Trauma Recap

Question 1

Three treatment options for pulpal exposure of vital immature tooth

Answer 1

Pulp cap
Pulpotomy
Pulpectomy

Question 2

Pulp cap indications

Answer 2

Small exposure <24 hours old
Apply calcium hydroxide (dycal) direct to exposure site

Question 3

Pulpotomy indications

Answer 3

Larger exposure, delay in treatment
Maintains vitality of remaining pulp
Root formation can continue

Question 4

Tx options of pulpal exposure of non-vital immature tooth

Answer 4

Pulpectomy
Apical barrier formation
Apexification

Question 5

Pulpectomy vs RCT

Answer 5

Pulpectomy
Primary teeth, removal of pulp tissue, no further Tx

Question 6

Apical barrier formation

Answer 6

Apical constriction needs to be larger than 60K file
MTA is used to provide apical barrier against which to condense root canal filling
5mm min MTA at apex

Question 7

Apexification

Answer 7

Calcium hydroxide placed in root canal to induce apical barrier
Takes 9 months

Question 8

Long term use of calcium hydroxide in root canals

Answer 8

Reduce mineral content in dentine, tooth more susceptible to root fracture

Question 9

Why use Apexification

Answer 9

Only if child unable to manage MTA placement

Question 10

MTA two uses

Answer 10

Root-end filling
Pulp capping agent

Question 11

MTA as a root end filling

Answer 11

Forms tight seal between root canal system and surrounding tissues
Prevents re infection and promote healing of periapical tissues

Question 12

MTA as a pulp capping agent

Answer 12

Promotes formation of dentine bridge and stimulates pulpal healing