This document provides information about pulpectomy procedures for primary teeth. It begins with definitions of pulpectomy and considerations for primary teeth. Indications include traumatized or carious primary teeth with signs of pain or infection, while contraindications include non-restorable teeth or excessive root resorption. The procedure involves accessing the pulp chamber, removing coronal and radicular pulp tissue, cleaning and shaping canals, and obturating with resorbable materials like zinc oxide eugenol. Access cavities must be carefully prepared and obturation techniques like lentulo spirals or pressure syringes are discussed. Success criteria include resolution of symptoms and adequate root length for exfoliation. Periodic reviews are

2. TOPIC-
PULPECTOMY
PRESENTED BY-
SHUBHAM GUPTA

3. DEFINATIONS
PRIMARY TEETH CONSIDERATIONS
INDICATIONS
CONTRAINDICATIONS
PROCEDURE
RULES FOR ACCESS CAVITY PREPERATION
OBTURATING TECHNIQUES
INSTRUMENTS
OBTURATING MATERIALS
CRITERIA FOR SUCCESS
FOLLOW UP
PULPECTOMY VS EXTRACTION

4. DEFINATIONS
Pulpectomy involves complete removal of necrotic pulpal tissue
from the root canals and coronal portion of non vital primary
teeth to maintain a tooth in the dental arch.
Richard J Mathewson, 1993
Pulpectomy refers to the removal of all pulpal tissue from the
tooth, including both coronal and root portions.
Sidney B Finn, 1999

5. Pulpectomy is removal of the roof and contents of the pulp chamber
in order to gain access to the root canals which are debrided,
enlarged and disinfected.
- Shobha tandon
Gaining access to the root canals which are then debrided, enlarged,
disinfected and filled with a resorbable material.
-
American Academy of Paediatric Dentistry, 1999

6. WHY CONVENTIONAL
ENDODONTIC
THERAPY IS DIFFICULT IN
PRIMARY TEETH ?

7. • Hibbard and Ireland, 1957, studied primary root
canal morphology by removing pulp from
extracted teeth, forcing acrylic resin into the pulp
canals and dissolving the covering of tooth
structure in 10% nitric acid.
• They found that immediately following root
formation, a single canal is usually present in
each root.
• Deposition of secondary dentin & accelerated
physiological root resorption.
• Variations included lateral branching, connecting
fibrils, apical ramifications and partial fusion of

8. • Another difficulty is the apparent connection
between the coronal pulpal floor with the
intraradicular area. –Moss et al, 1965
• These foramina allow the necrotic products to
pass into the bifurcation or trifurcation area.
• Using dyes and a vacuum system , Ringelstein
and Seow ,1989 found that many of the
foramina of primary second molars were
located on the root surfaces.

9. INDICATIONS
TEETH PAIN HISTORY CLINICAL
EXAMINATION
RADIOGRAPHIC
EXAMINATION
Traumatised
primary incisors
and canines
Spontaneous pain –
generally occuring
at night
Presence of
intraoral swelling or
sinus
Deep carious lesion
extending upto the
pulp
Primary 1st molar
before the second
primary molar
erupts
Extensive bleeding
from the site of
amputation if
pulpotomy
procedure tried
Inter radicular
radiolucency
Primary second
molars, before
eruption of first
permanent molar
Clinically evident
carious exposure
Pathologic root
resorption not
involving more than
1/3rd of the root
Tenderness to
percussion
Moderate mobility
Minimal
destruction of the
bone support

10. CONTRAINDICATIONS
• A non restorable tooth.
• Internal resorption in the roots visible on the radiographs.
• Excessive pathologic root resorption involving more than 1/3
rd
of the root.
• Teeth with mechanical or carious perforations of the floor of
the pulp chamber.

11. • Periapical or interradicular lesion involving the crypt of the
succedaneous tooth.
• Excessive pathologic loss of bone support with loss of normal
periodontal attachment.
• The presence of a dentigerous or follicular cyst.
• Chronic illness with leukemia, rheumatic and congenital heart
disease, chronic kidney disease etc.

