This document provides an overview of different vital pulp therapy procedures for primary and young permanent teeth, including indirect and direct pulp capping, pulpotomy, partial pulpectomy, and complete pulpectomy. It describes the techniques, indications, and materials used for each procedure. Potential causes of failure after vital pulp therapy like internal resorption and alveolar abscess are also discussed. The document concludes by mentioning contraindications for pulp treatment in primary teeth and alternative pulpotomy methods like electro surgery and laser pulpotomy.
pulpotomy procedures in primary dentitionParth Thakkar
A pulpotomy involves removing the inflamed coronal pulp while leaving the healthy radicular pulp intact. The aim is to relieve pain and allow for root development. Formocresol pulpotomy is commonly used and involves applying formocresol to the exposed pulp stump to fix tissues and eliminate microorganisms. It is performed using either a single-stage or two-stage technique. Other materials used include calcium hydroxide, glutaraldehyde and ferric sulfate. Success rates depend on strict case selection and technique.
This document summarizes research on the use of Endocem MTA for vital pulp therapies like direct pulp capping, partial pulpotomy, and pulpotomy. It finds that Endocem MTA has biocompatibility, odontogenic effects, sealing ability, lacks discoloration, and antibacterial effects similar to ProRoot MTA. Case studies show high success rates for these treatments over periods of up to 3 years. While long term studies are still needed, Endocem MTA appears to be an effective and safer alternative to calcium hydroxide for vital pulp therapies.
Medicament's used in pulp therapy of pediatric dentistry Izhar Ali
The document discusses various medicaments used in pulp therapy for primary teeth. It describes techniques such as pulp capping, pulpotomy, and pulpectomy. Formocresol and ferric sulfate are commonly used vital pulpotomy medicaments, though concerns exist regarding formocresol's toxicity. Mineral trioxide aggregate and NuSmile NeoMTA are newer alternatives that are non-staining with good clinical success rates. Calcium hydroxide was previously used but causes resorption in primary teeth. Overall, multiple medicaments are available though studies show MTA and ferric sulfate may be favorable replacements for formocresol.
Reaction of the pulp to various capping materials 2003Asmaa Ali
This document discusses various pulp treatment materials and their effects. It outlines the objectives of pulp treatment as maintaining tooth integrity and vitality. Types of treatment include conservative (protective base, pulp capping, pulpotomy) and radical (partial pulpectomy, pulpectomy, nonvital pulpotomy). Ideal materials are bactericidal, biocompatible, harmless, promote healing and not interfere with resorption. Materials discussed include zinc oxide-eugenol, calcium hydroxide, antibiotics/corticosteroids with calcium hydroxide, tricalcium phosphate with calcium hydroxide, adhesive liners, mineral trioxide aggregate, lasers, growth factors and calcium phosphate compounds. Histological responses
The document discusses various modalities for pulp treatment including protective base placement, indirect pulp capping therapy, direct pulp capping, pulpotomy, and root canal treatment. It describes indications, contraindications, materials, and procedures for each treatment. Key points include calcium hydroxide and mineral trioxide aggregate being common pulp capping agents, formocresol and glutaraldehyde used for devitalizing pulpotomies, and ferric sulfate and mineral trioxide aggregate promoting pulp preservation and regeneration respectively.
This document discusses pulpotomy procedures for primary teeth. Pulpotomy involves removing the coronal portion of the pulp and dressing the remaining radicular pulp. It is indicated for cariously exposed primary teeth when retention is preferable to extraction. Techniques include devitalization with formocresol or other chemicals to fix the pulp, preservation techniques using milder chemicals to maintain pulp vitality, and regeneration techniques to encourage reparative dentin formation. Alternatives to formocresol discussed are glutaraldehyde, ferric sulfate, electrosurgery, and lasers.
The document discusses Cvek's pulpotomy procedure, which involves removing the inflamed pulp tissue beneath an exposure in a young permanent tooth up to 1-3mm deep. This preserves the vitality of the remaining healthy pulp tissue and allows for normal root development. The procedure involves removing carious material, performing the pulpotomy, applying calcium hydroxide to arrest bleeding and provide a bacterial seal, and restoring the tooth permanently. The tooth is then reviewed after 1 month and every 6 months for up to 4 years to check pulp vitality and sensitivity.
This document discusses various pulpotomy procedures for primary teeth. It defines pulpotomy as removing the coronal pulp and placing a medicament on the radicular pulp stumps. Several materials used for pulpotomy are discussed, including formocresol, glutaraldehyde, calcium hydroxide, ferric sulfate, and MTA. The procedure, success rates, advantages and disadvantages of different materials are summarized. Alternative methods like laser pulpotomy and electrosurgery are also mentioned.
pulpotomy procedures in primary dentitionParth Thakkar
A pulpotomy involves removing the inflamed coronal pulp while leaving the healthy radicular pulp intact. The aim is to relieve pain and allow for root development. Formocresol pulpotomy is commonly used and involves applying formocresol to the exposed pulp stump to fix tissues and eliminate microorganisms. It is performed using either a single-stage or two-stage technique. Other materials used include calcium hydroxide, glutaraldehyde and ferric sulfate. Success rates depend on strict case selection and technique.
This document summarizes research on the use of Endocem MTA for vital pulp therapies like direct pulp capping, partial pulpotomy, and pulpotomy. It finds that Endocem MTA has biocompatibility, odontogenic effects, sealing ability, lacks discoloration, and antibacterial effects similar to ProRoot MTA. Case studies show high success rates for these treatments over periods of up to 3 years. While long term studies are still needed, Endocem MTA appears to be an effective and safer alternative to calcium hydroxide for vital pulp therapies.
Medicament's used in pulp therapy of pediatric dentistry Izhar Ali
The document discusses various medicaments used in pulp therapy for primary teeth. It describes techniques such as pulp capping, pulpotomy, and pulpectomy. Formocresol and ferric sulfate are commonly used vital pulpotomy medicaments, though concerns exist regarding formocresol's toxicity. Mineral trioxide aggregate and NuSmile NeoMTA are newer alternatives that are non-staining with good clinical success rates. Calcium hydroxide was previously used but causes resorption in primary teeth. Overall, multiple medicaments are available though studies show MTA and ferric sulfate may be favorable replacements for formocresol.
