pain and primary tooth pulp therapy Flashcards
signs of reversible pulpitis
- clinical signs of caries
- not TTP
- no abnormal mobility
- no signs of infection
signs of irreversible pulpitis
- clinical signs of caries
- not TTP
- no abnormal mobility
- no signs of infection
signs of periradicular periodontitis
- clinical signs of caries
- increased mobility
- TTP
- signs of infection
symptoms of reversible pulpitis
short lived pain
does not linger
pain in direct response to stimuli
symptoms of irreversible pulpitis
spontaneous pain
prolonged
lingers on removal of stimuli
pt wakes from sleep
symptoms of periradicular periodontitis
often acute symptoms gone
dull throbbing pain
can be asymptomatic
what are the 3 signs of infection
swelling
sinus
suppuration
what is the criteria for restoring a tooth
no signs of irreversible pulpitis
no infection
no sinus
clear band of dentine separating the pulp from caries
what are options if there are symptoms of irreversible pulpitis
pulp therapy
extract
monitor
what are the types of pulp therapy
vital pulp therapy - pulpotomy
non vital pulp therapy - pulpectomy
medical factors for carrying out pulpotomy
at risk from xLA - bleeding disorder
at risk from GA - cystic fibrosis
social factors for carrying out pulpotomy
regular attender
good compliance with preventative advice
positive parental attitudes
when do you not do a pulpotomy
preecoperation
more than 3 pulp therapies needed
extensive root resorption
tooth unrestorable
signs of infection
medical disorders that contraindicate pulpotomy
those at risk from residual infection - endocarditis/ immunocompromised
how many roots do lower primary molars have
2
what are the canal orifices of primary mandibular molars
mesial and distal
how many distal root canals are in a mandibular primary molar
1 or 2
where do you find the pulp horns of a primary mandibular molar
below the cusps
how many roots do primary maxillary molars have
3
how many canals do upper maxillary primary molar have
3
mesiobuccal
distobuccal
palatal
haemostatic medicaments
ferric sulphate (15.5%) - apply for 2 mins
mineral trioxide aggregate (MTA)
other haemostatic options
saline
LA with vasoconstrictor
what do you fill the pulp chamber with
zinc oxide-eugenol cement
what is the tooth restored with following pulpotomy
stainless steel crown
what is used to stick down a hall crown
GI cement
what stages are required if pulpotomy turns into a pulpectomy
gently debride canals with endodontic file (2mm short of WL), up to size 30
irrigate with chlorhexidine
pulpectomy technique
dry canals
fill with non-setting calcium hydroxide
restore with glass ionomer core
restore with SS crown
complications of primary molar pulp therapy
early resorption leading to early exfoliation
over-preparation
infection
caries
