Pulpotomy procedure for a primary molar tooth video Flashcards
Outline the procedure for a pulpotomy on a primary molar
- Consent
- LA and rubber dam
- Remove caries
- Access pulp
- Remove roof of pulp chamber
- Remove coronal pulp only
- Achieve haemostasis
- Apply pulp medicament - ferric sulfate 15% for 15 seconds
- Wash and dry pulp chamber
- Fill pulp chamber with ZOE
- Restore tooth with performed metal crown
What burs are used in the pulpotomy procedure
- 330 bur
- Non-end cutting ubr
- Large Rosehead bur
Why should you expect the pulp to bleed in a pulpotomy
As this treatment is only suitable for teeth with vital pulps
If there is a lack of bleeding when accessing the pulp what treatment does this indicate
- Indicates a non-vital tooth and then a pulpectomy or an extraction is required
How much pulp do you want to remove in a pulpotomy
Only coronal pulp
When do we try to achieve haemostasis in a pulpotomy
After you have removed the coronal pulp
What do we use to try and achieve haemostasis in a pulpotomy and how long does it usually take
Using a sterile cotton pledget soaked in saline
Usually takes about 4 minutes
When do we apply ferric sulphate in a pulpotomy
After achieving haemostasis (acts as another haemostats agent)
How long do we apply ferric sulfate for
15 seconds
What happens if the bleeding of the pulp in a pulpotomy doesnt arrest after 30 seconds of using ferric sulfate
The tooth has irreversible pulpitis and an extraction of a pulpectomy is required
What do we do after we apply ferric sulfate in a pulpotomy
Thoroughly wash and dry the pulp chamber and then rinse the pulp chamber with saline
After washing, drying and rinsing the pulp chamber with saline in a pulpotomy what is next
Fill the pulp chamber with ZOE (the sausage roll up one)
What are some post op instructions you might give after a pulpotomy
- Pain
- Numbness
- Loss of vitality
- Need for further treatment e.g. extraction
