INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.com
Treatment Modalities for a Young
Permanent Tooth with extensive
involvement of Pulp.
•Vital Pulp
•Non Vital Pulp
www.india...
Vital Pulp
Open Apex
»Calcium hydroxide pulpotomy
»RCT + Restoration
»Apexogenesis
www.indiandentalacademy.com
Non – Vital Pulp
Open Apex
Apexification
RCT + Restoration
Closed Apex
RCT + Restoration
www.indiandentalacademy.com
Apexogenesis
• Apexogenesis is defined as the treatment
of vital pulp by pulp cappimg or pulpotomy
in oredr to permit cont...
Apexogenesis
Indications
–Reversible pulpitis
–Irreversible pulpitis
Contraindications
–When tooth is sensitive to percuss...
Goals of Apexogenesis
1. Sustaining a viable Hertwig’s epithelial root
sheath, thus allowing continued development
of root...
Apexogenesis - Medicaments
• Calcium hydroxide
• Formocresol
• Glutaraldehyde
www.indiandentalacademy.com
Apexogenesis Restoration
• Root canal system should be obturated
with gutta percha. Dentinal bridge at
pulpotomy site is p...
Necrotic Pulps in YPT
1. Blunt end or rolled cone ( Customized
cone)
2. Short fill
3. Periapical surgery
4. Apical closure...
Apexification
• Apexification is a method of inducing
apical closure through formation of
mineralised tissue in the apical...
Procedure
• First visit- Extirpation + CMCP
• Second Visit- Establish working length+
BMP + CMCP
• Third Visit- BMP + Calc...
Recall After 6 months – following
results are possible
1. No radiographic change is observed but if an
instrument is inser...
Final Filling
1. Vertical gutta percha technique
2. Lateral condensation technique- rolled
cone.
www.indiandentalacademy.c...
Apexogenesis VS Apexification
Physiologic process of root
development in vital infected
tooth
Method of inducing
developme...
www.indiandentalacademy.com
THANK
YOU
www.indiandentalacademy.com
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Treatment modalities for a young permanent tooth with /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Treatment modalities for a young permanent tooth with /certified fixed orthodontic courses by Indian dental academy

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Treatment Modalities for a Young Permanent Tooth with extensive involvement of Pulp. •Vital Pulp •Non Vital Pulp www.indiandentalacademy.com
  3. 3. Vital Pulp Open Apex »Calcium hydroxide pulpotomy »RCT + Restoration »Apexogenesis www.indiandentalacademy.com
  4. 4. Non – Vital Pulp Open Apex Apexification RCT + Restoration Closed Apex RCT + Restoration www.indiandentalacademy.com
  5. 5. Apexogenesis • Apexogenesis is defined as the treatment of vital pulp by pulp cappimg or pulpotomy in oredr to permit continued growth of root and / continued closure of the open apex. • Apexogenesis is defined as physiological root end development and formation. www.indiandentalacademy.com
  6. 6. Apexogenesis Indications –Reversible pulpitis –Irreversible pulpitis Contraindications –When tooth is sensitive to percussion, long history of pain, indicating chronically inflammed pulp. Apexogenesis contraindicated in cases with total necrotic pulps or presence of sinus associated with the infected tooth.www.indiandentalacademy.com
  7. 7. Goals of Apexogenesis 1. Sustaining a viable Hertwig’s epithelial root sheath, thus allowing continued development of root length for a more favorable crown to root ratio. 2. Maintaining pulpal vitality, thus allowing remaining odontoblasts to lay down dentin, producing a thickes root and decreasing the chance of root fracture. 3. Promoting root end closure thus creating a natural apical constriction for gutta percha obturation. 4. Generating a dentinal bridge at the site of pulpotomy. www.indiandentalacademy.com
  8. 8. Apexogenesis - Medicaments • Calcium hydroxide • Formocresol • Glutaraldehyde www.indiandentalacademy.com
  9. 9. Apexogenesis Restoration • Root canal system should be obturated with gutta percha. Dentinal bridge at pulpotomy site is perforated with a round bur for instrumentation. • Pulpotomy therapy should be permanently sealed with a restoration. www.indiandentalacademy.com
  10. 10. Necrotic Pulps in YPT 1. Blunt end or rolled cone ( Customized cone) 2. Short fill 3. Periapical surgery 4. Apical closure induction 5. One visit apexification- resorbable ceramic form of calcium phosphate. www.indiandentalacademy.com
  11. 11. Apexification • Apexification is a method of inducing apical closure through formation of mineralised tissue in the apical pulp region of a non vital tooth with an incompletely formed apex. • It is a specific therapy to stimulate root growth and apical repair subsequent to pulpal necrosis in anterion permanent teeth. www.indiandentalacademy.com
  12. 12. Procedure • First visit- Extirpation + CMCP • Second Visit- Establish working length+ BMP + CMCP • Third Visit- BMP + Calcium hydroxide paste • Forth visit – After 6 weeks change CaOH • Fifth visit – After 6 weeks change CaOh and then recall every two to three months. www.indiandentalacademy.com
  13. 13. Recall After 6 months – following results are possible 1. No radiographic change is observed but if an instrument is inserted, a blockage at the apex will be encountered. 2. Radiographic evidence of calcific material is seen at or near the apex. 3. Apex closes without any change in canal space. 4. Apex continues to develop with closure of canal 5. No radiographic evidence of change is seen and clinical symptoms and / or development of a periapical lesion occur. www.indiandentalacademy.com
  14. 14. Final Filling 1. Vertical gutta percha technique 2. Lateral condensation technique- rolled cone. www.indiandentalacademy.com
  15. 15. Apexogenesis VS Apexification Physiologic process of root development in vital infected tooth Method of inducing development of root apex in an immature pulpless tooth by formation of osteocementum or other bone like tissue. Normal or pulp tissue with minimal inflammation is present: DPC or Pulpotomy Indicated where there is no normal pulp tissue i. e irreperable necrosis. Normal root end development takes place Normal root development takes place rarely. More commonly, calcific barrier is formed clinically, on a radiograph or both.www.indiandentalacademy.com
  16. 16. www.indiandentalacademy.com
  17. 17. THANK YOU www.indiandentalacademy.com

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