Pulp Therapy Flashcards
What is a carious exposure?
Point where communication exists between pulp and the oral cavity
May be symptom free
May have symptoms of irreversible pulpitis
What are contraindications to pulp therapy
Not enough hard tissue for diffinitive restoration
Pre cooperative patient
Patient medically compromised
Orthodontic extractions required
What type of pulp therapy is available for vital primary teeth
Pulp capping
Pulpotomy
Desensitising pulp therapy
What is carried put for a Pulpotomy?
Removal of diseased coronal portion of the pulp
Application of medicament to remaining pulp tissue
Restoration
What are contraindications to Pulpotomy?
Abscess- infected radicular pulp
Excessive bleeding upon access to pulp chamber
No bleeding at all on access to pulp chamber
Describe medicaments used in pulp therapy
Formecresol
Formocresol:
Very efficient
No longer used due to mutagenic/carcinogenic properties
Contains active ingredients:
Tricesol-antiseptic
Formalin-tissue fixative
Tissue is fixed- rendered inert and resist further bacterial breakdown
Disadvantages:
Local tissue damage if extruded via apical foramen. Can alps damage permanent tooth germ
Healthy pulp tissue becomes non vital
What are requirements for use of formecresol?
Rubber dam essential
Well blotted, small amount
Restoration margins must be well sealed
Describe properties or ferric sulphate
Now most commonly used medicament for pulp therapy
Non tissue fixative
Excellent haemostatic agent
Possible anti microbial properties
Applied to pulp stumps 15% for 15 seconds
Describes properties of gluteraldehyde
2-4% aqueous solution
Powerful fixative
Toxic effects discovered
Not as effective as formecresol
Describe properties of calcium hydroxide
Equally efficient as formecresol when used in pure powder form
No toxic side effects
Encourages formation of tertiary dentine due to irritant ( dentine bridge)
Acts as barrier to prevent bacterial invasion of remaining pulp
Allows healing rather than fixing
Describe technique for Pulpotomy
LA Isolate with rubber dam Outline form Remove all caries Remove pulp chamber roof using round bur Use excavator to remove contents of pulp chamber Care taken not to damage chamber floor NEVER AIR DRY irrigate with saline Dry with pledget Apply medicament If bleeding is controlled Hard setting calcium hydroxide Zinc oxide euganol fill PMC
What are indications for desensitising pulp therapy
Carious pulp exposure - no symptoms or loss of vitality
Hyperaenemic pulp during attempted Pulpotomy
Hyperalgesic pulp
Describe the technique for desensitising pulp therapy
Access pulp chamber Place steroidal antibiotic paste over exposure site Place well sealed temporary dressing Review in 2 weeks Pulpotomy or pulpectomy
When is pulpectomy indicated?
If pulp is non vital
No bleeding on attempted Pulpotomy
How does pulpectomy differ to RCT
Apical foamin wider than in permanent therefor damage could occur to permanent tooth germ
Canals harder to instrument to to ribbon like morphology
Canal walls thinner and prone to perforation
Material must be resorbable as primary roots resorb
