Vital pulpotomy (lab) Flashcards
_______ pulp horn of __________ is _________ mm from outer enamel surface
MB
1st primary molar
1.8 mm
in regards to primary pulpal anatomy how is the apical foramen different?
wider
what are the radicular portions of the primary teeth described as?
tortuous and ribbon-like
what is a pulpotomy?
The surgical removal of the entire coronal pulp, leaving intact the vital (healthy) radicular pulp within the canals followed by placement of a medicament and a good coronal seal
when do we need to do a pulpectomy?
- tooth treatment planned for pulpotomy in which the radicular pulp exhibits clinical signs of irreversible pulpitis
- pulp necrosis
- suppuration, purulence
what is a distal shoe SM?
PE in a primary second molar with a poor prognosis is sometimes indicated, even if that tooth is maintained only until the first permanent molar has erupted, and then the primary molar is extracted and replaced with a space maintainer
T/F with indirect pulp cap you need to make sure that both infected/affected dentin is removed prior to restoration
false leave affected to avoid pulpal exposure
what are indirect pulp cap indications?
IPT is indicated in a primary tooth with deep caries that exhibits no pulpitis or with reversible pulpitis when the deepest carious dentin is not removed to avoid a pulp exposure.The pulp is judged by clinical and radiographic criteria to be vital and able to heal from the carious insult.
b/w indirect pulp cap and and pulpotomy, which is better long term?
indirect pulp cap
what is the medicament history?
- Formocresol has long been the gold standard
- Ferric Sulfate – 15.5%
- Mineral Trioxide Aggregate (MTA) – our latest iteration
T/F Calcium hydroxide is used for indirect pulp cap with MTA
False
calcium hydroxide is NOT recommended for direct pulp caps in primary teeth
what are indications for pulpotomy?
- Carious/mechanical exposure in vital asymptomatic teeth
- Tooth free of radicular pulpitis
- Presence of at least 2/3 root length
- Absence of abscess or fistula
- Absence of bone loss in furcation
- Absence of internal or external root resorption
- Tooth must be restorable
what are contraindications for PT?
Local Factors
* Spontaneous pain
* Fistula or swelling
* Mobility
* Marked tenderness to percussion
* Internal/External Resorption
* Furcation involvement
* Absent/profuse hemorrhage/serous exudate at exposure
* Tooth is non-restorable
* Less than 2/3 root remaining
Medical Factors
* Cardiac condition
* Immunocompromised kids
with chemotherapy and children when can you do a pulpotomy
just ext tooth
can be life threatening even if done well
what are the steps for removing the roof of the chamber for a pulpotomy?
- Penetrate roof of chamber in are of pulp horn (Only tip of bur penetrates the roof – you will feel a slight break in resistance)
- Move the bur around the roof from one pulp horn to another, severing the roof of the chamber (Remove any overhanging ledge of dentin)
- Do not make any attempt to control hemorrhage at this time