Reaction of the pulp to various capping materials 2003Asmaa Ali
This document discusses various pulp treatment materials and their effects. It outlines the objectives of pulp treatment as maintaining tooth integrity and vitality. Types of treatment include conservative (protective base, pulp capping, pulpotomy) and radical (partial pulpectomy, pulpectomy, nonvital pulpotomy). Ideal materials are bactericidal, biocompatible, harmless, promote healing and not interfere with resorption. Materials discussed include zinc oxide-eugenol, calcium hydroxide, antibiotics/corticosteroids with calcium hydroxide, tricalcium phosphate with calcium hydroxide, adhesive liners, mineral trioxide aggregate, lasers, growth factors and calcium phosphate compounds. Histological responses
The document discusses various modalities for pulp treatment including protective base placement, indirect pulp capping therapy, direct pulp capping, pulpotomy, and root canal treatment. It describes indications, contraindications, materials, and procedures for each treatment. Key points include calcium hydroxide and mineral trioxide aggregate being common pulp capping agents, formocresol and glutaraldehyde used for devitalizing pulpotomies, and ferric sulfate and mineral trioxide aggregate promoting pulp preservation and regeneration respectively.
This document discusses pulpotomy procedures for primary teeth. Pulpotomy involves removing the coronal portion of the pulp and dressing the remaining radicular pulp. It is indicated for cariously exposed primary teeth when retention is preferable to extraction. Techniques include devitalization with formocresol or other chemicals to fix the pulp, preservation techniques using milder chemicals to maintain pulp vitality, and regeneration techniques to encourage reparative dentin formation. Alternatives to formocresol discussed are glutaraldehyde, ferric sulfate, electrosurgery, and lasers.
The document discusses Cvek's pulpotomy procedure, which involves removing the inflamed pulp tissue beneath an exposure in a young permanent tooth up to 1-3mm deep. This preserves the vitality of the remaining healthy pulp tissue and allows for normal root development. The procedure involves removing carious material, performing the pulpotomy, applying calcium hydroxide to arrest bleeding and provide a bacterial seal, and restoring the tooth permanently. The tooth is then reviewed after 1 month and every 6 months for up to 4 years to check pulp vitality and sensitivity.
This document discusses various pulpotomy procedures for primary teeth. It defines pulpotomy as removing the coronal pulp and placing a medicament on the radicular pulp stumps. Several materials used for pulpotomy are discussed, including formocresol, glutaraldehyde, calcium hydroxide, ferric sulfate, and MTA. The procedure, success rates, advantages and disadvantages of different materials are summarized. Alternative methods like laser pulpotomy and electrosurgery are also mentioned.
Pulpectomy is a dental procedure to remove infected or dead pulp from the root canals of primary teeth. It aims to maintain the tooth in a non-infected state by cleaning and filling the root canals. A partial pulpectomy removes pulp from a single visit, while a complete pulpectomy is done over two visits with emergency treatment followed by root canal filling. Common filling materials for primary teeth include zinc oxide eugenol paste and iodoform paste, which resorb at a rate similar to the tooth root. The procedure involves local anesthesia, access through the crown, pulp removal, canal cleaning and shaping, irrigation, drying and obturation.
This document summarizes different techniques for pulp capping including direct and indirect pulp capping. It discusses the history of various materials used for pulp capping such as calcium hydroxide and mineral trioxide aggregate. Key points covered include the indications and contraindications for pulp capping, the ideal properties of capping materials, and the histological response after pulp capping including zone formation. The document provides an overview of pulp capping procedures and factors influencing their success.
Vital pulp therapy in primary and permanent toothVaishnavi1996
This document provides information on various vital pulp therapy procedures including indirect pulp capping, direct pulp capping, and pulpotomy. It defines each procedure and discusses their objectives, indications, contraindications and treatment considerations. Indirect pulp capping involves sealing off carious dentin near the pulp to encourage recovery, while direct pulp capping places a protective material directly over an exposed pulp. Pulpotomy involves removing the coronal pulp and placing a medicament to preserve the vitality of the remaining radicular pulp. The document outlines the factors that influence the success of each procedure such as the size of any pulp exposure and presence of preoperative pain or radiographic abnormalities.
This document discusses pulp capping, which involves placing a biocompatible material over exposed dental pulp to avoid pulp tissue exposure and promote healing. It describes indirect pulp capping, which leaves decayed dentin behind to avoid pulp exposure, and direct pulp capping, which dresses small pulp exposures with calcium hydroxide or resin bonding agents. Successful pulp capping requires maintaining pulp vitality without pain or pathology and promoting dentin bridge formation. Calcium hydroxide is commonly used but can degrade over time, while resin bonding agents may provide a better seal but with less evidence of success.
it will provide u a detail description about direct pulp capping treatment,its indication ,contraindication,methods and materials used,techniqes,advantage and disadvantage and its limitation on primary teeth
This document discusses various clinical and radiographic assessment techniques for evaluating the status of the primary tooth pulp, including tests for sensitivity and pulp testing reliability. It also summarizes different types of pain and their association with pulp status. Treatment options like indirect and direct pulp capping, pulpotomy, and the various medicaments used are described, along with their indications, objectives, techniques and success rates. Concerns regarding materials like formocresol are also mentioned.
This document provides an overview of pulpotomy procedures for primary teeth. It begins with definitions of pulpotomy and discusses the rationale, objectives, indications, contraindications and classification of different pulpotomy techniques. It then describes various medicaments that can be used, including formocresol, glutaraldehyde, calcium hydroxide, and ferric sulfate. The document outlines techniques for formocresol pulpotomy, electrosurgical pulpotomy, and laser pulpotomy. It also discusses recent concepts in pulpotomy including the use of bone morphogenetic protein and enamel matrix derivatives. The document concludes by examining reasons for failure of pulpotomy therapy.
This document discusses various pulp therapies for primary teeth including indirect pulp capping, direct pulp capping, pulpotomy, and apexogenesis. It provides details on the procedures, indications, contraindications, and materials used for each therapy. Indirect pulp capping involves carious dentin removal while avoiding pulp exposure and using calcium hydroxide or MTA to protect the pulp. Direct pulp capping is used when a small exposure occurs, using calcium hydroxide or MTA directly on the exposure. Pulpotomy involves removing the coronal pulp and using formocresol or other medications to preserve the remaining vital pulp.