12. PROCEDURE
Local anaesthesia is given
Isolate the tooth with rubber dam
Prepare access cavity
Remove all coronal pulp tissue with sharp spoon excavator
Extirpate radicular pulp tissue with K files
Irrigate with saline
Determine the working length with the help of diagnostic radiograph

13. Cleaning and shaping of the canals is done 1.5 – 2 mm short of radiographic
apex proceeding sequentially from smaller to larger files
Irrigate thoroughly to flush out all debris. Dry the canals with absorbed paper points.
Obturate the tooth with a resorbable biocompatible material
Restore with a permanent restoration and stainless steel crown

14. STEPS IN PULPECTOMY
STEPS IN PULPECTOMY INSTRUMENT USED PURPOSE
Access cavity preparation Round bur Gain entry into chamber
and remove dentinal roof
Tapered fissure bur Remove overhanging
dentin
Endo Z Remove remaining carious
dentin
Coronal pulp extirpation NO 4 OR 8 excavator Extirpate coronal pulp
Ensuring canal patency Endodontic explorer or
smooth broach or 15 size K
file
Ensure patency of canal
upto apex

15. Radicular pulp extirpation Barbed broach Extirpate radicular pulp in
toto
Establishing working length K file with stopper Length determination
radiograph
Debridement and
enlargement
21 mm H file Debride and enlarge root
canal upto three times its
size
Irrigation Syringe, saline, sodium
hypochlorite
Done to flush out debris
Drying Paperpoints Drying of enlarged root
canal
Obturation lentulo spirals and
endodontic pressure
syringe
Obturate the canal with
material without voids till
the determined working
length , without expulsion
of material into apex
Bulk restoration composite restoration
GIC
Fill the access cavity

16. Post endodontic
restoration
Stainless steel crown Post endodntic
rehabilitation of a
pulpectomised tooth
Review every 6 months Mouth mirror, probe,
radiograph
Check for signs or
symptoms of irreversible
pulpitis, dentoalveolar
abscess and appropriate
root resorption

17. RULES FOR PROPER ACCESS
PREPARATION
• ENDODONTIC DOGMA “ Careful cavity preparation and root
canal obturation are the keystones to successful root canal
therapy”
• The objective of entry is to gain direct access to the apical
foramina and not merely to the canal orifices.
• Access cavity preparation are not guided by topography of
occlusal grooves, pits and fissures.

18. • Radiographs taken from different angles must be considered.
• Endodontic entries are prepared always through the occlusal
or lingual surface.
• The unsupported cusps of posterior teeth must be reduced to
avoid weakening of the tooth structure.

19. ACCESS OPENINGS FOR PULPECTOMY
ANTERIOR PRIMARY TEETH
• Traditionally – lingual surface except for discolored maxillary
primary incisors.
• Discoloration – escape of hemosiderin pigments into the
dentinal tubules.
• Root canal is filled with ZOE.
• Dycal is placed over ZOE
to serve as a barrier between the composite
resin and root canal filling.

20. POSTERIOR PRIMARY TEETH
• Less extension towards the exterior of the tooth.
• Working length radiograph – paralleling technique.
• 2-3 mm short of radiographic length.
• Thin walls of the roots- use of sonic and ultrasonic cleaning
devices, Gates Glidden drills– contraindicated.
Nickel –Titanium instruments recommended.

21. Important differences between the primary and permanent teeth
are-
 Length and bulbous shape of the crowns
 A very thin dentinal wall at the pulpal floor
 The depth necessary to penetrate into the pulp
chamber is quite less than that in the permanent
teeth
 Likewise, the distance from the occlusal surface to the pulpal
floor is much less than in permanent teeth.

22. To achieve optimal preparation. three factors are considered-
-Size of pulp chamber-
More extensive preparation in young children than older
-Shape of pulp chamber –
The finished outline should accurately mimic the shape of the pulp
chamber.
-Number ,position and curvature of the root canals

23. OBTURATION TECHNIQUES
IN PRIMARY TEETH

24. TECHNIQUES OF ROOT CANAL FILLING IN
PRIMARY TEETH
 Pressure Syringe Technique –Greenberg (Pulpdent
corporation, America).
 Disposable tuberculin syringe or Local Anaesthetic syringe
technique.
 Slowly rotating Lentulo Spiral Technique.
 Jiffy tubes
 Incremental pressure syringe

25. PRESSURE SYRINGE
• Comprises
TECHNIQUE
• The filling material – heavy putty like consistency.
• Hub of the needle –loaded with the paste.
• Needle is threaded on the syringe barrel, plunger is turned.
• Needle is reinserted in the canal , tip is repositioned 1mm
short
Syringe barrel
Threaded plunger
Wrench
Threaded needles (gauge 13-30)

26. PRESSURE SYRINGE TECHNIQUE
• Threaded plunger- one hand, wrench in opposite hand.
• Threaded plunger is adjusted one quarter turn and retracted
slightly.
• Additional condensation – moist cotton pellet.
• Multiple canals – 2 periapical films
Weisz, 1976 designated pressure syringe as the optimal selection for
exact placement of paste within apical portions of fine and tortuous
canals.
He found the spiral lentulo most effective in treating single rooted teeth
with straight canals.

