Pulp therapy in the primary dentition Flashcards
What is the primary objective of pulp therapy in the primary dentition?
- Prevent space loss and malocclusion
- Aid in mastication
- Preserve the primary tooth in the case of hypodontia
- Prevent possible speech problems
- Maintain esthetics
- Prevent aberrant tongue habits
Lower first molars tend to do what?
-Tip over and drift
Upper first molars tend to do what?
-Drift a little more upright
What are pulp therapies in pediatric dentistry?
- Protective liner
- Indirect or direct pulp cap
- Pulpotomy
- Pulpectomy
T/F in relation to their crowns, the pulp of primary teeth are larger than permanent teeth
True
Are mesial or distal pulp horns closer to the outer surface of the teeth and can be readily exposed to caries or trauma?
-Mesial (especially in the 1st primary molar)
T/F Pulp horns under each cusp is longer than is suggested by external anatomy
True
T/F Maxillary molar chamber are bigger than mandibular molar chambers
False
-Opposite
Where is the first radiographic evidence of an infection in primary molars?
-The furcation
Where do accessory canals in the primary pulp chamber floor lead directly into ?
-The intra radicular furcation
T/F At cervical region the roots of primary molars flare outwards to a greater degree
True
What are the indications for a protective liner?
-In a tooth with a normal pulp when all caries is removed for a restoration, a protective liner may be placed in the deep areas of the preparation to minimize injury to the pulp
What are the objectives for a liner?
- Preserve tooth’s vitality
- Promote pulp tissue healing
- tertiary dentin formation
- minimize bacterial micro-leakage
What can you use for protective liners?
- GLUMA
- Glass Ionomers
- RMGI
What are the indications for an indirect pulp cap?
-In a tooth with no pulpitis or with reversible pulpitis when the deepest carious dentin is not removed
What are the objectives in indirect pulp capping?
- The restorative material should seal completely the involved dentin from the oral environment
- Vitality preserved
What materials can you use for and indirect pulp cap?
- Calcium hydroxide
- Zinc oxide and Eugenol
- MTA
- Resin modified GI
- GI cement
What can stimulate tertiary dentin?
- Calcium hydroxide
- MTA
What are the indications of a direct pulp cap?
-A small mechanical or traumatic exposure when conditions for a favorable response are optimal
What materials do you use for a direct pulp cap?
- Calcium hydroxide
- MTA
What are the objectives in a pulpotomy?
-Radicular pulp should remain asymptomatic
What materials do you use in a pulpotomy?
- Formocresol
- Preservation such as ferric sulfate
- Regeneration such as MTA
- ZOE (IRM)
If you open up the pulp chamber and it doesn’t bleed or the bleeding doesn’t stop will you do a pulpotomy?
-No you will do a pulpectomy
What materials do you use for a pulpectomy?
- ZOE
- Iodoform paste
What are the keys to success in pulp therapy in peds?
- Diagnosis
- Isolation
- Technique
- Seal
What are contraindications to pulp therapy in primary tooth?
- Internal or external root resorption
- Close to exfoliation
- Periapical abscess formation with swelling and drainage
- Cellulitis
- Unrestorable tooth
- Medically complex
