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Peds II > Pulp III > Flashcards

Pulp III Flashcards

1
Q

General characteristics of young permanent teeth? (6)

A
  • Big pulp chamber
  • Marked pulp horns
  • Big apical foramen
  • Thin tooth walls
  • Slow apical closure (3-4 years)
  • Great regeneration capacity of the pulp
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2
Q

Objectives of the pulp treatment in young permanent teeth? (2)

A
  • Keep, if possible, the pulp vitality
  • Reach the normal radicular development and apical closure:
    correct corono-radicular proportions
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3
Q

Factors to take into account to decide the treatment of the young permanent teeth? (8)

A
  • Level of pulp affectation (gravity of the process)
  • Level of maturity and pulp age (open or closed apex)
  • Possibility to restore the tooth
  • Kind of restoration we are going to do
  • Child´s collaboration
  • Economic cost of the treatment
  • Duration of the treatment
  • Implications for the occlusal development of the tooth
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4
Q

Treatments that keep pulp vitality? (4)

A
  • Cavity base
  • Indirect pulp capping
  • Direct pulp capping
  • Apexogenesis (pulpotomy)
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5
Q

Treatments that do not keep pulp vitality? (2)

A
  • Apexification

* Revascularization

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6
Q

Direct pulp capping definition?

A

Application of a medicine over an exposed pulp

exposed during the removal of the last portions of caries or as a consequence of a trauma

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7
Q

Direct pulp capping indications?

A

There must be a minimum or inexistent inflammation
of the pulp (It is indicated small mechanical or traumatic
exposure).

  • Clinically and radiographicaly asymptomatic tooth.
    • Mechanical exposure caused by iatrogenia (excessive cavity
    preparation)
    • Small pulp exposure by caries surrounded by healthy dentin
    • Traumatic lesion
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8
Q

Direct pulp capping requirements? (3)

A
  • Size of exposure <1 mm
  • Controllable bleeding on the site of exposure
  • Time of pulp exposure (<24 hours)
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9
Q

Direct pulp capping objective?

A

Induce the sound young pulp to form a bridge of
dentin, trying to cover the site of exposure and conserve the
pulpar vitality.

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10
Q

Direct pulp capping materials?(2)

A
  • Calcium hydroxide

* MTA

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11
Q

How many steps are there in the direct pulp capping technique?

A

7

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12
Q

Direct pulp capping step 1?

A

Topical and local anesthesia

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13
Q

Direct pulp capping step 2?

A

Rubber dam isolation

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14
Q

Direct pulp capping step 3?

A

Remove ALL the caries (starting on the walls far away from the pulp chamber and finishing on the closest wall of the pulp) and make a pulp exposure <1mm.

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15
Q

Direct pulp capping step 4?

A

Cleansing (saline solution) and drying of the area

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16
Q

Direct pulp capping step 5?

A

Placement of calcium hydroxide or MTA on the área

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17
Q

Direct pulp capping step 6?

A

Final obturation of the cavity

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18
Q

Direct pulp capping step 7?

A

Radiographic control of formation of dentin bridge (3-6 weeks later)

WE do not remove it on a second session

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19
Q

Apexogenisis other name?

A

vital pulpotomy

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20
Q

Apexogenesis definition?

A

Removal of the coronal pulp with preservation of the vitality
of the root pulp)

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21
Q

Apexogenesis objective?

A

It will permit the final physiological development of the root

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22
Q

Apexogenesis indications and requirements to preform it? (4)

A

• Size of exposure ( > 1 mm )
• Time of exposure( > 24 horas)
• Inflammation of the cameral pulp
• Healthy radicular pulp (no signs of inflammation, incuding
correct hemostasia of the radicular stumps)

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23
Q

Apexogenesis materials?

A
  • Calcium hydroxide
  • MTA may be used on those case where we know the radicular pulp is
    completely healthy, because once the MTA is hard, it is very hard to remove it on a posterior sesion.
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24
Q

How many steps are in the apexogenesis technique?

A

10

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25
Q

Apexogenesis step 1?

A

Topical and local anesthesia

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26
Q

Apexogenesis step 2?

A

Rubber dam isolation

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27
Q

Apexogenesis step 3?

A

Remove ALL the caries (starting on the walls far away from the pulp chamber and finishing on the closest wall of the pulp) and make a pulp exposure <1mm.

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28
Q

Apexogenesis step 4?

A

Removal of the pulp chamber roof (endo-z bur)

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29
Q

Apexogenesis step 5?

A

Removal of the cameral pulp (With round low-speed bur or sharp excavator, careful not to extirpate the pulp)

30
Q

Apexogenesis step 6?

A

Cleansing of the cavity with saline solution

31
Q

Apexogenesis step 7?

A

Hemostasia with cotton pellets

32
Q

Apexogenesis step 8?