28. LENTULOSPIRAL TECHNIQUE
• Pastes can also be filled by means of lentulo spiral mounted
on the micro motor hand piece. They have shown the success
rate of 96% and 92% when hand held. The direction of
rotation needs to be checked for the material to properly flow
into the canals

29. • The primary teeth with their larger canals can be filled with
the thin mix coating the walls of the canal with the help of a
reamer in an anti clock wise direction while taking it out
slowly followed by the placement of the thicker mix which is
then pushed manually.

30. • Root length is the most reliable criteria of root integrity and
atleast 4mm of the root length is necessary for the primary
tooth to be treatable. – Rimmondini L, Baroni C, 1995
• If the inflammation is beyond the coronal pulp with only
interradicular but no periapical radiolucency, a single visit
pulpectomy is preffered. On the other hand if the pulp is
necrotic with periapical involvement , filling procedure is
delayed.

31. According to Finn-
• Care should be observed not to penetrate past the apical ends
of the tooth when reaming out of the canals.
• Secondly, a resorbable compound such as zinc oxide eugenol
should be used as a filling material. Silver points and gutta
percha should not be placed.
• Thirdly filling material should be introduced into the canal
with light pressure.
• Fourthly, apicoectomy should not be performed except in the
absence of a developing permanent tooth.

32. REVIEW OF LITERATURE
Acceptable result was obtained with lentulospiral in length of
obturation compared to insulin syringe and endodontic plugger
technique. Insulin syringe technique resulted in increased
underfilling with least number of voids. More number of voids
were seen in middle one-third and least number of voids were
observed at apical one third of the root among all the 3
techniques of obturation. The study concluded that void
identification is improved with D.I.O.R compared to C.B.C.T.
Akhil JEJ et al Comparative evaluation of three obturation techniques in primary
incisors using digital intra-oral receptor and C.B.C.T-an in vitro study. Clin Oral
investgn 2018 May 10.

33. AAPD GUIDELINES
 Following treatment, the radiographic infectious process should
resolve in 6 months, as evidenced by bone deposition in the
pretreatment radiolucent areas.
 Pre-treatment clinical signs and symptoms should resolve within a
few weeks.
 There should be radiographic evidence of successful filling without
gross overextension or underfilling.
The treatment should permit resorption of the primary tooth root
and filling material to permit normal eruption of the succedaneous
tooth.
 There should be no pathologic root resorption or furcation/apical
radiolucency.

34. OBTURATING
MATERIALS MOST
COMMONLY USED
IN PRIMARY TEETH

35. IDEAL PROPERTIES
• Resorption rate should be similar to that of primary root.
• Should not interfere in the eruption of permanent successors.
• Should be harmless to periapical tissue and permanent tooth
germ.
• Should not cause foreign body reaction when pressed beyond
the apex.
• Should be antimicrobial and have easy handling property.
• Should be easy to mix and fill the root canals.

36. • Material should be radio opaque.
• Material should not discolor the tooth.
• Should adhere to the canal walls and should not shrink.
• Material should be economical.

37. • Zinc- Oxide eugenol cement
• Iodoform
- Walkhoff paste
- KRI paste
- Maisto paste
• Calcium hydroxide
• Calcium hydroxide
+ iodoform

38. ZINC- OXIDE EUGENOL CEMENT
• The filling material of choice in the US is ZOE without a
catalyst.
ADVANTAGES
Easy to mix
Economical
Time tested material
DISADVANTAGES
Overfilling- foreign body reaction.
Resorption rate is less than that of the
root.
May deflect the path of permanent
successors.
Extrusion beyond the apex may cause
hypoplastic changes in the permanent
successors.

