Vital Pulp Therapy Flashcards
what is vital pulp therapy
treatment aimed at preserving and maintaining pulp tissue that has been compromised by trauma, caries, or restorative procedures in a healthy state
complete caries removal is essential to eliminate:
infected tissues
residual caries compromises:
necessary observations of pulpal inflammation levels and areas of potential necrosis
what is carious pulp exposure
a pulp exposure resulting from the progressive destruction of tooth structure by acids and proteolytic enzymes elaborated through microbial activity
- underlying pulp is inflammed to a varying and unknown extent, due to the progression of dental caries
what is mechanical pulp exposure
- an accidental exposure of the pulp by hand or engine driven dental instruments in the absence of dental caries
- if aseptic conditions are maintained the underlying pulp is usually not inflamed
what is a traumatic pulp exposure
a pulp exposure due to fracture of a tooth
what is a pulp cap
treatment of an exposed vital pulp by sealing the pulpal wound with a dental material such as calcium hydroxide or mineral trioxide aggregate to facilitate the formation of reparative dentin and maintenance of a virtal pulp
what is a direct pulp cap
a dental material placed directly on a mechanical or traumatic vital pulp exposure
what is an indirect pulp cap
a procedure in which a material is placed on a thin partition of remaining carious dentin that, if removed, might expose the pulp in immature permanent teeth
what is the protocol for a pulp exposure on a vital pulp
- isolate the tooth
- remove all remaining caries
- irrigate with 8.3% NaOCl to achieve homeostasis
- gently place dycal in the pulp exposure and a temporary restoration - IRM, PARACORE
- after you have filled out forms and taken radiographs contact endo faculty at a later time via email to review paperwork and get the patient referrred or scheduled in clinic
what is a pulpotomy
the removal of the coronal portion of the vital pulp as a means of preserving the vitality of the remaining radicular portion
- may be performed as an emergency procedure for temporary relief of symptoms or therapeutic measure as in the instance of a Cvek pulpotomy
what is a partial pulpotomy
- the removal of a small portion of the vital coronal pulp as a means of preserving the remaining coronal and radicular pulp tissues
when do you do a cavity restoration without bases
- reversible pulpitis
- no pulp exposure
- sound dentin at bottom of cavity
when do you do direct pulp cap
- reversible pulpitis
- pulp exposure
- sound dentin around exposure
- continuous blood filled pulp
- bleeding controlled within 2 mins
- no dentin chips displaced
when do you do a pulpotomy
- irreversible pulpitis: pulp exposure, continuous pulp tissue, bleeding controlled in 2 mins
- reversible pulpitis: pulp exposure, not sound dentin around exposure, not continuous blood filled pulp, bleeding not controlled in 2 mins, dentin chips displaced
when do you do a pulpectomy
- irreversible pulpitis
- pulp exopsure
- not continuous pulp tissue
- bleeding not controlled in 2 mins
how should we manage carious pulp exposure
- direct pulp capping
- pulpotomy
- teeth must have reversible pulpitis
- need a microscope
- not calcium hydroxide
where do bacteria live in the dentin
in the tubules
no wound healing will take place in the presence of:
bacteria
if the infection invades tertiary dentin:
infectde dentin is removed and a hermetic restoration is provided
- pulp vitality is maintained
what is another name for pulpotomy
pulp removal
what is another name for partial pulpotomy
-shallow pulpotomy
- Cvek pulpotomy
what treatment is main clinical proceure with highest success rate
partial pulpotomy
what procedures are reported to have lower success rates
complete pulpotomy and direct pulp capping
describe pulp histology at 3 months after using CaOH
- no dentin bridge
- pulpal inflammatino
- zone of necrosis present
describe pulp histology at 3 months using mineral trioxide aggreate
dentin bridge formation
