vital pulp therapy and open apex Flashcards
What is a key factor in determining the pulp condition for VPT?
The degree of pulpal bleeding at the exposure site.
What clinical signs are traditionally used to assess pulp condition?
Sensibility and pain testing.
Why is pulpal bleeding a better indicator than traditional testing methods?
It suggests the depth of inflammation and can guide treatment decisions.
What does increased pulpal bleeding indicate?
Inflammation extends deeper into the pulp tissue, requiring a more extensive treatment, such as partial pulpotomy.
What are the key factors for successful VPT?
Blood supply, a healthy periodontium, and an adequate coronal seal.
What grades of periodontal states are unsuitable for VPT ?
Teeth with moderate to severe periodontal disease are not suitable for VPT.
What is the impact of an inadequate coronal seal on VPT?
It increases the risk of bacterial microleakage and decreases the prognosis.
What is a common method used to control hemorrhage in VPT?
Applying mechanical pressure using a sterile cotton pellet soaked in water or saline.
What role does NaOCl play in VPT?
It controls hemorrhage, removes coagulum and dentin chips, disinfects the cavity, and aids in dentinal bridge formation.
Why is disinfection important in VPT?
It helps prevent bacterial contamination, which can compromise the success of the treatment.
Which teeth are indicated for VPT?
Teeth with incomplete root development, primary teeth, and teeth with healthy pulps and minimal hemorrhage.
Why are teeth involved in complex prosthetics contraindicated for VPT?
They require the root canal space for posts and core placement.
Why are teeth with infected or inflamed pulps contraindicated for VPT?
The presence of infection reduces the chance of maintaining pulp vitality.
What are the main techniques of vital pulp therapy?
Pulp capping (indirect and direct), pulpotomy (partial and full).
What is indirect pulp capping?
A procedure where carious dentin close to the pulp is preserved to avoid pulp exposure and covered with a biocompatible material.
What is the success rate of indirect pulp capping with a healthy pulp?
Approximately 90%.
Why has calcium hydroxide traditionally been used in IPC?
Due to its alkaline pH, biocompatibility, and ability to induce pulpo-dentin remineralization.
What is a concern with calcium hydroxide in IPC?
Its long-term solubility and lack of adhesion to dentin.
What materials are commonly used in IPC other than calcium hydroxide?
Resin-modified glass ionomer cements (RM-GIC) and mineral trioxide aggregate (MTA).
What is direct pulp capping?
Treatment of a mechanical or traumatic pulp exposure by placing a biomaterial directly on the exposed pulp.
What is the success rate of direct pulp capping?
Around 70%, with a range from 30% to 70% depending on studies.
Why does direct pulp capping have a high failure rate?
Due to the difficulty in maintaining a bacteria-tight restoration and proper pulpal healing.
What is partial pulpotomy?
The surgical removal of a small portion of the coronal pulp tissue to preserve the remaining healthy pulp.
When is partial pulpotomy indicated?
In cases of small pulp exposure with controlled pulpal bleeding within 2-5 minutes.