Difference between pulpotomy and pulpectomyOwais92
Pulpotomy involves removing the coronal portion of the pulp and placing a medicament, indicated for large carious lesions involving the marginal ridge in a vital tooth with no pain or infection. Pulpectomy removes all pulp tissue from the chamber and root canals, indicated for teeth with irreversible pulpitis throughout the pulp or abscessed primary teeth. Contraindications for both procedures include the presence of infection, bone loss, or non-restorable teeth.
The document discusses various pulp treatment procedures for primary teeth, including indirect pulp capping (IPC) and direct pulp capping (DPC). IPC involves removing gross caries and sealing the cavity to allow the remaining infected dentin to be arrested, while DPC places a protective material directly over an exposed pulp site. Both aim to preserve pulp vitality and encourage reparative dentin formation. Key factors in success include residual dentin thickness and choice of capping agent. DPC is not recommended for primary teeth due to their higher cellular content and inflammatory response compared to permanent teeth.
MTA is now the material of choice for apexification and apexogenesis procedures due to its advantages over calcium hydroxide. It induces the formation of dentin, cementum, and bone, has excellent biocompatibility and sealing ability, and sets in the presence of moisture. For apexification, thorough debridement and coronal sealing are critical for apical closure. Calcium hydroxide was previously used but has disadvantages like a long treatment time.
This document discusses pulp capping materials, including their definition, ideal properties, classification, types and examples. Pulp capping materials are applied directly or indirectly to the pulp to help develop defenses to preserve its vitality. They are classified into three categories: pulp devitalization, preservation and healing. Examples of devitalization materials include formocresol, glutaraldehyde and electrosurgery. Preservation materials include ZnO-E, resin cements, ferric sulfate and glass ionomer. Healing materials promote regeneration and include calcium hydroxide, MTA, tricalcium phosphate and various experimental materials like growth factors, lasers and biomaterials. The document provides details on various materials and their mechanisms
This document discusses apexification and indirect pulp capping procedures. Apexification is used to induce calcification at the open apex of an immature tooth to allow for root canal treatment. Materials used include calcium hydroxide, tricalcium phosphate, and MTA. Calcium hydroxide is placed in the canal and replaced every 3 months until radiographic evidence of apical barrier formation. MTA can also be used by placing it at the apex. Indirect pulp capping covers the deepest carious dentin with a biocompatible material like calcium hydroxide to prevent pulpal exposure while removing infected dentin, allowing for pulp preservation.
This document discusses apexogenesis and apexification, which are processes for encouraging continued root development in immature permanent teeth with open apices or non-vital pulps. Apexogenesis aims to maintain pulp vitality through treatments like pulpotomy to allow for continued physiological root development, while apexification uses materials like calcium hydroxide or MTA to induce the formation of an apical barrier in a pulpless tooth to enable filling of the root canal. The document provides details on the objectives, materials, techniques and outcomes of these procedures.
Direct pulp capping involves placing a medicated material directly on a exposed dental pulp to encourage formation of reparative dentin and seal the exposure. It is generally not recommended for primary teeth due to factors like the primary pulp's closer proximity to the outer enamel, more rapid response to irritation, and higher risk of internal resorption. Success requires a small, asymptomatic exposure with no signs of infection and use of calcium hydroxide or other materials to stimulate dentin bridge formation while preventing further inflammation.
This document discusses different types of vital pulp therapy procedures used to maintain pulp vitality when it has been exposed or injured. It describes indirect pulp capping, direct pulp capping, pulpotomy, and apexification procedures. Key goals are to treat reversible pulpal injuries, neutralize contamination, and prevent further contamination. Materials used include calcium hydroxide and MTA, with advantages and disadvantages discussed for each. The ideal properties of pulp capping agents are also reviewed.
Pulp capping involves placing a specialized agent on or near the pulp to encourage formation of new dentin and promote pulp healing. Successful pulp capping requires a healthy, uninfected pulp exposure of less than 0.5mm. Common pulp capping materials include cavity sealants, bases like zinc phosphate or polycarboxylate cements, and liners such as calcium hydroxide, glass ionomer cement, or zinc oxide eugenol. Recent advances in pulp capping include the use of mineral trioxide aggregate, hydroxyapatite, collagen, biodentine, and polycarboxylate cements which help stimulate dentin bridge formation and seal exposed pulps.
This document provides an overview of pulp therapy procedures for permanent and young primary teeth. It discusses the histology and structural elements of the dental pulp, as well as the reactions of pulp to dental caries and operative procedures. Indirect and direct pulp capping techniques are described, along with the medicaments and materials used. The document also notes the limitations of direct pulp capping in primary teeth and points to consider during these procedures.
This document discusses the management of Class IV Ellis fractures, which involve trauma to teeth resulting in pulp involvement or loss of crown structure. It describes the emergency treatment, which may include reinserting an avulsed tooth. Intermediate treatment options for exposed or necrotic pulps include pulpectomy, apexification, or extraction. Pulpectomy involves conventional root canal treatment to eliminate infection, while apexification induces formation of new tissue at the root end in immature teeth. The document also discusses crown fractures involving enamel, dentin, or both, and the treatment options depending on the extent of injury and pulp involvement. These may include protective dressings, temporary crowns, or reattachment of fragments.
Pulpectomy is a dental procedure to remove infected or dead pulp from the root canals of primary teeth. It aims to maintain the tooth in a non-infected state by cleaning and filling the root canals. A partial pulpectomy removes pulp from a single visit, while a complete pulpectomy is done over two visits with emergency treatment followed by root canal filling. Common filling materials for primary teeth include zinc oxide eugenol paste and iodoform paste, which resorb at a rate similar to the tooth root. The procedure involves local anesthesia, access through the crown, pulp removal, canal cleaning and shaping, irrigation, drying and obturation.
This document summarizes different techniques for pulp capping including direct and indirect pulp capping. It discusses the history of various materials used for pulp capping such as calcium hydroxide and mineral trioxide aggregate. Key points covered include the indications and contraindications for pulp capping, the ideal properties of capping materials, and the histological response after pulp capping including zone formation. The document provides an overview of pulp capping procedures and factors influencing their success.
