Pulp therapy Flashcards
Describe the pulp morphology of a deciduous tooth (5)
Increased number of accessory canals, foramina and porosity in the pulpal floor
Roots are more ribbon like
Pulp system is fine and filamentous
Complete extirpation of pulp remnants is almost impossible
Canal opening is several mm’s away from the radiographic apex
What can cause irreversible pulpitis? (3)
Caries
Trauma
Wear
What clinical feature indicated irreversible pulpitis?
More than 1/3 of marginal ridge breakdown
What is a carious exposure?
communication between the pulp and oral cavity
What is a pulp polyp?
Hyperaemic overgrown pulp
What are the contraindications for pulp therapy? (4)
Not enough tooth tissue to restore
Pt is unco-operative
Medically compromised
Ortho xLa
What are the possible results of a pulpotomy? (3)
Abscess (infected or inflammed radicular pulp)
Excessive bleeding upon opening pulp chamber
no bleeding on opening
What is the aim of a pulp amputation?
Removing the diseased coronal portion of the pulp only and applying a medicament to the remaining pulp allowing the tooth to function as normal
Why pulpotomy over a direct pulp cap?
Better success rate
what are the 4 medicaments used in pulp therapy?
Gluteraldehyde
CaOH
Formocresol
Ferric sulphate
What are the active ingredients in formocresol?
Tricresol- Anti septic
Formalin- Tissue fixative
How does formocresol act as a medicament?
bactericidal and devitalising agent
‘Fixes’ the tissue to make it resistant to breakdown by bacterial enzymes
Why don’t we use Formocresol in pulp therapy anymore?
Cariogenic and mutagenic properties found from animal studies
Quick absorption in organs in animals
possible damage to permanent tooth germ if extruded through foramen
What type of agent is ferric sulphate?
haemostatic agent, NOT a fixative
Describe calcium hydroxide as a medicament (5)
When in a pure powder form, as effective as formocresol
Encourages new dentine formation
Forms a dentine bridge
This protects the pulp from invading bacteria
Heals the pulp tissue rather than fixing it
How long do you apple formocresol or ferric sulphate for?
Formocresol- 4-5 mins
Ferric sulphate- 15% for 15 secs
What are the indications for a desensitising pulp therapy?
Carious exposure but no symptoms, loss of vitality
Hyperanalgesic pulp
Hyperaemic pulp
How long do you leave a desensitizing pulp therapy for?
2 weeks
What is the aim of a pulpectomy?
to remove infected necrotic tissue and obturate the canals
