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Pulp Therapy for Primary Teeth
Published in M S Duggal, M E J Curzon, S A Fayle, K J Toumba, A J Robertson, Restorative Techniques in Paediatric Dentistry, 2021
M S Duggal, M E J Curzon, S A Fayle, K J Toumba, A J Robertson
A pulpotomy is the procedure of removing the coronal part of the pulp tissue, inflamed or infected as a result of deep caries, and the maintenance of vital radicular pulp tissue. A medicament is applied to the remaining root tissue with the aim of ‘fixing’ it. Currently the most widely accepted material, supported by a large number of research studies, is a 1/5 dilution of the original Buckley’s formocresol, the constituents of which are shown in Table 4.1.
Dentin-Pulp Complex Regeneration
Published in Vincenzo Guarino, Marco Antonio Alvarez-Pérez, Current Advances in Oral and Craniofacial Tissue Engineering, 2020
Amaury Pozos-Guillén, Héctor Flores
There are no objective clinical parameters to determine how much carious dentin should be removed; the question arises as to whether to cap the exposed pulp or perform a root canal treatment directly. A systematic review reported success in different longitudinal studies when a complete root canal treatment is performed (Ng 2007). Tooth with pulp exposure subsequent to caries excavation, the cost-benefit relation between a capping procedure, and root canal treatment could still be balanced or even favor pulpectomy (Schwendicke and Stolpe 2014). Completed root formation is a prerequisite for pulpectomy after pulp exposure. As an alternative to pulpectomy, pulpotomy offered a viable alternative to root canal treatment for teeth with vital pulps in short terms (Simon et al. 2013).
Radiosurgical Techniques
Published in Jeffrey A Sherman, Oral Radiosurgery, 2020
A pulpotomy is the amputation of the coronal portion of the pulpal tissue of a vital tooth. A pulpectomy is the complete removal of pulpal tissue when the tooth is non-vital. Radiosurgery can be used to remove part or all of the pulpal tissue to perform a pulpotomy or pulpectomy effectively.
A randomized clinical trial of hyaluronic acid gel pulpotomy in primary molars with 1 year follow-up
Published in Acta Odontologica Scandinavica, 2022
Gökçe Çiçek Ildeş, Batın Ilgıt Sezgin, Alexandre Rezende Vieira, Ali Mentes
Before the treatment, 136 primary molars were randomly distributed to three groups: 1-Formocresol group (FC), 2-Ferric sulphate group (FS) and 3-Hyaluronic acid group (HA). Pulpotomy procedure was initiated with an infiltration anaesthesia. The relevant tooth was isolated by a rubber dam (Roeko Dental Dam®, Coltene Whaledent) and a saliva ejector was inserted. Cavity preparation of the teeth was done using a high speed handpiece (KaVo Dental GmbH, Germany) and a diamond round bur (Dialom, Diamond Tools Ltd.). Carious dentine tissue was removed from the periphery to the centre using round steel burs (NTI-Kahla GmbH, Germany). The roof of the pulp chamber was removed, and the pulp chamber was cleaned with another sterile slow-speed round bur. Remaining pulp tissue was removed with a sterile sharp excavator (Carl Martin GmbH, Germany). The pulp chamber was irrigated with sterile saline solution and then dry sterile cotton pellets were placed on pulp stumps for 4 min to achieve haemostasis.
Which procedures and materials could be applied for full pulpotomy in permanent mature teeth? A systematic review
Published in Acta Odontologica Scandinavica, 2019
M. Zanini, M. Hennequin, PY. Cousson
Dogmas are changing with the evolution of knowledge. For several decades, the widespread view was that full pulpotomies should not be indicated as definitive treatments in permanent mature teeth. Full pulpotomies in vital permanent teeth are now, however, promoted as an alternative to root canal treatment, aiming to preserve pulpal vitality, to reduce the risks for failure of root canal treatment and for economic reasons. A previous quantitative synthesis review including six studies reported [1] that the weighted mean success rate of full pulpotomy reached at least 90% in treating carious vital pulp exposure of permanent mature teeth with closed root apices. It concluded that full pulpotomy could be considered as a substitute to extraction or root canal treatment in specific conditions. Many general dentists may be interested in knowing how to perform full pulpotomy, in face of difficult endodontic cases of vital teeth.
Cost-effectiveness of pulp capping and root canal treatment of young permanent teeth
Published in Acta Odontologica Scandinavica, 2019
Joséphine Brodén, Thomas Davidson, Helena Fransson
Despite the accepted approach of minimally invasive restorative dentistry, excavation of deep caries can lead to a pulp exposure, even with stepwise excavation [1]. In a Scandinavian randomized clinical trial comparing stepwise and immediate complete caries excavation, pulpal exposure was recorded in 17.5% of the 156 teeth randomized to stepwise excavation [2]. The aim of treatment of carious exposures in the permanent teeth of children should ideally be to retain the tooth in a healthy state throughout life. In clinical practice, there are two main approaches to the treatment of an exposed vital pulp: pulp capping (direct pulp capping and partial pulpotomy) and root canal treatment (also referred to as a pulpectomy). Pulp capping is the less invasive approach: the aim is to maintain the vitality of the tooth by application of a capping material to the exposed pulp. Pulpectomy is more invasive: the vital pulp tissue is extirpated, the walls are mechanically debrided and the root canal space is obturated. At present, little is known about the relative cost-effectiveness of these two treatment options in cariously exposed young permanent teeth in Scandinavian conditions.