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    PULPECTOMY

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    Justforkiddslaserdental Ch
    Pulpectomy is the removal of the coronal and radicular pulp from a primary tooth, followed by filling of the canals with a resorbable material. It is indicated for irreversible pulpitis, necrotic pulp, and minimal periradicular changes with sufficient bone support. The procedure involves local anesthesia, isolation, access cavity preparation, pulp extirpation, working length determination, canal debridement and irrigation, and filling of the canals. Common filling materials include zinc oxide-eugenol paste and calcium hydroxide with iodoform paste, which are resorbable and safe for periradicular tissues.

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    PULPECTOMY

    Uploaded by

    Justforkiddslaserdental Ch
    119 views31 pages
    Pulpectomy is the removal of the coronal and radicular pulp from a primary tooth, followed by filling of the canals with a resorbable material. It is indicated for irreversible pulpitis, necrotic pulp, and minimal periradicular changes with sufficient bone support. The procedure involves local anesthesia, isolation, access cavity preparation, pulp extirpation, working length determination, canal debridement and irrigation, and filling of the canals. Common filling materials include zinc oxide-eugenol paste and calcium hydroxide with iodoform paste, which are resorbable and safe for periradicular tissues.

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    Pulpectomy is the removal of the coronal and radicular pulp from a primary tooth, followed by filling of the canals with a resorbable material. It is indicated for irreversible pulpitis, necrotic pulp, and minimal periradicular changes with sufficient bone support. The procedure involves local anesthesia, isolation, access cavity preparation, pulp extirpation, working length determination, canal debridement and irrigation, and filling of the canals. Common filling materials include zinc oxide-eugenol paste and calcium hydroxide with iodoform paste, which are resorbable and safe for periradicular tissues.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    119 views31 pages

    PULPECTOMY

    Uploaded by

    Justforkiddslaserdental Ch
    Pulpectomy is the removal of the coronal and radicular pulp from a primary tooth, followed by filling of the canals with a resorbable material. It is indicated for irreversible pulpitis, necrotic pulp, and minimal periradicular changes with sufficient bone support. The procedure involves local anesthesia, isolation, access cavity preparation, pulp extirpation, working length determination, canal debridement and irrigation, and filling of the canals. Common filling materials include zinc oxide-eugenol paste and calcium hydroxide with iodoform paste, which are resorbable and safe for periradicular tissues.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 31

    PULPECTOM

    Y
    PULPECTOMY IN PRIMARY
    TEETH:
    ♠ Removal of coronal & radicular pulp
    ♠ Subsequent filling of canals with a
    resorbable material

    INDICATIONS:
    ♠ Irreversible pulpitis; necrotic pulp
    ♠ Minimal periradicular changes with
    sufficient bone support
    ♠ Root length – at least 2/3 of normal
    ♠ Internal resorption without
    perforation
    CONTRAINDICATIONS:

    ♠ Systemic conditions
    ♠ Lack of patient cooperation
    ♠ Non restorable tooth
    ♠ Excessive mobility
    ♠ Excessive root resorption
    ♠ Internal resorption with perforation
    ♠ Extensive periradicular involvement
    extending to permanent tooth bud
    PROBLEMS ASSOCIATED WITH
    PULPECTOMY:

    ♠ Multiple, tortuous root canals


    → mechanical debridement &
    filling are difficult
    ♠ Connection between floor of pulp
    chamber & furcation area
    PROCEDURE:

    1. Local anaesthesia
    2. Isolation- rubber dam
    3. Caries excavation
    4. Access cavity preparation
    5. Coronal pulp amputation
    6. Locating the canals
    7. Pulp extirpation
    7. Working length determination
    → 2-3 mm short of radiographic
    apex
    8. Debridement
    → Chemical, mechanical
    preparation of root canals
    → Irrigation
    → Relative pulpectomy
    → Selective filing
    9. Dry root canals – paper points
    10. Filling of root canals
    ROOT CANAL FILLING
    MATERIALS FOR PRIMAY
    TEETH:
    ♠ Resorbable at same rate as root
    ♠ Safe for periradicular tissues &
    permanent tooth bud
    ♠ Readily resorb if it flows
    periapically
    ♠ Stable disinfection
    ♠ Easy insertion & removal
    ROOT CANAL FILLING
    MATERIAL FOR PRIMARY
    TEETH (CONTD):