39. IODOFORM PREPARATIONS
WALKHOFF PASTE-
Sterilized iodoform paste
Mixture of parachlorophenol, camphor, menthol
KRI PASTE COMPOSITION-
Iodoform 80.8%
Camphor 4.9%
Parachlorophenol 15%
Menthol
MAISTO PASTE-
Iodoform 42g
Zinc oxide 14g
Thymol 2g
Chlorophenol camphor 3cc
Lanolin 0.50g

40. IODOFORM
ADVANTAGES OF IODOFORM PREPARATIONS-
 It can be easily forced into the pulp canals and any accessory
canals.
 Bactericidal paste.
 Resorbs rapidly from the periapical tissue and root canal
system.
 Does not produce undesirable effects on the erupting
permanent successors.
 Iodoform is an ideal pulpectomy agent. It disinfects, is
managed well clinically and resorbs simultaneously with the
primary root. ( Ranly and Garcia Godoy, 1991)

41. • The antibacterial activity of an iodoform containing paste (KRI Paste)
has been shown to be less than that of ZOE whereas its cytotoxicity
in direct or indirect contact with the cells is equal to or greater than
that of ZOE.
• Several studies have endorsed iodoform paste as a biocompatible
substitute for the ZOE –formocresol combination (Rifkin, 1980;
Garcia Godoy, 1987)

42. CALCIUM HYDROXIDE
• CALCIUM HYDROXIDE- IODOFORM MIXTURE
( VITAPEX/METAPEX)
COMPOSITION
Iodoform 40.4%
Calcium hydroxide 30.3%
Silicone 22.4%
ADVANTAGES-
Easy to apply.
Radio-opaque.
Resorbs at a faster rate than roots.
Does not produce any toxic effects on erupting permanent
successors.

43. Machida Y ,1983 considered calcium hydroxide- iodoform
mixture as the Ideal primary tooth filling material :
• Easy to apply
• Resorbs at a slightly faster rate than that of the roots
• Has no toxic effects on the permanent successor
• Is radioopaque
• Vitapex is particularly easy to use for primary incisors but less
practical for narrow canals of primary molars.

44. • Another preparation with similar composition –US –
ENDOFLAS ( Sanlor Laboratories, Columbia, South America)
• One condition for success of endoflas is the prevention of
microleakage.
• A permanent restoration should be placed as soon as possible
after clinical signs and symptoms of inflammation are
eliminated.

45. COMPOSITION OF COMMONLY USED
ROOT CANALS MATERIALS FOR PRIMARY
TEETHWALKHOFF PASTE
Parachlorophenol
Camphor
Menthol
KRI PASTE
Iodoform 80.8%
Camphor 4.86%
Parachlorophenol 2.025%
Menthol 1.215%
MAISTO PASTE
Zinc oxide 14 g
Iodoform 42 g
Thymol 2g
Chlorophenol
Camphor 3cc
Lanolin 0.5g
VITAPEX
Calcium hydroxide
Iodoform
Oily additives

46. ENDOFLAS
Zinc oxide 56.5%
Barium sulfate 1.63%
Iodoform 40.6%
Calcium hydroxide 1.07%
Eugenol
Pentachlorophenol
COLLA COTE
Synthetic collagen
GUEDES- PINTO PASTE
Iodoform 0.30g
Calcium hydroxide 0.25g
Camphorated paramonochlorophenol 0.1ml

47. DESIRABLE AND UNDESIRABLE
PROPERTIES OF OBTURATING MATERIALS

48. COMPARISON OF THE PROPERTIES OF OBTURATING MATERIALS
OBTURATING MATERIAL DESIRABLE PROPERTIES UNDESIRABLE PROPERTIES
Zinc oxide eugenol cement Bactericidal properties
Radio opacity
Optimal manipulative
properties
Stable in the canal and
maintains an optimally good
periapical seal
• takes longer time to resorb
than dentin or cementum
• material extruded into the
periapical region stimulates
a foreign body like reaction.
•Resorbs incompletely with
extraneous delay
Calcium hydroxide cement High alkalinity
Excellent antibacterial
properties
Optimal manipulative
properties
No foreign body like
reaction
Not discoverable in a
radiograph
Takes less time than
dentin/cementum to resorb
Does not obtain a stable
periapical seal as zinc oxide
eugenol

