the Nerve Instead of Removing It
Vital pulp therapy encompasses a group of conservative treatments designed to maintain the vitality of the dental pulp when it has been exposed or is at risk of exposure — avoiding the need for root canal treatment. The concept is straightforward: if the pulp inflammation is limited and the remaining tissue is healthy, remove the inflamed portion, seal the exposure with a bioactive material, and allow the pulp to heal. At Aloha Dental Specialty Center, Dr. Ostovar evaluates every case of pulp exposure or deep caries to determine whether vital pulp therapy is a viable alternative to root canal treatment, using clinical testing, the quality of the exposure bleeding, and CBCT imaging as decision-making tools.
Vital pulp therapy includes several related procedures, each defined by how much pulp tissue is preserved. An indirect pulp cap involves leaving a thin layer of caries-affected dentin over the pulp and sealing it with a bioactive liner — the pulp is never directly exposed. A direct pulp cap applies MTA or Biodentine directly over a tiny mechanical or traumatic pulp exposure where the surrounding pulp is healthy. A partial (Cvek) pulpotomy removes only 2 to 3 millimeters of superficial pulp tissue at the exposure site and places MTA over the deeper healthy pulp. A full coronal pulpotomy removes all pulp in the chamber while preserving the radicular pulp. The choice of procedure depends on the size of the exposure, the duration of pulp inflammation, the bleeding characteristics, and the patient's age.
The advantages of preserving pulp vitality are significant. A vital tooth maintains its blood supply, which delivers immune cells to fight infection, delivers nutrients for continued dentin deposition, and maintains the tooth's hydraulic cushioning system that prevents fracture under biting loads. A vital tooth also retains proprioceptive sensation — you can feel when you are biting too hard. Dr. Ostovar is a strong advocate for vital pulp therapy when the clinical evidence supports it, but he is equally direct when the pulp has progressed beyond the point of recovery and root canal treatment is the appropriate path.
Serving Beaverton, Aloha, Hillsboro & Washington County
Aloha Dental Specialty Center is located at 18455 SW Alexander St, Suite A, in Beaverton, Or 97003egon. We serve patients from across the Tualatin Valley and greater Portland metro, including Aloha, Hillsboro, Tigard, Lake Oswego, and Tualatin. Our Beaverton office is a 5-minute drive from Aloha, 10 minutes from Hillsboro, and 15 minutes from Tigard via SW 185th Avenue.
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Intel Campuses (Ronler Acres & Jones Farm)
10 to 15 minutes via NW 185th Ave. We accommodate the schedules of tech professionals who need efficient, high-quality specialty care.
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Nike World Headquarters
About 8 minutes via SW Baseline Rd. We frequently see patients from the Nike campus for surgical and implant procedures with sedation options.
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Streets of Tanasbourne & Orenco Station
Easily accessible via US-26 and NW 185th. Local general dentists in these communities regularly refer patients to us for specialty procedures.
Why Local Dentists Refer to Us
We work as a trusted partner to general dentists throughout the Tualatin Valley. When cases require CBCT-guided planning, IV sedation, bone grafting, or other advanced procedures, local providers refer to Dr. Ostovar for his fellowship-trained expertise and predictable results.
We handle the complex surgical phases and coordinate closely with your general dentist for smooth continuity of care from start to finish.
Understanding Your Investment
At Aloha Dental Specialty Center, we provide transparent pricing before any treatment begins. The cost of your procedure depends on clinical complexity, materials used, and sedation requirements. We walk you through every line item during your consultation so there are no surprises.
What Affects Cost:
- Clinical Complexity: Bone loss, sinus proximity, nerve involvement, or the need for grafting affects treatment planning and surgical time.
- Materials: We use research-backed implant systems, purified bone graft matrices, and high-strength ceramics from established manufacturers.
- Sedation: Options range from local anesthesia to IV sedation, each with different associated costs. We discuss the best option for your comfort and procedure.
Insurance & Financing
We accept most major dental insurance plans and file claims on your behalf. Our team verifies your benefits before treatment and submits pre-treatment estimates with clinical documentation to maximize coverage.
For out-of-pocket costs, we partner with CareCredit and Cherry for flexible payment plans. We also offer our ADSC Dental Savings Plan for patients without insurance.
Recovery & Healing Timeline
Understanding the healing process helps you plan ahead and follow post-operative instructions for the best possible outcome.
First 48 Hours
Mild swelling and tenderness are normal. Apply ice packs in 20-minute intervals and take prescribed or over-the-counter anti-inflammatory medication. Eat soft foods and avoid the surgical site when chewing.
Days 3 to 7
Swelling peaks around day three and then improves. The tissue begins closing over the surgical site. Continue with soft foods and use any prescribed antimicrobial rinse. Most patients return to normal activities during this phase.
Long-Term Healing
Surface tissue heals within two to three weeks. Bone integration and deep healing continue for three to six months. Avoid smoking, follow up as scheduled, and maintain good oral hygiene throughout recovery.