Vital pulp therapy in primary and permanent toothVaishnavi1996
This document provides information on various vital pulp therapy procedures including indirect pulp capping, direct pulp capping, and pulpotomy. It defines each procedure and discusses their objectives, indications, contraindications and treatment considerations. Indirect pulp capping involves sealing off carious dentin near the pulp to encourage recovery, while direct pulp capping places a protective material directly over an exposed pulp. Pulpotomy involves removing the coronal pulp and placing a medicament to preserve the vitality of the remaining radicular pulp. The document outlines the factors that influence the success of each procedure such as the size of any pulp exposure and presence of preoperative pain or radiographic abnormalities.
This document discusses pulp capping, which involves placing a biocompatible material over exposed dental pulp to avoid pulp tissue exposure and promote healing. It describes indirect pulp capping, which leaves decayed dentin behind to avoid pulp exposure, and direct pulp capping, which dresses small pulp exposures with calcium hydroxide or resin bonding agents. Successful pulp capping requires maintaining pulp vitality without pain or pathology and promoting dentin bridge formation. Calcium hydroxide is commonly used but can degrade over time, while resin bonding agents may provide a better seal but with less evidence of success.
it will provide u a detail description about direct pulp capping treatment,its indication ,contraindication,methods and materials used,techniqes,advantage and disadvantage and its limitation on primary teeth
This document discusses various clinical and radiographic assessment techniques for evaluating the status of the primary tooth pulp, including tests for sensitivity and pulp testing reliability. It also summarizes different types of pain and their association with pulp status. Treatment options like indirect and direct pulp capping, pulpotomy, and the various medicaments used are described, along with their indications, objectives, techniques and success rates. Concerns regarding materials like formocresol are also mentioned.
This document provides an overview of pulpotomy procedures for primary teeth. It begins with definitions of pulpotomy and discusses the rationale, objectives, indications, contraindications and classification of different pulpotomy techniques. It then describes various medicaments that can be used, including formocresol, glutaraldehyde, calcium hydroxide, and ferric sulfate. The document outlines techniques for formocresol pulpotomy, electrosurgical pulpotomy, and laser pulpotomy. It also discusses recent concepts in pulpotomy including the use of bone morphogenetic protein and enamel matrix derivatives. The document concludes by examining reasons for failure of pulpotomy therapy.
This document discusses various pulp therapies for primary teeth including indirect pulp capping, direct pulp capping, pulpotomy, and apexogenesis. It provides details on the procedures, indications, contraindications, and materials used for each therapy. Indirect pulp capping involves carious dentin removal while avoiding pulp exposure and using calcium hydroxide or MTA to protect the pulp. Direct pulp capping is used when a small exposure occurs, using calcium hydroxide or MTA directly on the exposure. Pulpotomy involves removing the coronal pulp and using formocresol or other medications to preserve the remaining vital pulp.
Difference between pulpotomy and pulpectomyOwais92
Pulpotomy involves removing the coronal portion of the pulp and placing a medicament, indicated for large carious lesions involving the marginal ridge in a vital tooth with no pain or infection. Pulpectomy removes all pulp tissue from the chamber and root canals, indicated for teeth with irreversible pulpitis throughout the pulp or abscessed primary teeth. Contraindications for both procedures include the presence of infection, bone loss, or non-restorable teeth.
The document discusses various pulp treatment procedures for primary teeth, including indirect pulp capping (IPC) and direct pulp capping (DPC). IPC involves removing gross caries and sealing the cavity to allow the remaining infected dentin to be arrested, while DPC places a protective material directly over an exposed pulp site. Both aim to preserve pulp vitality and encourage reparative dentin formation. Key factors in success include residual dentin thickness and choice of capping agent. DPC is not recommended for primary teeth due to their higher cellular content and inflammatory response compared to permanent teeth.
MTA is now the material of choice for apexification and apexogenesis procedures due to its advantages over calcium hydroxide. It induces the formation of dentin, cementum, and bone, has excellent biocompatibility and sealing ability, and sets in the presence of moisture. For apexification, thorough debridement and coronal sealing are critical for apical closure. Calcium hydroxide was previously used but has disadvantages like a long treatment time.
This document discusses pulp capping materials, including their definition, ideal properties, classification, types and examples. Pulp capping materials are applied directly or indirectly to the pulp to help develop defenses to preserve its vitality. They are classified into three categories: pulp devitalization, preservation and healing. Examples of devitalization materials include formocresol, glutaraldehyde and electrosurgery. Preservation materials include ZnO-E, resin cements, ferric sulfate and glass ionomer. Healing materials promote regeneration and include calcium hydroxide, MTA, tricalcium phosphate and various experimental materials like growth factors, lasers and biomaterials. The document provides details on various materials and their mechanisms
This document discusses apexification and indirect pulp capping procedures. Apexification is used to induce calcification at the open apex of an immature tooth to allow for root canal treatment. Materials used include calcium hydroxide, tricalcium phosphate, and MTA. Calcium hydroxide is placed in the canal and replaced every 3 months until radiographic evidence of apical barrier formation. MTA can also be used by placing it at the apex. Indirect pulp capping covers the deepest carious dentin with a biocompatible material like calcium hydroxide to prevent pulpal exposure while removing infected dentin, allowing for pulp preservation.
This document discusses apexogenesis and apexification, which are processes for encouraging continued root development in immature permanent teeth with open apices or non-vital pulps. Apexogenesis aims to maintain pulp vitality through treatments like pulpotomy to allow for continued physiological root development, while apexification uses materials like calcium hydroxide or MTA to induce the formation of an apical barrier in a pulpless tooth to enable filling of the root canal. The document provides details on the objectives, materials, techniques and outcomes of these procedures.
Direct pulp capping involves placing a medicated material directly on a exposed dental pulp to encourage formation of reparative dentin and seal the exposure. It is generally not recommended for primary teeth due to factors like the primary pulp's closer proximity to the outer enamel, more rapid response to irritation, and higher risk of internal resorption. Success requires a small, asymptomatic exposure with no signs of infection and use of calcium hydroxide or other materials to stimulate dentin bridge formation while preventing further inflammation.
This document discusses different types of vital pulp therapy procedures used to maintain pulp vitality when it has been exposed or injured. It describes indirect pulp capping, direct pulp capping, pulpotomy, and apexification procedures. Key goals are to treat reversible pulpal injuries, neutralize contamination, and prevent further contamination. Materials used include calcium hydroxide and MTA, with advantages and disadvantages discussed for each. The ideal properties of pulp capping agents are also reviewed.