49. OBTURATING MATERIAL DESIRABLE PROPERTIES UNDESIRABLE PROPERTIES
Iodoform paste Antibacterial properties and
antiseptic properties
Radioopaque
Stable periapical seal
Poor manipulative
properties
Calcium hydroxide +
iodoform paste (Metapex,
vitapex)
Combined advantage of
calcium hydroxide cement
and iodoform.
Excellent antibacterial
properties.
Optimal manipulative
properties.
Radio-opacity.
Forms stable periapical
seal.
Material extruded in
periapical region resorbs in
3 weeks.
No distinct disadvantages
except that antibacterial
properties although
optimal are less than those
of calcium hydroxide
cement

50. Zinc oxide eugenol +
calcium hydroxide +
iodoform
All desirable properties of
zinc oxide eugenol ,
calcium hydroxide and
iodoform
Forms a more stable
periapical seal than
calcium hydroxide +
iodoform.
Foreign body like reaction
unlikely on material
extrusion into the
periapical region
No distinct disadvantages
Stability of the cement
makes the material
preferable as a root canal
sealer than an obturating
material for pulpectomy

51. ROTARY ENDODONTICS-
• The rotary NiTi files are specially designed to provide superior
flexibility and unmatched efficacy.
• They enable clinicians to create uniformly tapered shapes in
anatomically difficult and curved canals.
• The latch type design of NiTi files allows the attachment to a
handpiece.

52. Advantages –
• Consistently dense fill due to uniform debridement .
• Allows for greater apical enlargement
• Prevent apical exposure
• Reduced instrumentation time
Disadvantages-
• Skill is required for beginners.
• Resorption of roots in primary teeth may cause a problem
• Problem of breakage of files in the canals

53. KEDO ENDO FILES
• Kedo-S rotary files is a single file system consisting of D1, E1
and U1 files.
• The total length of these files is 16 mm and the working area
(cutting flutes) 12 mm in length.
• D1 Kedo-S file is designed to prepare the narrower canals of
the primary teeth namely the mesiobuccal and mesiolingual
canals and E1 Kedo-S file is to prepare the wider canals
namely the distal and palatal canals of the primary molar
teeth. The U1 Kedo-S file is used to prepare the upper and
lower anterior primary teeth.
• Kedo-S rotary files are recommended to be used with an
endodontic motor in clockwise rotation at 300 (Revolutions
Per Minute) RPM and 2.2 N cm torque.

55. Jeevanandan et al Clinical comparison of Kedo-S paediatric rotary files vs manual
instrumentation for root canal preparation in primary molars: adouble blinded
randomised clinical trial European Archives of Paediatric Dentistry. July 2018
Kedo-S exclusive paediatric rotary file system has shown
reduced instrumentation time and superior obturation quality
in primary molars. This system can be an effective alternative
in performing root canal treatment in primary molars with
great ease, thereby reducing the fatigue of dentists as well as
the children.
REVIEW OF LITERATURE

56. CRITERIA ACCEPTED FOR SUCCESSFUL
PULPECTOMY
-Given by Fuks et al
• Pulp treated primary teeth that have limited degree of
radiolucency or pathologic root resorption, in the absence of
clinical signs and symptoms.
• Check up in 6 months

57. Postoperative signs that indicate failure are
• Swelling of gingival margin
• Pus from gingival sulcus
• Patent fistula
• Excessive mobility
• Sensitivity to percussion
• Pain
• Development of radiolucency at the apex or furcation
• Premature root resorption

58. FOLLOW UP AFTER PRIMARY PULPECTOMY
• Study reported a 20% incidence crossbites or palatal eruption of
permanent incisors after pulpectomy on primary incisors.
• In the posterior teeth extraction was required in 22% of the cases because
of the ectopic eruption of the premolars or difficulty in exfoliation of the
treated primary molars- Coll JA,Sadrian R, 1996
• After normal physiologic resorption of the roots reaches the pulp
chamber, the large amount of ZOE present may impair the absorption and
lead to prolonged retention of the crown.
• Retention of filler was not related to success and caused no pathosis- Coll
JA, Sadrian R, 1993

59. TOOTH BUD OF DEVELOPING
SUCCEDANEOUS TOOTH
• Manipulation through the apex of the primary tooth –
contraindicated.
• Overextension of root canal instruments and filling materials –
avoided.
• Working length – 2-3mm short of radiographic apex.
• Hemorrhage after pulp removal –overextention.

