Guide to clinical endo AAE 2013 Flashcards
What is apexogenesis?
Apexogenesis is vital pulp therapy performed to allow continued physiological development and formation of the root. It involves the removal of a portion of pulp and application of a medicament with
the aim of maintaining the vitality of the remaining pulp and to encourage continued physiological development and formation of the root.
When is apexogenesis indicated?
Apexogenesis is indicated on permanent teeth with immature apices if all the following conditions exist:
a. Tooth has a deep carious lesion that is considered likely to result in pulp exposure during excavation.
b. No history of subjective pretreatment symptoms.
c. Pretreatment radiographs should exclude periradicular pathosis.
d. Mechanical exposure of a clinically vital and asymptomatic pulp occurs.
e. Bleeding is controlled at the exposure site.
f. Exposure occurs when the tooth is under dental dam isolation.
g. Adequate seal of the coronal restoration can be maintained.
h. Exposure permits the capping material to make direct contact with the vital pulp tissue.
i. Patient has been fully informed that endodontic treatment may be indicated in the future.
What materials can be used for apexogenesis?
MTA (mineral trioxide aggregate)- gold standard
Biodentine
Calcium hydroxide
State properties and advantages of MTA
(Mineral Trioxide Aggregate)
Properties: Biocompatible, excellent sealing ability, promotes hard tissue formation.
Advantages: Encourages dentin bridge formation and pulp healing.
What is biodentine?
Properties; advantages
Properties: Calcium silicate-based material with high biocompatibility and bioactivity.
Advantages: Faster setting time compared to MTA, promotes dentin bridge formation, good sealing properties.
What is a pulpotomy
Pulpotomy is the surgical removal of the coronal portion of vital pulp tissue. A biologically acceptable material is placed in the pulp chamber, and the tooth is restored
When is a pulpotomy indicated?
- Exposed vital pulps/irreversible pulpitis of primary teeth
- Emergency procedure in permanent teeth until RCT can be done
- Interrim for permanent teeth with immature root formation to allow apexogenesis