Pulp capping involves placing a specialized agent on or near the pulp to encourage formation of new dentin and promote pulp healing. Successful pulp capping requires a healthy, uninfected pulp exposure of less than 0.5mm. Common pulp capping materials include cavity sealants, bases like zinc phosphate or polycarboxylate cements, and liners such as calcium hydroxide, glass ionomer cement, or zinc oxide eugenol. Recent advances in pulp capping include the use of mineral trioxide aggregate, hydroxyapatite, collagen, biodentine, and polycarboxylate cements which help stimulate dentin bridge formation and seal exposed pulps.
This document provides an overview of pulp therapy procedures for permanent and young primary teeth. It discusses the histology and structural elements of the dental pulp, as well as the reactions of pulp to dental caries and operative procedures. Indirect and direct pulp capping techniques are described, along with the medicaments and materials used. The document also notes the limitations of direct pulp capping in primary teeth and points to consider during these procedures.
This document discusses the management of Class IV Ellis fractures, which involve trauma to teeth resulting in pulp involvement or loss of crown structure. It describes the emergency treatment, which may include reinserting an avulsed tooth. Intermediate treatment options for exposed or necrotic pulps include pulpectomy, apexification, or extraction. Pulpectomy involves conventional root canal treatment to eliminate infection, while apexification induces formation of new tissue at the root end in immature teeth. The document also discusses crown fractures involving enamel, dentin, or both, and the treatment options depending on the extent of injury and pulp involvement. These may include protective dressings, temporary crowns, or reattachment of fragments.
This document discusses the treatment of immature permanent teeth with incompletely formed roots. It describes apexogenesis for vital immature teeth, which aims to allow continued root formation through pulpotomy or partial pulpectomy. For non-vital immature teeth (apexification), the goal is inducing apical closure with calcified tissue using calcium hydroxide paste placed in the root canal. Placement of the paste every 3-6 months allows formation of a hard tissue bridge at the apex seen on x-rays within 3-12 months, at which point further root canal treatment can be completed. Calcium hydroxide has shown success rates of 74-100% for stimulating apexification.
Apexogenesis aims to preserve the vital pulp tissue in an immature tooth to allow continued root development. It involves a deep pulpotomy to remove inflamed tissue while maintaining healthy tissue. Apexification induces formation of a calcified barrier at an open apex in a nonvital immature tooth. Calcium hydroxide is typically used over multiple visits but MTA can induce barrier formation in a single visit. The goal is to create an artificial barrier against which root filling can be condensed to allow restoration of the immature tooth.
This document discusses apexogenesis and apexification procedures for teeth with open apices. Apexogenesis refers to treatments that maintain pulp vitality and allow continued root development and apex closure. These include indirect pulp capping, direct pulp capping, and apical closure pulpotomy using materials like calcium hydroxide or MTA. Apexification induces artificial root end closure when the pulp is necrotic, using repeated dressings of calcium hydroxide or MTA to encourage hard tissue deposition. Clinical success depends on factors like the treatment material and maintaining a bacteria-tight seal during root development.
Indirect pulp capping involves removing gross caries while leaving a thin layer over the pulp to avoid exposure. It allows the remaining caries to arrest over 6-8 weeks under a restoration. Direct pulp capping is for small exposures, usually accidental, surrounded by sound dentin. Calcium hydroxide or MTA is placed directly on the exposure. Pulpotomy removes the coronal pulp for carious or mechanical exposures, with various medicaments like formocresol or MTA placed on the remaining pulp stumps. Success requires careful case selection and technique. Indirect capping and MTA pulpotomy show promise but need more long-term research for primary teeth.
The document discusses several alternative modalities to traditional root canal therapy that aim to preserve pulp vitality, including pulpotomy, pulp capping, gentle wave procedure, lasers, regenerative endodontics, and various natural remedies. It provides details on techniques such as formocresol pulpotomy, Cvek's pulpotomy, electrosurgical pulpotomy, indirect and direct pulp capping. The gentle wave procedure utilizes multisonic ultracleaning technology while lasers allow endodontic treatment using an Er,Cr:YSGG laser. Overall, the document outlines various treatments that offer less invasive options compared to traditional root canal therapy.
This document discusses various vital pulp therapies including direct and indirect pulp capping. Indirect pulp capping involves covering the deepest layer of remaining carious dentin with a biocompatible material to prevent exposure and further trauma to the pulp. It aims to arrest the carious process and allow reparative dentin formation. Direct pulp capping places a protective material directly over an exposed pulp to maintain its vitality. Materials used include calcium hydroxide and MTA, with each having their own application technique. Factors like exposure size and timing influence the prognosis of direct pulp capping. Maintaining a sterile, adhesive seal over the exposed site is important for treatment success.
This document discusses classification and treatment of dental trauma. It begins by classifying crown fractures from Class I (simple enamel fracture) to Class IV (loss of entire crown). It then discusses treatment for each class of fracture, including covering exposed dentin with glass ionomer or bonding. For pulp exposures, it describes pulpotomy/pulpectomy techniques using materials like MTA or calcium hydroxide. For immature permanent teeth with open apices, it recommends apexogenesis using calcium hydroxide or MTA to encourage continued root development. Direct pulp capping may be used for small, recent exposures, while endodontic treatment is needed for symptomatic or large exposures.
Vital pulp therapy aims to maintain pulp vitality by removing irritants and placing protective materials over exposed pulp. Indirect pulp capping covers deep caries with a biocompatible material to stimulate tertiary dentin formation and arrest decay. Direct pulp capping places protective dressings directly over pulp exposures to induce reparative dentin bridges. Calcium hydroxide and mineral trioxide aggregate are commonly used capping agents. Apexification forms apical barriers in open-apexed teeth while pulpotomy removes coronal pulp to preserve radicular vitality. Gentle techniques and accurate diagnoses are important for predictable outcomes of vital pulp therapies.
General pediatric dentistry for undergraduate students.pptxNikhilSuresh47
This document provides an overview of various clinical procedures in pediatric dentistry, including indirect pulp capping, direct pulp capping, pulpotomy, apexogenesis, pulpectomy, and apexification. It describes the definitions, objectives, indications, contraindications, and treatment procedures for each clinical technique.
