Primary Molar Endodontics Flashcards
Indications for pulp tx
Good cooperation
MH precludes XLa
Lack of perm successor
Age
Ortho considerations (space preservation)
Contraindications for pulp tx
Poor cooperation
MH precludes pulp tx (cardiac/immunocompromised)
Age
Ortho considerations (space closure desired)
Severe pain
Pus in pulp chamber
Advanced RR
What are the endo procedures for primary teeth?
Vital - pulpotomy
Non vital - pulpectomy
Clinical Indications for vital pulpotomy
Pulp minimally inflamed/reversible pulpits
Marginal ridge destroyed
Caries >2/3rds into dentine
Aims of vital pulpotomy
Haemostasis
Disinfection
Preserve vitality of apical portion of radicular pulp
Steps of primary molar vital pulpotomy
LA+dam+access
Remove coronal pulp
Assess bleeding
Ferric sulphate over root stumps 2mins with pressure
CAOH over root stumps –> GIC core –> SSC
Signs of a non vital molar
Hyperaemic
Pulp necrosis + furcation involvement
Irreversible pulpitis
If severe infection with facial swelling: XLa
Steps for primary pulpectomy (non vital)
LA+dam+access
Coronal pulp extirpation
RC prep 2mm short of apex
Obturation with CAOH iodoform paste
GIC core
SSC
Success rate of vital pulpotomy
85%
Success rate of non vital pulpectomy
90%
Review times
Clinical 6mths
Radiograph 12mths
Child with abscess congenital cardiac defect management
Liaise with cardiologist - IE risk abx?
XLa over non vital pulpotomy as bacteria risk for cardiac