Questions during recovery? Call us at (503) 822-0096. We are available for post-operative concerns.
Vital Pulp Therapy: Shifting the Treatment Paradigm
The traditional paradigm held that any pulp exposure in a permanent adult tooth required root canal treatment. This dogma has been overturned by evidence demonstrating high success rates for vital pulp therapy when bioactive materials (MTA and Biodentine) are used instead of calcium hydroxide cements. A 2023 systematic review and meta-analysis reported success rates of 90 to 97 percent for full pulpotomy with MTA or Biodentine in permanent teeth with carious pulp exposures and symptoms of irreversible pulpitis — challenging the assumption that irreversible pulpitis always requires root canal treatment. The key prognostic indicator is the quality of bleeding from the remaining pulp: bright red blood that is controllable with gentle pressure indicates healthy tissue suitable for preservation, while dark, stagnant blood or uncontrollable hemorrhage indicates tissue necrosis. Patient age also influences outcomes — younger patients with strong pulp blood supply have higher success rates than elderly patients.
Why Choose a Specialist?
Dr. Merat Ostovar integrates vital pulp therapy into his endodontic treatment planning when diagnostic criteria indicate that the pulp can be preserved. He uses MTA and Biodentine as standard capping materials, applies strict case selection criteria based on clinical assessment and bleeding quality, and monitors outcomes with periodic vitality testing and radiographic evaluation.
Your Apical Curettage Procedure Treatment Steps
- Consultation & Exam: Comprehensive apical curettage procedure evaluation with CBCT 3D imaging at our Beaverton office.
- Treatment Plan: Board-certified specialist discusses your apical curettage procedure options, timeline, and costs. Our procedures maintain a 95%+ success rate, backed by advanced 3D imaging and evidence-based protocols.
- Treatment: Procedure performed with comfort options including sedation if needed.
- Follow-Up: Post-treatment monitoring and care coordination for best healing.
Schedule Your Appointment Today
Book a consultation with our board-certified specialists at Aloha Dental Specialty Center in Beaverton, OR. Call (503) 822-0096 Office hours: Monday through Friday 7 AM to 7 PM, Saturday and Sunday 8 AM to 2 PM. or request an appointment online.
Related Services at Aloha Dental Specialty Center:
Dental Implants · Oral Surgery · Root Canal · Invisalign · Periodontics · Pediatric · TMJ Treatment · Sedation · Cosmetic · Emergency · Sleep Apnea
A Note from Your Dental Team
In my experience, the patients who get the best results from apical curettage procedure are those who come in with realistic expectations and follow their post-treatment instructions carefully. I’d rather spend extra time explaining what to expect than have a patient be surprised later.
“Every patient I see has a different story, a different set of concerns, and a different definition of what ‘success’ looks like. That’s why I don’t believe in one-size-fits-all treatment plans. When you come in for a consultation, I’ll listen first, examine second, and recommend third.
I also won’t recommend a procedure you don’t need. If your tooth can be saved with a filling instead of a crown, I’ll tell you that. If watchful waiting is appropriate, I’ll explain why. My job isn’t to sell treatment — it’s to give you my honest clinical judgment so you can make an informed decision.
If you have questions about whether this treatment is right for you, or if you’ve been told you need this procedure by another dentist and want a second opinion, call us at (503) 822-0096. We’re happy to take the time to explain everything — no rush, no pressure.”
— Dr. Merat Ostovar & Dr. Jovan Gvozden | Aloha Dental Specialty Center, Beaverton, OR
I know many patients feel anxious about dental procedures — you’re not alone in that. What I hear most often after treatment is: “That was so much easier than I expected.” We’re here to make this as comfortable as possible for you.
Typical Healing Timeline:
Days 1-3: Initial healing, mild swelling managed with ice and medication. Days 4-7: Swelling subsides, gradual return to normal diet. Weeks 2-4: Soft tissue heals completely. Months 2-6: Bone remodeling and full integration (for surgical procedures). Individual recovery varies — we provide detailed post-op instructions specific to your procedure.
For additional clinical information, visit the American Dental Association (ADA).
Last reviewed by our dental specialists: March 2026. Clinical information on this page reflects current evidence-based dental practices.
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Frequently Asked Questions
What is vital pulp therapy?
Vital pulp therapy is a conservative treatment approach that preserves the living nerve and blood supply inside your tooth instead of removing them entirely with a root canal. It involves removing only the damaged portion of the pulp, sealing the remainder with a bioactive material like MTA or Biodentine, and allowing the pulp to heal and continue functioning.
How is vital pulp therapy different from a root canal?
A root canal removes all pulp tissue from the tooth, leaving it without blood supply or nerve function. Vital pulp therapy removes only the compromised portion and preserves the healthy pulp in the roots. The tooth remains alive with intact blood supply, nerve sensation, and the ability to form protective dentin.
