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ENDODONTICS
PULPOTOMY
.
CONTRAINDICATIONS:
TREATMENT APPROACHES:
THREE CATEGORIES
(varying with rationale & various medicaments)
1. DEVITALIZATION
2. PRESERVATION
3. REGENERATION
1. DEVITALIZATION:
Pharmacotherapeutic Non-pharmacotherapeutic
- Corticosteroids - Electrosurgical
- Glutaraldehyde - Laser
- Ferric sulphate
3. REGENERATION:
- 35% tricresol
- 19% formaldehyde
- Zone of fixation:
fixation A broad eosinophilic zone
- Zone of atrophy:
atrophy A broad pale-staining zone with
poor cellular definition
- Zone of inflammation:
inflammation Diffusing apically into normal
pulp tissue
FIXATION
Formocresol Pulpotomies:
may be empirical clinical success, but histologically
they are failures to one degree or another
F PULPOTOMY TECH. IN 1O TEETH
INDICATIONS:
Restorable teeth with inflammation confined to
coronal portion of the pulp
Nonrestorable teeth
Necrotic teeth
PROCEDURE:
1. Local toxicity
2. Systemic toxicity
Initial
zone of fixation that didnt progress
apically
Cold,buffered, 2% Glutaraldehyde
most stable
FERRIC SULFATE
CELL-INDUCTIVE AGENTS:
- Mineral trioxide aggregate
- Calcium phosphate cement
- Calcium phosphate ceramics
- Hydroxyapatite
- Bone morphogenic proteins
- Freeze-dried bone
FERRIC SULPHATE
BASIC PRINCIPLES:
Amputate infected coronal pulp
ADVANTAGES:
Quick and efficient
Good homeostasis
Good visibility of the field
No systemic effects
Sterilization at the site of
application
Electrosurgical Pulpotomy
DISADVANTAGES:
Heat leads to tissue destruction
Persistent inflammation
Pulp inflammation
LASERS