pulpotomy= removed coronal pulp only
Non vital coronal pulp but vital radicular pulp
Pulpectamy= entirely non vital pulp
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what are the symptoms for reversible pulpitis
clinical signs of caries, not TTP, no abnormal mobility, no signs of infection, swelling, sinus, suppuration
3 of 19
what are the symptoms for irreversible pulpitis
clinical signs of caries, not TTP, no abnormal mobility, no signs of infection, swelling, sinus, suppuration
4 of 19
what are the symptoms for periradicular pulpits
clinical signs of caries, increased mobility, TTP, signs of infection, swelling, sinus, suppuration
5 of 19
what are the signs for reversible pulpitis
pain short lived, does not linger, pain in direct response to stimuli,
6 of 19
what are the signs for irreversible pulpitis
spontaneous pain, prolonged, lingers on removal of stimulus, pt wakes from sleep
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what are the signs for periradicular periodontitis
often acute symptoms gone, dull throbbing pain, can be asymptomatic
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The pulpotomy – When don’t we do them?
precooperative child
Multiple pulp therapies needed
(>3)
Close to exfoliation
Extensive root resorption
Tooth unrestorable
Signs of infection - sinus, swelling, suppuration
Radiographic signs of infection - widening at the furcation or apices
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The pulpotomy – when do we do them?
THE MAIN REASONS:
When we have compliance:
Require local anaesthetic and rubber dam
When the tooth is restorable
No signs of infection
Radiographically signs of
caries involving the pulp
OTHER CONSIDERATIONS:
Hypodontia (missing permanent succ
10 of 19
The pulpotomy- why do we do them
THE MAIN REASONS:
Keep the tooth!
Restore dental health
Avoid negative
psychological impacts
Extraction as a source
of future anxiety
OTHER CONSIDERATIONS:
Impact on aesthetics (i.e. avoid smiling)
Support normal speech and masticatory functio
11 of 19
what is the Pulpal anatomy of mandibular primary molars
Two roots
Mesial
Distal
Two root canal orifices
Mesial
Distal
One or sometimes two
distal root canals in distal root
pulp horns below cusps
12 of 19
what is the Pulpal anatomy of maxillary primary molars
Saline, local anaesthetic with vasoconstrictor and ferric sulphate
common options
Ferric sulphate (15.5%) has a clinically proven efficacy as haemostatic
agent
14 of 19
Obturating materials in pulpectomy
Non-setting Calcium Hydroxide
15 of 19
Potential complications of primary molar pulp therapy
Early resorption leading to early exfoliation
Over-preparation
Infection
Caries!
Pulpectomy - extrusion of files
beyond the apices and through furcation area
16 of 19
what are the signs of failure...
Clinical signs of failure
Pain
Tenderness to percussion in a non exfoliating tooth Alveolar tenderness, sinus or swelling
Non physiological mobility
Radiographic signs of failure
Inter radicular radiolucency/ furcation bone loss
External/ inte
17 of 19
if everything. went well what are the signs
Clinical signs success:
Absence of symptoms
No infection
No sinus or swelling
No mobility or tenderness Retention of tooth
Natural exfoliation
Radiographic signs of success:
No bone loss in furcation region
No evidence of internal resorpti
18 of 19
can we just restore the tooth? what criteria must be met?
tooth is restorable
no signs of irreversible pulp-titis
no infection
no sinus
radiogrpahycallyu- clear band of dentine separating the pulp chamber from the caries
19 of 19
Other cards in this set
Card 2
Front
what is pulpotomy and pulpectomy
Back
pulpotomy= removed coronal pulp only
Non vital coronal pulp but vital radicular pulp
Pulpectamy= entirely non vital pulp
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