08 August 2012

PULPECTOMY | pedodontic dentistry


Pulpectomy the complete removal of a pulp from the pulp chamber and root canal. The pulpectomy procedure is also called partial root canal. Pulpectomy refers to a common endodontic procedure in which the dental pulp and root canal are completely removed. This procedure is done on primary teeth.

INDICATION
  1. Inflammation extending beyond coronal pulp
  2. Primary teeth with necrotic pulps
  3. Roots and surrounding bone free of pathology
  4. At least ½ of root length remaining
  5. Second primary molar retention for the erupting first permanent molars
  6. No permanent successor
  7. Internal resorption without any obvious perforation
  8. Pulpless primary teeth with sinus tracts

CONTRAINDICATION
  1. Teeth with non restorable crowns
  2. Periradicular involvement extending to the permanent tooth bud
  3. Pathological resorption of at least one third of root with a fistulous sinus tract
  4. Excessive internal resorption
  5. Extensive pulp floor opening into the bifurcation
  6. Systemic disease such as congenital or rheumatic heart disease, hepatitis, leukemia.
  7. Primary teeth with underlying dentigerous or follicular cysts

IMAGE

PULPECTOMY TECHNIQUE
  1. Remove caries and determine site of pulp exposure
  2. Remove roof of the pulp chamber
  3. Remove coronal pulp tissue and identify root canals
  4. Clean out canals and remove pulp tissue
  5. Dry canals with paper points
  6. Fill root/coronal chamber with ZNOE
  7. Fill pulp chamber with thickened mix of paste
  8. Restore tooth with stainless steel crown 

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