60. • A total of 50 children, aged between 4 and 9 years, who were screened for
unilateral or bilateral carious deciduous molars were studied.
• Out of these, 15 children were randomly selected for endodontic
treatment. Obturation was done with a mixture of zinc oxide powder and
aloe vera gel. Clinical and radiographic evaluation was done after7 days, 1
month, 3 months, 6 months, and 9 months. Endodontic treatment using a
mixture of zinc oxide powder and aloe vera gel in primary teeth has
shown good clinical and radiographic success.
Khairwa et al, Clinical and radiographic evaluation of zinc oxide with aloe vera
as an obturating material in pulpectomy: An in vivo study JISPPD Jan Mar
2014, 32(1): 33-38
REVIEW OF LITERATURE

61. • Past inject exhibited the highest number of optimally filled canals, while
the highest number of underfilled canals were observed with bi-
directional spiral, and the highest number of overfilled canals were
observed with pressure syringe. A minimum number of voids was present
in canals filled with the Pastinject technique and pressure syringe.
Grover R Mehra M, Pandit IK, Srivastava N, Gugnani N, Gupta M. Clinical efficacy of
various root canal obturating methods in primary teeth: a comparative study
Eur J Paediatr Dent. 2015 Jun;14(2):104-8.
REVIEW OF LITERATURE

62. • A total of 239 canals were prepared and obturated with zinc-oxide
eugenol paste. Obturation methods compared were: anesthetic syringe;
NaviTip syringe; pressure syringe; tuberculin syringe; lentulo spiral; and
packing with a plugger.
• Lentulo produced the best results in terms of length of obturation, while
NaviTip syringe produced the best results in controlling paste extrusion
from the apical foramen and having the smallest void size and lowest
number of voids.
Memarpour M Shahidi S, Meshki R. Comparison of different obturation
techniques for primary molars by digital radiography. Pediatr Dent. 2013
May-Jun;35(3):236-40.
REVIEW OF LITERATURE

63. • Clinical and radiographic evaluation suggested that teeth obturated with
ozonated oil-zinc oxide demonstrated good success rate (93.3 %) as
compared to zinc oxide eugenol (63.3 %). However, no statistically
significant variation (p = 0.408) was observed between the groups.
• Ozonated oil-ZnO demonstrated a good clinical and radiographic success
at 12 months follow-up and it can be considered as an alternative
obturating material in infected primary teeth.
S. P. Chandra, R. Chandrasekhar, K. S. Uloopi, C. Vinay, N. M. Kumar
Success of root fillings with zinc oxide-ozonated oil in primary molars
: preliminary results European Archives of Paediatric Dentistry
June 2014, Volume 15, Issue 3, pp 191-195
REVIEW OF LITERATURE

64. • ZOE pulpectomy clearly delayed the root resorption of primary molars
without permanent successors , whereas resorption of primary molars
with Vitapex pulpectomy started at almost the same time as physiologic
resorption. Compared with Vitapex, ZOE was a more effective root canal
filling material in delaying the root resorption of primary molars.
Ron et al Effects of zinc oxide-eugenol and calcium hydroxide/ iodoform on delaying root
resorption in primary molars without successorsDental Materials Journal 2016; 33(4): 471–475
REVIEW OF LITERATURE

65. Ozone Therapy
• With the emerging trends ,ozone will soon be the first choice
in endodontics (non vital cases) and regenerative endodontics
.
• This therapy includes ozonated water, ozonated oil and
ozonated aloe vera.
• It is used along with file and as irrigant as it reaches all
anatomies.

66. • OZONE IN PEDODONTICS-
Dahnhardt et al studied treated open carious lesion with ozone in
anxious children. In fact the children who will not get treatment of a
very early stage of dental caries are most likely the ones who can be
the most anxious and not cooperative during routine dental
procedures.
With ozone treatment 94 percent of the children were treatable
and 93 percent lost their dental anxiety.

67. REFERENCES-
• Pathways of Pulp – Stephen Cohen and Kenneth
Hargreaves – 9th edition
• Clinical Pedodontics – Sidney B Finn – 4th edition
• Ingle’s Endodontics 7th edition
• Textbook of pedodontics by Shobha Tandon -4th edition
• Grossman Endodontic Practice -13th edition – Dr
Gopikrishna