    ♠ Insoluble in water
    ♠ Radioopaque
    ♠ Should not discolour tooth
    No material currently meets all
    the criteria
    ROOT CANAL FILLING
    MATERIALS:

    1. Zinc oxide – Eugenol


    paste:
    ♠ most commonly used
    ♠ without catalyst
    ADVANTAGES DISADVANTAGE
    S
    ♠ Antiseptic
    ♠ Easy ♠ Slow resorption
    application ♠ Foreign body
    ♠ Radioopaque reaction
    ♠ Does not cause ♠ Overfilling does
    discolouration not resorb
    of tooth ♠ Deflection of
    ♠ Adheres to permanent tooth
    walls ♠ Difficult removal
    2) Ca(OH)2 with iodoform paste:

    Vitapex; Metapex

    Advantages:
    ♠ Bactericidal
    ♠ Overfilling resorbs
    ♠ Easy removal- does not set into
    hard mass
    ♠ Radioopaque
    ♠ Does not cause tooth discolouration
    ♠ Faster resorption than root
    OTHERS:
    Walkhoff Maisto
    KRI paste
    paste paste
    Parachlorophe Iodoform
    Zno 14g
    nol 80.8%
    Camphor Iodoform
    Camphor
    4.86% 42g
    Parachloroph
    Menthol Thymol 2g
    enol 2.025%
    Menthol Camphor
    1.215% lanolin
    Ca(OH)2 paste → also being tried

    OBTURATING METHODS:
    ♠ Lentulo spiral
    ♠ Endodontic pressure syringe

    Single Visit Vs Multiple Visit


    Pulpectomy
    ENDODONTIC MANAGEMENT
    OF YOUNG PERMANENT
    TEETH:
    ♠ APEXOGENESIS:
    ♠ Physiologic process of root development
    ♠ Large vital exposures in permanent
    teeth with incompletely formed apex
    Methods:
    Direct pulp capping
    → Traumatic exposure
    → Traumatic injury < 1 – 2 hrs after
    exposure
    → Pinpoint carious exposure with sound
    surrounding dentin
    CALCIUM HYDROXIDE
    PULPOTOMY:

    ♠ Traumatized immature permanent


    teeth with exposure > 2hours
    ♠ Carious exposure in immature,
    vital permanent teeth

    Normal root end closure


    APEXIFICATION:

    ♠ Inducing development of root apex


    in an immature pulpless tooth by
    formation of osteocementum /
    other bone like tissue
    ♠ Calcific barrier

    WHY?
    ♠ Condensation of GP difficult
    ♠ Apicectomy cannot be done
    INDICATION:

    ♠ Pulpless, immature
    permanent teeth

    OBJECTIVE:
    ♠ Induce root end closure
    STEPS:
    ♠ L.A.
    ♠ Isolation
    ♠ Access cavity preparation, remove
    necrotic tissue
    ♠ Working length determination
    ♠ Cleaning and shaping
    ♠ Irrigation – Na Hypochlorite, dry
    ♠ Seal CMCP pellet – 1-2 wks &
    provisional restoration
    ♠ Recall visit after 1-2 weeks:
    Remove temporary
    Clean canal
    Ca(OH)2 + CMCP
    ↓
    Force into apical area
    ↓
    Radiograph
    ↓
    Recall after 6 months
    At recall, confirm apical barrier
    formation :
    IOPA radiograph
    No. 35 file – tactile – apical stop
    ROOT END CLOSURE TYPES:

    ♠ No apparent closure, resistance to


    file
    ♠ Calcific barrier – at apex
    ♠ Apical closure without canal space
    changes
    ♠ Normal continuance of root closure
    ♠ Evidence of resolving radiolucency

    After apical closure – obturate with GP

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