7. Pulp Therapy Flashcards by Janae Garofalo

Define indirect pulp cap

Biocompatible material placed in deep carious tooth approximating the pulp
No signs of pulpal degeneration or exposure

How well did you know this?

Not at all

Perfectly

Define Direct pulp cap

Pinpoint mechanical exposure during prep covered with biocompatible material

How well did you know this?

Not at all

Perfectly

Define pulpotomy

-Removal of pulp in the chamber with the intent to maintain the vitality of the radicular pulp

How well did you know this?

Not at all

Perfectly

Define pulpectomy

Removal of entire pulp (coronal and radicular)

How well did you know this?

Not at all

Perfectly

What is the typical restoration for a primary tooth after indirect pulp cap

SSC

How well did you know this?

Not at all

Perfectly

What materials can be used for indirect pulp capping

RMGI (vitrebond)

- CaOH2 followed by vitrebond

How well did you know this?

Not at all

Perfectly

Which has a higher success rate indirect pulp capping or pulpotomy for primary teeth

indirect pulp cap

How well did you know this?

Not at all

Perfectly

Success of indirect pulp capping is dependent on what

accurate pulpal diagnosis

How well did you know this?

Not at all

Perfectly

Indirect pulp capping will not be successful if

Furcation RL (or PA RL)

- Pathologic root resorption

How well did you know this?

Not at all

Perfectly

What materials are used for direct pulp cap

MTA or CaOh2

How well did you know this?

Not at all

Perfectly

Direct pulp cap is not recommended for pulp exposures that are _

carious (should be a mechanical pulp exposure)

How well did you know this?

Not at all

Perfectly

What should you due for a carious pulp exposure

pulpotomy

How well did you know this?

Not at all

Perfectly

(T/F) After a pulpotomy the tooth should remain in place and exfoliate at the normal time

How well did you know this?

Not at all

Perfectly

After a pulpotomy you may see _ resorption but you should not see

internal… pathologic external root resorption

How well did you know this?

Not at all

Perfectly

What are the criteria for a primary tooth pulpotomy

Pulp exposure
Dx normal or reversible pulpitis (reversible pulptitis= pain with stimulus no spontaneous pain)
Clinical exam (no mobility, fistula, no pain with percusion and must be restorable)
Radiographic exam (no furcation involvement or PA RL Want at least 2/3rds of the root remaining)

How well did you know this?

Not at all

Perfectly

Contraindications for a pulpotomy

Pulpal Dx or irreversible pulpitis (spontaneous pain- does your child wake up at night with a toothache)
Clinical pathology (Swelling, fistula, pathologic mobility, pain with percussion)
Radiographic pathology (Furcation/periapical lucency, external root resorption)
Unrestorable tooth
Excessive bleeding after coronal pulp amputation
No bleeding after coronal pulp amputation (necrosis)

How well did you know this?

Not at all

Perfectly

Preparation of a tooth for a SSC should occur (before/after) the pulpectomy

before

How well did you know this?

Not at all

Perfectly

Coronal pulp removal should be done with what bur

Round bur slow speed

How well did you know this?

Not at all

Perfectly

Hemorrhagic pulp means what

inflammation has spread to radicular pulp

How well did you know this?

Not at all

Perfectly

During a pulpotomy the chamber should be treated with any one of these three medicaments

Foromcresol
Ferric sulfate
MTA

How well did you know this?

Not at all

Perfectly

Coronal filling after a pulpotomy should be done with

IRM

The ideal pulpotomy medicament has what properteries

Bactericisal
Harmless to pulp and surroundign tissues
Promote healing of radicular pulp
Not interfere with physiologic process of root resorption

Foromcresol should be placed in the chamber for how long

5 mins

Foromcresol can be diluted to what ratio

5:1

What is the gold standard medicament for pulpotomies

formocresol

What is formocresol made of

formaldehyde and cresol

Is foromcresol bactericidal

yes

What are the cons of formocresol

- Can cause inflammarory responses or necrosis in remaining radicular pulp (leads to internal root resorption) - Potentially immunogenic, carcinogenic (formaldehyde)

Success rate of formocresol is

70-90%

Directions for ferric sulfate use are

apply to pulp chamber for 10-15 sec and rinse | -Seals BVs --> hemostasis

Success rate of ferric sulfate is

81-97%

Is ferric sulfate bactericidal

Which material for pulpotomies has the highest success rate

MTA (Close to 100%)

MTA sets in the presence of what

moisture

pH of MTA is _ similar to that of _

12.5... CaOH2

Is MTA antimicrobial

yes

does MTA has cytotoxic effects like formocresol

what are the cons of MTA

expensive and hard to work with

Does MTA promote hard tissue formation

yes

Pulpectomy is indicated when

- Pulpal Dx is necrosis or irreversible pulpitis | - Hemorrhagic coronal pulp removal

Filling material for a pulpectomy must be _ such as....

resorbable such as iodoform/CaOH2

Why can pulpectomies cause ectopic eruption

it is hard to resorb the filling materia

Pulpectomy is limited to what teeth

2nd primary molars | Maxillary incisors

Pulpectomies with _ root systems are difficult

Narrow and flared

T/F overinstrumentation during a pulpectomy can damage the permenant tooth

Root formation is generally complete _ years after eruption

3 years

For an immature permanent tooth- bleeding is controlled in pulpotomy by

irrigation or chlorhexidine or sodium hypochloritie

Cvek pulpotomies can be done for teeth that have undergone

traumatic exposures

What is apexogenesis

continued physiologic development and formation of the root's apex

What is apexification

- Method of introducing end closure of an incompletely formed non-vital permanent teeth - Non-vital pulp tissue removed just short of the root end - Biocompatible CaOH2 placed in canal space to disinfecrt - Apical barrier (MTA) placed - Fill with gutta percha