Pulp Therapy Flashcards
what are there an increased number of in root canals of deciduous teeth?
accessory canals and foramina
what is the porosity like of root canals in deciduous teeth?
more porous
what are the root canal shapes like of deciduous teeth?
more ribbon like
is canal debridement harder in deciduous teeth?
yes
why is complete extirpation of deciduous root canals so difficult?
the morphology of the roots
where does the root canal lie in the tooth?
several mm coronal to the radiographical apex
irriversible pulpitis leads to what treatment?
pulp therapy
if 1/3 of the marginal ridge is broken down what is likely to be happening in the tooth?
irriversible pulpitis
what is a pulp polyp?
chronic response
inflammatory hyperplastic response to disease associated with a non vital tooth
may be symptom free - as chronic
do not do pulp therapy if?
tooth not long term unrestorable
pre co operative pt
medically compromised (e.g bleeding tendancies)
ortho
what are the 3 types of VITAL pulp therapy?
pulp capping
pulpotomy
desensitising therapy
what is a pulpotomoy?
when would a pulpotomoty not be suitable?
the removal of the diseased portion of pulp only, applying medicaments to remaining pulp = continue function
can only carry out if no diseased radicular pulp
cant do a pulpotomy if? (non vital signs or diseased radicular pulp)
abscess - radicular
excessive bleeding - radicular
no bleeding on access = non vital
what is formocresol made of?
tricesol - antiseptic
formalin - stops decomposition
works by binding bacterial and pulp proteins
what are the properties of formocresol?
bacteriocidal/devitalising
mutagenic/carcinogenic
kidneys/liver fast absorb
tissue fixed - rendered inert and resistant to further bacterial breakdown
when can formocresol cause tissue damage?
if passes through apical foramen and damage the underlying tooth germ
causes 80-90% of pulp to become non vital
superficial tissue demineralisation
what is ferric sulphate and how is it used?
haemostatic agent
not a fixative
15% applied to pulp stumps for 15seconds
may have bacteriocidal properties
what is gluteraldehyde?
aqueous sol 2-4%
powerful fixative
some toxic effects
not as effective
what is calcium hydroxide?
causes internal resorption
tertiary dentine stimulated
dentine bridge - causes a barrier against bacterial invasion
pure powder form - as effective as formacresol
not used as medicament bc internal resorption
allows healing in pulp rather than fixing the tissue
what do you create a large access cavity for?
to visualise all the pulp horns
what part of the pulp chamber do you remove in a pulpotomy and with what kind of bur?
roof of chamber
round head stainless steel bur
why is a 3in1 not used in pulp therapy?
air bubble in blood can cause emphysema
what do you irrigate the pulp with in a pulpotomy?
saline
what do you restore the tooth with during a pulpotomy?
dycal, zinc oxide eugenol, crown
what is desensitising therapy?
reduce pulpal inflammation and or symptoms
when is a desensitising therapy used?
carious pulp exposure, no signs/symptoms/vitality loss
hyperaemic pulp
hyperalgesic pulp
what is the desensitising therapy technique?
pulpotomy up to medicament step
cotton pledget and ledermix
place well sealed temp dressing
rev in 2 weeks
what is a pulpectomy?
remove necrotic tissue and obturate the canals
if diseased radicular pulp
diff to RCT bc morphology
what is the irrigation solution used in a pulpectomy?
sodium hypochlorite
what are the steps of a pulpectomy following irrigation?
canal instrumentation file canal walls irrigate paper points and dry temp dressing - rev 7 days irrigate root filler
what is a tooth filled with during a pulpectomy?
non setting calcium hydroxide/zinc oxide eugenol
zinc oxide and crown
if a tooth has pulp therapy, vital or non vital how often should it be reviewed?
6 monthly follow up
yearly review and radiographs
