pulpotomy quiz

Question 1

5 reasons why would it be appropriate to retain a primary molar with extensive caries?

Answer 1

1. Prevent mesial migration of 1st permanent molars.
2. Hypodontia of permanent dentition.
3. Solitary or minimal teeth with extensive caries.
4. Patient at higher risk from general anaesthetic (cardiac conditions/cystic fibrosis).
5. Patient at higher risk from extraction.

Question 2

Bella is a 6 year old who attends with a symptomatic tooth with pulpal exposure. She is immunocompromised and susceptible to endocarditis, what is the most suitable treatment option and why?

Answer 2

Extraction

Means Bella will be less likely to have residual infection.

Question 3

Primary molar morphology is susceptible to caries progression and loss of vitality because of certain features.

What are those 3 features?

Answer 3

1. Wide approximal contact areas.
2. Large pulp chamber in comparison to permanent teeth.
3. Thinner enamel.

Question 4

What symptoms and clinical signs would be associated with significant pulpal inflammation and pathology?

Answer 4

Symptoms:
- spontaneous pain, especially at night.
- pain on biting.
- analgesics requires to relieve pain.

Clinical Signs:
- extent of caries.
- marginal ridge breakdown associated with caries involving the pulp.
- intraoral swelling.

Question 5

What indicates a successful removal of inflamed coronal pulp?

Answer 5

Pulp stumps that are bright red and good haemostasis after 3-5 minutes.

Question 6

What indicates an unsuccessful removal of coronal pulp tissue?

Answer 6

Deep crimson colour and continued bleeding after 3-5 minutes.

Question 7

If assessing the pulp chamber and there is no pulpal tissue or bleeding, what is not indicated and what should you do instead?

Answer 7

Non-vital pulpotomy or extraction should be performed.

Pulpotomy is NOT indicated.