This document discusses various methods and materials used for pulp protection during restorative procedures. It describes the pulp-dentin complex and factors that can irritate the pulp. Methods for protecting the pulp include indirect and direct pulp capping. Direct pulp capping involves placing a biocompatible material over an exposed pulp. Indirect pulp capping leaves a thin layer of dentin and caries to avoid exposure. Materials traditionally used include calcium hydroxide, zinc oxide eugenol, and glass ionomers. Newer materials like Biodentine, a calcium silicate-based cement, have shown promising results for pulp capping and stimulation of reparative dentin formation.
This document provides information on the surgical procedure of apicoectomy. It begins by defining apicoectomy as the surgical resection and removal of the root tip along with pathological tissues. It then lists indications for the procedure such as teeth with active periapical inflammation despite satisfactory endodontic therapy. The document describes the surgical technique which includes flap design, exposing the apex, resection of the apex, and potentially retrograde filling. It provides details on instruments used and cautions to take such as ensuring the resection is at a right angle to reduce apical leakage.
This document defines pulpotomy and describes the various techniques used. It begins by defining pulpotomy as the complete removal of the coronal portion of the dental pulp, followed by placement of a dressing to promote healing and preserve tooth vitality. It then discusses indications, contraindications, classification into vital, non-vital techniques. Specific techniques are described like formocresol pulpotomy, electrosurgery pulpotomy, and laser pulpotomy. Materials used for devitalization, preservation and regeneration of the pulp are also outlined. The objectives of treatment and techniques for both single and two-stage devitalization pulpotomies are provided in detail.
1. Dental resorption is the loss of dental hard tissues due to osteoclast activity and can be physiological or pathological. It includes internal root resorption within the root canal and external resorption on the root surface.
2. Internal root resorption presents with non-specific symptoms but radiographs show a smooth radiolucency within the root canal space. External resorption like external inflammatory resorption after dental trauma leads to bone loss visible on radiographs.
3. Management depends on the type and severity of resorption but involves root canal treatment, surgery, and restoration with materials like mineral trioxide aggregate or gutta-percha to repair defects.
This document discusses pulpectomy procedures for primary teeth. It begins by defining pulpectomy as the complete removal of necrotic pulp tissue from the root canals and filling them with an inert material. The objectives and indications for pulpectomy in primary teeth are then outlined. These include maintaining the tooth free of infection and promoting root resorption. Contraindications like excessive tooth mobility or communication between pulp chamber and furcation are also defined. The document proceeds to describe procedures for single-visit and multiple-visit pulpectomies and discusses factors like access opening, working length determination, chemo-mechanical preparation and various obturation materials and techniques used in primary teeth.
Endodontic surgery ppt dr. ahmed elfatoryaabdesalam
Endodontic surgery, also known as apicoectomy, involves surgically resecting the root tip and surrounding pathological tissues to resolve periapical lesions and restore tissue health. It is often performed when root canal treatment fails or has difficulties. The aim is to disinfect the pulp space and seal it to prevent reinfection. Periapical lesions are caused by microbial contamination reaching the apex via caries or trauma. Treatment options include extraction, retreatment, or surgery. Endodontic surgery requires resection of the apex and removal of pathological tissue. Care must be taken near anatomical structures like the maxillary sinus or mental foramen. Both conventional and retrograde approaches are used depending on the clinical situation.
This document discusses various aspects of endodontic treatment including:
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- Pain control techniques in endodontics including local anesthesia administration and use of conscious sedation.
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- Pulp amputation (pulpotomy) which involves removing part of the pulp, the indications, and technique.
- Pulpectomy (pulp extirpation) which involves removing the entire pulp, the indications, and steps in the technique.
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The document discusses principles of oral surgery including access, visibility, and flap design. It states that adequate access requires wide mouth opening and retraction of tissues away from the surgical field. Improved access can be gained by creating surgical flaps using incisions. Key principles of incisions and flap design are outlined such as using a sharp blade, firm strokes, avoiding vital structures, and designing flaps to ensure adequate blood supply and healing. Common flap types including triangular, trapezoidal, envelope, and semilunar flaps are described. Careful handling of tissues is also emphasized to minimize damage.
Lecture 3 Facial cosmetic surgery
Maxillofacial Surgery
Dental Students Fifth Year second semester
Al Azhar University Gaza Palestine
Dr. Lama El Banna
https://twitter.com/lama_k_banna
Lecture 1 Facial cosmetic surgery
Maxillofacial Surgery
Dental Students Fifth Year second semester
Al Azhar University Gaza Palestine
Dr. Lama El Banna
https://twitter.com/lama_k_banna
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Lecture 4 facial neuropathology
Maxillofacial Surgery
Dental Students Fifth Year second semester
Al Azhar University Gaza Palestine
Dr. Lama El Banna
https://twitter.com/lama_k_banna
Lecture 2 Facial cosmetic surgery
Maxillofacial Surgery
Dental Students Fifth Year second semester
Al Azhar University Gaza Palestine
Dr. Lama El Banna
https://twitter.com/lama_k_banna
Lecture 12 general considerations in treatment of tmdLama K Banna
Maxillofacial Surgery
Dental Students Fifth Year First semester
Lecture Name 12 general considerations in the treatment of TMJ
Al Azhar University Gaza Palestine
Dr. Lama El Banna
Maxillofacial Surgery
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Al Azhar University Gaza Palestine
Dr. Lama El Banna
https://twitter.com/lama_k_banna
Lecture 11 temporomandibular joint Part 3Lama K Banna
Maxillofacial Surgery
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Lecture Name TMJ temporomandibular joint Part 3
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Al Azhar University Gaza Palestine
Dr. Lama El Banna
Maxillofacial Surgery
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Lecture Name TMJ anatomy examination 2
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Al Azhar University Gaza Palestine
Dr. Lama El Banna
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Maxillofacial Surgery
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Lecture Name Correction of dentofacial deformities Part 2
Lecture 7
Al Azhar University Gaza Palestine
Dr. Lama El Banna
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Maxillofacial Surgery
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Al Azhar University Gaza Palestine
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The document discusses epidemiological studies that estimate the prevalence of malocclusion and dentofacial deformities in the United States population. The National Health and Nutrition Examination Survey found that approximately 2% of the US population has severe mandibular deficiency or vertical maxillary excess, while other abnormalities such as mandibular excess or open bite affect about 0.3-0.1% of the population. Overall, about 2.7% of Americans may have dentofacial deformities severe enough to require surgical treatment along with orthodontics.
lecture 4 Diagnosis and management of salivary gland disordersLama K Banna
Maxillofacial Surgery
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Lecture Name Salivary gland
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This document discusses principles of managing panfacial fractures, including anatomic considerations of the craniofacial skeleton and buttresses. It describes two main theories for management: bottom up/inside out and top down/outside in. Reduction, fixation, immobilization and early return of function are discussed. Closed reduction uses manipulation without visualization, while open reduction allows visualization but requires surgery. Various fixation methods are outlined, including arch bars, wiring techniques, and maxillomandibular fixation.