A

Placement of calcium hydroxide on the pulp chamber floor

33
Q

Apexogenesis step 9?

A

Obturation of the pulp chamber with ZOE

34
Q

Apexogenesis step 10?

A

Final restoration with composite or preformed crown

35
Q

Apexogenesis radiographics follow up?

A

The ápex must close and there must be a dentin bridge at the pulp chamber floor (entrance of the root canals)

36
Q

Apexogenesis check pulpotomy?

A
  • Partial pulpotomy On teeth with pulp exposure due to trauma we may do a partial pulpotomy:
    • We only remove the swollen cameral pulp (1-3mm) and achieve hemostasia after irrigation with sodium
    hypoclorite or clorhexidine.
    • We will place a layer of calium hydroxide or MTA on top of the pulp stump.
    • On top of the MTA or calcium hydroxide we place glass ionomer and a composite.
    • Make follow-ups to chek there is a physiological apical closure.
37
Q

Apexification definition?

A

Removal of all of the radicular pulp to stimulate with

biocompatible materials the closure of the foramen.

38
Q

Apexification indications? (2)

A
  • Necrotic pulp

* Irreversible pulpitis

39
Q

Apexification objectives? (2)

A
  • Control of the infection

* Closure of the apex

40
Q

Apexification materials? (2)

A
  • Calcium hydroxide

* MTA

41
Q

How many apexification steps exist?

A

8

42
Q

Apexification step 1?

A

Topical and local anesthesia

43
Q

Apexification step 2?

A

Rubber dam isolation

44
Q

Apexification step 3?

A

Removal of the caries and the pulp chamber roof

45
Q

Apexification step 4?

A

Removal of the pulp (with files)

46
Q

Apexification step 5?

A

Irrigation with sodium hypochlorite or clorhexidine

47
Q

Apexification step 6?

A

Careful instrumenta/on of the walls to scrape the adhered pulp (using the correct work length)

48
Q

Apexification step 7?

A

Dry the conducts with paper points

49
Q

Apexification step 8?

A

Placement of the material for apexification

50
Q

Apexification step 8 materials?

A

Calcium hydroxide

MTA

51
Q

Apexification material calcium hydroxide?

A
  • Fill up the root canal with calcium hydroxide using lentules,
    syringes,…
  • Control X-ray to check it is correctly filled
  • Temporary obturation (ZOE)
  • Control and change of the calcium hydroxide every 3 months
52
Q

Apexification material calcium hydroxide followup?

A

• Clinic and radiographical check-ups every 3 months
• Closure process: 3 months - 3 years
• Once the apical closure is finished———Root canal treatment
• The most frequent complication is the root fracture (big pulp and
thin walls)

53
Q

Apexification material MTA?

A

We place the Mta at the apical área, with a damp cotton pellet on
top and place a provisional obturation
A few days laterà root canal treatment
If necrosis or severe inflammationà Previous calcium hydroxide

54
Q

Revascularization definition?

A

Technique based on the capacity of the clot from

the periapical área to produce calcified tissue.

55
Q

Revascularization indications?

A

Permanent tooth with open apex and pulp necrosis

56
Q

Revascularization objectives? (2)

A
  • Control the infection

* Reach an apical closure

57
Q

Revascularization materials?

A

Triantibiotic paste:
• Ciprofloxacin 200 mg
• Metronidazole 500 mg
• Minocycline 100 mg

58
Q

Revascularization first session step 1?

A

Topical and local anesthesia

59
Q

Revascularization first session step 2?

A

Rubber dam isolation

60
Q

Revascularization first session step 3?

A

Removal of the caries and pulp chamber roof

61
Q

Revascularization first session step 4?

A

Removal of the pulp with files (up to work-length)

62
Q

Revascularization first session step 5?

A

Irrigation with sodium hypochlorite

63
Q

Revascularization first session step 6

A

Application of triantibiotic paste inside the conduct

64
Q

Revascularization first session step 7

A

Provisional closure with a cotton pellet and provisional

obturation (cavit or ZOE)

65
Q

Revascularization second session step 1? (2)

A
  • 14-30 days after

- Topical and local anesthesia

66
Q

Revascularization second session step 2?

A

Rubber dam isolation

67
Q

Revascularization second session step 3?

A

Removal of the provisional obturation and cotton pellet

68
Q

Revascularization second session step 4?

A

Irrigation of the conduct with sodium hypochlorite 5,25% and dry the conduct with paper points

69
Q

Revascularization second session step 5?

A

After the desinfection of the root canal, it is proveked the bleeding of the surrounding periodontal tissue

70
Q

Revascularization second session step 6?

A

Placement of MTA at the entrance of the root canals

71
Q

Revascularization second session step 7?

A

Composite restoration or preformed crown

72
Q

Revascularization second session step 8?

A

Control x-ray at 3, 6, 12 and 18 months

Peds II (11 decks)

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