08 August 2012

PULPOTOMY | pedodontic dentistry



Pulpotomy as the complete removal of the coronal portion of the dental pulp followed by a placement of a suitable dressing or medicament that will promote healing and preserve vitality of the tooth.

The pulpotomy procedure involves removing the coronal pulp tissue that has undergone inflammation or degenerative changes and leaving intact the remaining vital tissue in the rootcanals which is then covered with  pulpotomy agent to promote healing at the amputation site or an agent for fixation of the underlying tissue.

INDICATION FOR PULPOTOMY
  1. Carious primary teeth with infected pulp
  2. Irreversible inflamed pulp
  3. Failed in direct pulp capping
  4. Absence of spontaneous pain
  5. Absence of swelling or alveolar abscess formation
  6. 2/3 root length remaining
CONTRAINDICATION
  1. Permanent successor close to eruption 
  2. An unrestorable tooth
  3. Less than 2/3 of root remaining
  4. Presence of fistula or swelling
  5. Evidence of necrotic irreversibly damaged pulp
  6. Uncontrolled pulpal hemorrhage
  7. Periapical or bifurcation or trifurcation radioluency
  8. Pathological resorption of pulp
  9. Dystrophic calcification(pulp stones)
IMAGES:

Medicaments available for pulpotomy
  1. Formocresol
  2. Mineral trioxide aggregate
  3. Glutaraldehyde solution
  4. Paraformaldehyde
  5. Calcium hydroxide powder
  6. Ferric sulphate
  7. Beechwood creosote
  8. Camphorated monochlorophenol
  9. Laser
  10. Electro surgery
  11. Creating
  12. ZOE
Pulpotomy technique
  1. Remove caries and determine site of pulp exposure
  2. Remove roof of the pulp chamber
  3. Remove coronal pulp tissue and control bleeding
  4. Appropriately use pulpal medicament
  5. Fill pulp chamber with cement/restore

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