Pulp Tx Primary Teeth

Question 1

When can vital pulp therapy be carried out?

Answer 1

ONLY ON VITAL ASYMPTOMATIC

TEETH

Question 2

Types vital pulp therapy?

Answer 2

Indirect pulp therapy
Direct pulp cap
Pulpotomy

Question 3

What is indirect pulp therapy?

Answer 3

Stepwise caries removal

Remove as much caries as possible w/o exposing followed by restoration w/ good seal

Question 4

What is used for direct pulp cap?

Answer 4

Calcium hydroxide

Tricalcium silicates - MTA/biodentien

Question 5

When is a direct pulp cap considered?

Answer 5

Small traumatic pulp exposure in asymptomatic teeth

Place calcium hydroxide/ MTA over exposure

Question 6

Issue direct pulp cap?

Answer 6

Dubious exposure - poor success rate

Lead to internal resoprtion/ necrosis

Question 7

What materials don’t form good coronal seal?

Answer 7

GIC/amalgam

Question 8

What is Hall technique?

Answer 8

Provision of PMC w/o need for LA/ tooth prep

Question 9

How provide PMC?

Answer 9

1. Create space w/ ortho seps
2. Select correct size PMC
3. Cement w/ GIC

Question 10

Issue of providing pulp therapy?

Answer 10

Knowing if pulp reversible or irreversible inflamed

Question 11

What is used in pulptomy to stop bleeding?

Answer 11

Can use ferric sulphate - haemostat agent

Question 12

What shouldn’t be used in combination w/ ferric sulphate?

Answer 12

Zinc oxide eugenol - contribute internal resoprtion

Question 13

How else can arrest bleed in pulpotomy?

Answer 13

Cotton pledget socket in saline - gentle pressure

Question 14

Why MTA used?

Answer 14

Biocompatible material and can induce hard tissue formation

Question 15

How manage a symptomatic non-vital primary tooth?

Answer 15

Pulpectomy

Can be done in one or two stages

Question 16

When should pulpecotmy be done in two stages?

Answer 16

Purulent

Excesss bleeding

Question 17

Clinical stages pulpectomy?

Answer 17

1. Pre-op PA
2. LA and dam
3. Access canals
4. Irrigate
5. Estimate WL 2mm short apex
6. Gentle filiing
7. If infected - dress w/ CaOH and temporise
8. If canal dry -obturate by injecting slow-setting zinc oxide eugenol/non setting CaOH
9. Restore w/ coronal seal

Question 18

Why is placement of mixture antibiotic into canals not advocated?

Answer 18

Mixture ab hard to obtain

Issue ab resistance

Question 19

What is Ledermix?

Answer 19

Desensitising paste - steroid and antimicrobial

Question 20

Is Ledermix used primary teeth?

Answer 20

Sparse evidence

Question 21

What is odontopaste?

Answer 21

Zinc-oxide based paste w/ broad spec ab and steroid

CAREFUL AS CLINDAMYCIN - THOSE TETRACYCLINE ALLERGY

Question 22

Is odontopaste used in primary teeth?

Answer 22

No evidence base