3. Vital Pulp Theory Flashcards
if a patient is in pain what would you do as a dentist?
NSAID first and if this is not helpful they can take it with paracetamol.
use an ice pack or a warm compression
what is root canal treatment?
You need to access into that pulp chamber to begin with, identify and open each of the canals sufficiently, and then once you’ve done that, your primary aim is to disinfect.
why do we do a root canal treatment?
if the patient has:
- irreversible pulpitis
- periapical periodontitis
after access and shaping tne canals what is next?
-temporary fill
-final fill
why do we do temporary fill?
to check that the pain resolves if there’s any swelling, the swelling resolves.
So it’s calcium hydroxide paste that goes into the canals which is similar to the disinfectant used during the treatment, which is sodium hypochlorite and it works to just clean out the remaining space ensuring it is sterile before we fill it.
Must be sealed to protect from the external environment with gutta-percha and restoration op top (amalgam OR composite )
why would you put a crown on a root canal tooth?
prevent any future fractures
why do we need to consider vital pulp therapy after a root canal treatment?
longevity of the tooth.
It’s another strand of treatment that can be put in before root canal treatment or as an alternative to root canal treatment in the hope that we can increase the longevity of the tooth.
Preservation of natural tooth: Vital pulp therapy aims to save the natural tooth structure, avoiding the need for more invasive treatments
Why was root canal treatment the main treatment for cases with irrestible pulpitis?
-Difficulty in determining the actual histopathological state of the pulp based on the available diagnostic tests.
-Severe pulpal inflammation in a low compliance environment leads to rapid deterioration of the pulpal tissue
-Impossibility of identifying and removing selectively diseased and/or infected pulpal tissue
-Difficulty achieving a long-lasting bacteria tight seal with restorative materials that promote healing of the remaining pulp tissue
what is Vital Pulp Therapy?
A treatment which aims to preserve and maintain pulp tissue that has been compromised but not destroyed by caries, trauma, or restorative procedures in a healthy state.
what are the features of deep caries
-up to the inner quarter of the dentine
-zone of the hard or firm dentine between the caries and the pulp
-risk of the pulp exposure during operative treatment
what are the features of extremely deep caries?
-penetrates the full thickness of dentine
-radiographically detectable
-pulp exposure is unavoidable
what are the recommendations for the management of deep caries?
-selective caries is advocated in the teeth with reversible pulpitis, providing radiographically the carious lesion is no deeper than the inner 1/4 of the dentine with a zone of dentine separating the carious lesions from the pulp chamber.
-must use a rubber dam and aseptic technique.
-a hydraulic calcium silicate or glass ionomer cement should be placed over the deep dentine.
what are the aims of vital pulp therapy?
-maintain vitality
-pulpal repair
-tertiary dentine to form
-manage bacterial contamination
-arrest caries progression
what are the categories for which vital pulp therapy works well for?
-Traumatically Exposed Teeth
-Reversible Pulpitis
-Immature teeth
-Mature Teeth
-Irreversible Pulpitis
what are the 4 vital pulp therapy treatments
-Indirect Pulp Capping (least invasive)
-Direct Pulp Capping
-Partial Pulpotomy
-Full Pulpotomy (most invasive)
