Guidelines for vital molar therapy are presented based on best available evidence. Often the cause for vital intervention is due to caries, but seldom the depth of the carious lesion is mentioned in literature, which may hamper the evaluation of prognosis following treatment. Moreover, the lack of devices for monitoring objectively the degree of pulp inflammation makes the topic a clinical challenge where proper tooth selection is important. In this chapter, the deep and extremely deep caries lesion is defined and linked to specific treatment protocols, which include both direct pulp as well as indirect pulp capping procedures. Particularly, a classification of the pulp capping procedure is described, which relates to two specific scenarios. In Class I the need for pulp capping arises by accident, while in Class II the capping procedure is expected and the set-up for the vital pulp therapy includes the use of the operating microscope.