regendo Flashcards
why do vital pulp therapy?
tooth might still be developing its roots
pt can’t afford RCT
buying time for pt
when to do Indirect pulp capping
you probably pulped the tooth a little when you were excavating. the patient does NOT have any previous symptoms. the tooth is vital. the pt understands they might need RCT.
how do you do indirect pulp capping
excavate caries but leave a thin layer of dentin near pulp
place CaOH2 and GI base
place good restoration (want good coronal seal)
when to do RCT on indirect pulp capped tooth
if symptoms develop or pulpal diagnosis changes
what type of teeth are best for direct pulp capping
immature, vital, permanent teeth
why do direct pulp capping?
you want to keep an immature tooth vital so that the roots and apices develop fully. if you need tx in the future it is easier and creates a stronger tooth.
how to do direct pulp capping
take a little bit of the pulp away from exposure area
place MTA or bioceramics against pulp
place final restoration with good seal
MTA characteristics
alkaline
good biocompatibility
hard to manipulate
what are you watching for when following up on a direct pulp capped tooth
watch xrays for complete root development (tooth must stay vital)…if symptomatic or tooth necroses do RCT
what type of teeth are best suited for regendo
immature NECROTIC permanent teeth
what are the most common treatments of “apexicification”
apical barrier with MTA
apexification (long term application of calcium hydroxide)
what are the three factors in tissue engineering/regenerative medicine
stem/progenitor cells
growth factors
scaffold
case selection criteria for regendo:
tooth with necrotic pulp, immature apex
dont need to do a post and core
compliant patient not allergic to shit
first appointment for regendo
rinse everything out with diluted bleach solution. rinse with saline. place calcium hydroxide or triple antibiotic paste. put temporary restoration on.
second appointment for regendo
create bleeding into the system (by over instrumenting or you can use PRP). stop the bleeding but leave a blood clot small enough that you can put 3-4 mm of restorative material on top. place collagen gel, MTA. Place GI on top of that. yay.