Who is a good candidate for vital pulp therapy?
Candidates include patients with pulp exposure from deep cavities or trauma where the remaining pulp tissue appears healthy, patients with symptoms of reversible or even symptomatic irreversible pulpitis where bleeding quality suggests viable tissue, and younger patients with strong pulp blood supply. The final determination is made during the procedure based on the bleeding response.
What is a direct pulp cap?
A direct pulp cap involves placing a bioactive material (MTA or Biodentine) directly over a small, clean pulp exposure without removing any pulp tissue. It is most appropriate for tiny mechanical exposures during cavity preparation or small traumatic exposures in teeth with healthy pulps. Success rates exceed 90 percent when proper case selection criteria are met.
What is a Cvek pulpotomy?
A Cvek (partial) pulpotomy involves removing 2 to 3 millimeters of the superficial pulp at the exposure site, placing MTA or Biodentine over the deeper healthy pulp, and restoring the tooth. It is named after Dr. Miomir Cvek, who pioneered the technique for traumatic pulp exposures in young patients. Success rates exceed 95 percent for traumatic exposures treated within hours.
Can vital pulp therapy work on teeth with irreversible pulpitis?
Emerging evidence suggests yes, in selected cases. Recent studies show that full coronal pulpotomy with MTA or Biodentine achieves 90 to 97 percent success rates even in teeth diagnosed with symptomatic irreversible pulpitis — if the bleeding from the radicular pulp indicates healthy tissue. This challenges the traditional view that irreversible pulpitis always requires root canal treatment.
What happens if vital pulp therapy fails?
If the preserved pulp subsequently becomes necrotic — indicated by persistent or recurrent pain, periapical radiolucency, or negative vitality testing — the tooth can be converted to a conventional root canal. Vital pulp therapy does not compromise the ability to perform a future root canal. The attempt at conservation is worthwhile given the high success rates.
Is vital pulp therapy less expensive than a root canal?
Yes, generally. Vital pulp therapy involves a shorter procedure and fewer materials. Additionally, a tooth with a preserved vital pulp may not require a crown in every case (depending on remaining structure), which can significantly reduce the overall treatment cost compared to root canal treatment followed by a crown.
How do you know if the pulp is healthy enough to save?
The most reliable indicator is the bleeding quality at the time of the procedure. After removing the compromised pulp tissue, bright red blood that can be controlled with gentle pressure indicates healthy, viable tissue suitable for preservation. Dark, stagnant blood or hemorrhage that cannot be controlled indicates deeper inflammation or necrosis, and root canal treatment is recommended.
What materials are used in vital pulp therapy?
MTA (mineral trioxide aggregate) and Biodentine are the standard-of-care materials for vital pulp therapy. Both are bioactive calcium silicate cements that seal the exposure, are biocompatible with pulp tissue, maintain an antibacterial alkaline pH, and stimulate the pulp to form a protective dentin bridge over the capped site.
How long does vital pulp therapy take?
A direct pulp cap takes about 15 to 20 minutes beyond the normal restorative appointment. A partial or full pulpotomy takes 30 to 45 minutes. These procedures are shorter than root canal treatment because the root canals are not instrumented. The tooth is typically restored with a permanent restoration or crown at the same visit or shortly after.
How is vital pulp therapy monitored for success?
We monitor with vitality testing (cold test, EPT) and periapical radiographs at 3 months, 6 months, and 12 months, then annually. Success is confirmed by positive vitality response, no periapical pathology on radiograph, absence of symptoms, and (in young patients) evidence of continued root development. Any change in these parameters prompts re-evaluation.
Can vital pulp therapy be done on molars?
Yes. Full coronal pulpotomy on mature permanent molars with carious pulp exposures is gaining strong evidence support. The procedure involves removing the coronal pulp, placing MTA or Biodentine over the radicular pulp stumps, and restoring with a crown. Studies show success rates of 90 to 97 percent at 2-year follow-up.
Does age affect the success of vital pulp therapy?
Yes. Younger patients with strong pulp blood supply have higher success rates than older patients. However, vital pulp therapy is not limited to children — adults of all ages can benefit when the clinical criteria are met. The pulp's healing capacity diminishes with age but does not disappear entirely.
Is vital pulp therapy covered by dental insurance?
Pulp capping and pulpotomy procedures are covered by most dental insurance plans under endodontic or restorative benefit categories. Coverage typically ranges from 50 to 80 percent of the allowed fee. We verify your specific benefits before treatment and provide a cost estimate.
Deep Cavity Reaching the Nerve? Ask If Your Pulp Can Be Saved
Call our Beaverton office or request an appointment online. We look forward to helping you.
Clinically Reviewed by Dr. Merat Ostovar, DMD
Doctor of Dental Medicine | Implant & Specialty Dentistry | 15+ Years Experience
Aloha Dental Specialty Center — Serving Aloha, Beaverton, Hillsboro & Greater Portland
Last updated: March 19, 2026