Maxillofacial Surgery
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3. I. Indirect pulp capping.
II. Direct pulp capping.
III. Pulpotomy.
IV. Partial pulpectomy.
V. Complete pulpectomy (endodontic treatment).
Vital pulp therapy
3
5. • Calcium Hydroxide Pulpotomy:
It is indicated in young permanent teeth with
exposed vital pulp and incomplete root formation.
Under calcium hydroxide, the pulp is able to
maintain its vitality, it organizes an odontoblastic
layer to lay down reparative dentine and give the
chance to the root to complete its apical growth.
After pulpotomy and formation of healthy clot
a layer of Ca (OH)2 is applied then a layer of zinc
phosphate cement and permanent restoration is
inserted this procedure gives 61 % success.
5
6. • Formocresol Pulpotomy:
It is recommended for primary teeth with
carious exposure. The formocresol used is
Buckly's formocresol which is composed of 19%
formaline and 35 % cresol in a vehicle of
glycerin and distilled water. Formocresol
solution releases formaldehyde, which diffuse
through the pulp and by combining with cellular
protein fixes the pulp tissues. Formocresol, as
supplied, can be diluted to 1:5 concentration
using 3 parts of glycerin and one part distilled
water.
6
8. • There are two methods:
A. The one step technique (one visit
technique).
B. The two steps technique (2 visits
techniques).
8
9. A. The one step technique:
1. After amputation of the coronal part of the
pulp and removal of debris, stopping of the
bleeding and formation of the clot. Dip a
cotton pledget in formocresol, remove excess
of the solution by dapping on a cotton roll
and place it in the pulp chamber covering the
radicular pulp stumps for 4 - 5 minutes. Do
not allow the solution to lack on the gingival
tissue.
9
10. 2. Prepare a paste of inforced zinc oxide-eugenol.
Remove the cotton pledget and place just
enough paste to cover the radicular pulp
stumps. Pressure should be avoided on
radicular pulp tissues.
3. After setting of zinc oxide-eugenol base, the
tooth is ready for final restoration.
10
11. B. The two steps technique:
After amputation of the pulp and formation
of healthy clot. A pellet of cotton with
formocresol is placed over the floor of the pulp
chamber and cover it with temporary dressing.
In the second visit after 2-3 days isolate the
tooth with rubber dam without local anesthesia
(now the surface of the pulp tissue is fixed and
not sensitive) remove the dressing and the
pellet of cotton previously moistened with
formocresol and complete the procedure as
before in the one visit technique.
11
12. • N.B. A chrome steel crown is the ideal
restoration after pulpotomy because the crown of
the tooth treated by pulpotomy is weak, brittle
and may split fracture. If there is any sign of
hyperemia following removal of coronal pulp
(pain or excessive hemorrhage) indicating, that
inflammation is present in the tissue beyond the
coronal portion of the pulp. Pulpotomy should
not be performed but do partial pulpectomy or
even extraction of the tooth.
12
14. IV. Partial pulpectomy:
Definition:
It is the removal of coronal pulp tissue
and as much as possible from the content of
the root canal.
14
15. Indications:
1. It is indicated in the primary molars (due to
morphology of the root canal such as lateral
branching and ramification and presence of
accessory root canal where removal of the
all the content of the radicular pulp tissue is
impossible).
2. When the coronal pulp tissue and the tissue
entering the pulp canals are vital but show
clinical evidence of hyperemia.15
17. 3. The tooth may or may not have a history of
painful pulpitis.
4. No evidence of necrosis (suppuration).
5. Radiographically, there should be no
evidence of a thickened periodontal ligament
or radicular diseases.
17
18. Technique:
The technique is completed in one
appointment:
1. Remove the coronal pulp tissue (same steps in
pulpotomy).
2. Remove as much as possible from the content
of root canal with a serrated broach, care
should be taken not to penetrate the apex (root
canal instruments placed in a special hand piece
may be used for root canal debridement with
extreme care).
18
19. 3. No widening of the root canal.
4. Irrigation of the canals with normal saline or
mild antiseptic solution (hydrogen peroxide or
sodium hypochlorite).
5. Dry the canal with sterile paper points.
6. The root canal may be filled with zinc oxide-
eugenol or oxypara (a restorable material
which will be resorbed as normal root
resorption occurs).
19
20. • Filling the root canal
A thin mix of zinc oxide-eugenol paste may be
prepared and paper points covered with the
material are used to coat the root canal walls.
A thick mix of the zinc oxide-eugenol should
be prepared, rolled into a point and carried into
the root canal.
Root canal plugger may be used to condense
the material into the canal.
Zinc phosphate is put as a base and the tooth
should be restored with chrome steel crown.
20
21. V. Complete pulpectomy (endodontic
treatment):
Pulpectomy of the primary molars is often
considered impracticable because of the
difficulty of obtaining adequate access to the
root canals in the small mouth of children and
because of the complexity of the root canals in
primary molars. The canals are ribbon shaped
(narrow mesiodistally and wide bucco-
lingually) and have lateral branching and
ramification and their complexity increases as
physiological root resorption progresses.21
22. • These difficulties do not exist with primary
anterior teeth and therefore pulpectomy of
these teeth present no technical problems. The
canal may be cleaned and filled with a
resorbable material (zinc oxide or oxypara).
22
23. • Treatment of non-vital primary molars:
Ideally, a non-vital tooth should be treated
by pulpectomy and root canal filling. However,
pulpectomy in primary molars is extremely
difficult and often not practical. A non-vital
pulpotomy method is advocated.
