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Children's Dentistry > Pulp Therapy > Flashcards

Pulp Therapy Flashcards

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1
Q

Name some pulpotomy medicaments (other than Formocresol)

A

Coagulants - Ferric Sulfate
Mineralizing/Bacterialstatic agents - CaOH
Other - electro-surg, laser, pressure, MTA

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2
Q

How does Ferric Sulphate work? What is it used for?

A
  1. Used as a coagulation and he static agent (blood proteins react with ferric and sulphate ions with acidic pH solution)
  2. Agglutinate do proteins form plugs that occlude capillary orifices
  3. No concerns about toxicity or harmful effects
  4. Not an antibacterial

Ferric sulphate is used for pulpotomy treatment

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3
Q

What is MTA? What is it used for?

A

MTA is Mineral Trioxide Aggregate (MTA)

Made of:

  • tricalcium silicate
  • dicalcium silicate
  • tricalium aluminate
  • calcium sulfate dihydrate
  • bismuth oxide

Hardens in dampness or blood. It is an anti-microbial to facultative bacteria. Causes dentin bridge formation with less inflammation and less pulp all necrosis than CaOH. It is not hemostatic

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4
Q

What induced formation of dentin at a faster rate - CaOH or MTA?

A

MTA and it produces more complete dentin bridges

MTA has a very high success rate but it is expensive, technique sensitive, and has difficult handling properties

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5
Q

What is the difference in patient results between Formocresol and Ferric sulfate?

A

There is no difference

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6
Q

Which is better for a pulpotomy procedure? CaOH or Formocresol?

A

Formocresol is a much better option

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7
Q

What is better for pulpotomy? Sodium hypochlorite or Formocresol?

A

No difference but if there is internal resorption it is most likely due to failure in hypochlorite

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8
Q

What is better in a pulpotomy procedure – Formocresol or MTA?

A

MTA proved to have a lower failure rate with less occurrence of internal root resorption

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9
Q

What is the restoration of choice for primary teeth after a pulpotomy or pulpectomy?

A

SCC

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10
Q

How is timing important to preventing failure of restoration? (SCC and pulp treatment)

A

SCC with finished pulp at the same visit has a higher chance of success (82%) than if don’t at a later visit.

SCC with indirect pulp at same visit success rate is 93%

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11
Q

Where can signs of failure for pulptomy’s be seen first?

A

Radiographically before they are expressed clinically

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12
Q

Which pulp therapy treatment has a higher success rate – Pulpotomy or Indirect?

A

Indirect

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13
Q

What do we do if the pulp of a tooth is necrotic or hyperemic but we need the tooth?

A

Pulpectomy

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14
Q

What is used on incisors and molars respectively for pulpectomys?

A

Incisors and canines - broach is used to remove pulpal tissue

Molars - endodontic files used to remove pulpal tissue

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15
Q

What are some resort able materials used for pulpectomys?

A

ZOE paste

Kri-1 paste – iodoform paste

CaOH

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16
Q

What are some indications for pulpectomys?

A
  1. Chronic inflammation - canals are necrotic or hyperemic
  2. Fisutla, mild mobility
  3. Behavior management
  4. Finances
17
Q

What are some contraindications for pulpectomies?

A
  1. Non-restorable - gross loss of tooth structure
  2. If radiographically we see:
    - Advanced internal root resorption
    - External root resorption
    - Periodical infection involving crypt of the succedaneous tooth
    - pathological loss of bone or PDL
  3. Mechanical or various perforation of the floor of the chamber
18
Q

How far should you fill the pulp chamber with ZOE for pulpectomies?

A

Filled to or slightly short of apex

19
Q

Name some criteria for failure in pulpectomies

A 
Erythema
Swelling
Chronic paroles
Fistula us tract
Missing restoration
Mobility (sustained
Percussion sensitivity

Radiographically:

  • Interradicular pathology
  • Recurrent caries
  • Widened PDL space
  • Pathologic root resorption
20
Q

What is Formocresol?

A

Buckley’s Formula (1:5)

3 parts glycerine - 90ml
1 part water - 30ml
1 part Buckleys - 30ml

21
Q

When does the pulp experience irreversible inflammation in regards to caries

A

When there is progression to 0.5mm into the pulp

22
Q

How does spontaneous pain occur in pulp all inflammation?

A

The temperature of our own body can produce nerve firings

23
Q

How does discoloration of tooth structure (observed with luxation injuries) occur?

A

It is as a result of “leaking” blood components from injured pulp blood vessels and movement of this blood into the dentin all tubules

24
Q

Pulpal necrosis from trauma depends on which two important factors?

A
  1. The type of injury

2. Development of the tooth (open or closed apex)

Children's Dentistry (7 decks)

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