23
24. • Technique of non-vital pulpotomy:
First visit:
Necrotic coronal pulp is removed (as
pulpotomy) and the infected radicular pulp is
treated with strong antiseptic solution such as
(Beech wood cresote, formocresol camphorated
mono chlorophenol). The material, is applied on
cotton pledget and sealed in the pulp for 1-2
weeks. The strong antiseptic action of these
solutions combats infection in the radicular pulp.
24
25. Second visit:
The antiseptic solution is removed and
replaced by antiseptic paste (eugenol &
formocresol & zinc oxide powder) press
antiseptic paste firmly into the root canal with a
cotton pellet. Pressure forces the paste down the
root canal compressing the pulp tissue apically
and then restore the tooth as usual (chrome steel
crown).
25
26. • The presence of a sinus associated with a
chronic abscess or of some degree of tooth
mobility is not a contraindication for this
method. A sinus is expected to disappear
following control of infection and a mobile
tooth becomes firm as periapical bone reforms.
A tooth with acute abscess may be treated by
this method after draining the pus and
controlling the infection.
26
27. • Pulpectomy in primary anterior teeth:
Primary anterior teeth may be devitalized as a
result of trauma or caries. The basic principles of
endodontics can be applied. Gentle preparation
of the root canals with the help of radiographic
examination will be helpful. Care should be
taken not to traumatize apical region. A
resorbable root canal filling material such as
calcium hydroxide or zinc oxide-eugenol-
formocresol paste can be used.
27
29. • Reaction of the pulp to commonly used
capping materials:
A. Zinc oxide-eugenol:
Zinc oxide-eugenol when placed in contact
with vital tissue will produce chronic
inflammation, abscess formation and
liquefaction necrosis. 24 hours after capping
pulp with zinc oxide-eugenol, the adjacent
underlying tissue contains a mass of red blood
cells and P.N.L. The hemorrhagic mass is
demarcated from the underlying pulp tissue by
a zone of fibrin and inflammatory cells.
29
30. • Two weeks after the capping, degeneration
of the pulp is apparent at the capping site and
chronic inflammation extended deep to the
apex.
B. Ca(OH)2:
Because of its alkalinity (PH = 12), it is
so caustic such that when placed in contact
with vital pulp tissue, the reaction produces
superficial necrosis of the pulp. The irritant
qualities seen to be related to its ability to
stimulate development of a calcified barrier.
30
31. • This is done as follow:
The superficial necrotic area in the pulp
that develops beneath Ca(OH)2 is demarcated
from the healthy pulp tissues below by a new
deeply staining zone comprising basophilic
elements of Ca(OH)2 dressing. Against tins
zone is a new area of coarse fibrous tissue
likened to a primitive type of bone.
31
32. • On the periphery of the new fibrous tissue,
cells resembling odontoblasts appear to be
lining-up. One month after the capping
procedure, a calcified bridge is evident
radiographically. This bridge increase in
thickness during the next 12 months. The pulp
beneath the calcified bridge remains vital and
free from inflammatory cells.
32
33. C. Formocresol:
The surface of the pulp immediately
under formocresol treatment become fibrous
and acidophilic. This reaction was interpreted
as fixation of living pulp tissue. After
exposure of pulp to formocresol for periods
of 7 to 14 days three distinct zone become
evident:
33
34. A broad acidophilic zone (Fixation).
A broad pale staining zone in which the cells
and fibers are diminished (Atrophy).
A broad zone of inflammatory cells extend
deeply into tile apex.
The reaction of formocresol is a
progressive fixation of the pulp tissue with
ultimate fibrosis of the entire pulp.
34
36. 1. Internal resorption:
Radiographic evidence of internal
resorption occurring within the pulp canal
several months after pulpotomy procedure is
the most frequently seen evidence of abnormal
responses in primary teeth. Internal resorption
is a destructive process generally believed to
be caused by osteoclastic activity. No
satisfactory explanation for post pulpotomy
type of internal resorption has been given. The
possible cause for such condition may be:
36
38. 1. With a true carious exposure of the pulp
there will be an inflammatory process to
some degree. The inflammation may be
limited to the exposure site or it may diffuse
throughout the coronal portion of the pulp. If
the inflammation extended to the entrance of
the pulp canals osteoclasts may have been
attracted to the area and cause internal
resorption.
38
39. 2. All pulp capping materials in use are irritating
and produce at least some degree of
inflammation. Inflammatory cells attracted to
the area as a result of placement of capping
material might attract osteoclastic cells and
initiate the internal resorption.
3. Because the roots of primary teeth are
undergoing normal physiological resorption,
vascularity of the apical lesion increased and
there is osteoclastic activity in the area. This
may predispose the tooth to internal resorption
when irritant in the form of pulp capping
material is placed on the pulp.
39
40. 2. Alveolar abscess:
An alveolar abscess occasionally develops
some months after pulp therapy has been
completed. The tooth usually remains
asymptomatic and the child is unaware of the
infection, which may be present in the bone
surrounding the root apices or in the area of the
root bifurcation.
40
42. • A fistulation opening may be present indicating
the chronic condition of the infection. Primary
teeth that show evidence of an alveolar abscess
should be removed. Permanent teeth that have
previously been treated by pulp capping or by
pulpotomy and later show evidence of pulpal
necrosis and apical infection may be considered
for endodontic treatment.
42
43. • General contraindications for pulp
treatment of primary teeth:
1. A patient from family having unfavorable
attitude towards dental health and conservation
of the teeth.
2. A dentition in which multiple teeth have pulp
exposures. Such a dentition is probably
neglected and does not justify pulp treatment.
3. A tooth, with such gross breakdown that
restoration would be impossible following pulp
treatment.
43
44. 4. A tooth with caries penetrating the floor of
pulp chamber.
5. A tooth close to natural exfoliation.
6. A dentition in which the effect of previous
extraction have not been controlled. Extraction
is preferred, if the contralateral tooth is
missing.
7. A patient in poor general health.
44
45. • Electro surgery pulpotomy:
It is known as non-chemical devitalization.
Its mechanism of action is the cauterization of
the pulp tissue. It carbonizes heat denatured pulp
and bacterial contamination.
• Laser pulpotomy:
This technique of pulpotomy overcomes
histological effect of electro surgery. It creates
superficial zone of coagulation necrosis that
remain compatible with underlying tissue &
isolate pulp from vigorous effects of the sub-
base.45