2 Pulp Therapy for Primary Teeth Michael Kanellis, DDS, MSDepartment of Pediatric Dentistry
3 PulpotomyPulpotomy is the extirpation of vital inflamed pulp from the coronal chamber followed by medicament placement over radicular pulp stumps to fix (mummification) or stimulate repair of the remaining vital radicular pulp.
4 PulpotomyRationale: The radicular pulp tissue is healthy, and can either heal after the surgical amputation of the coronal pulp, or be fixed/mummified.Signs or symptoms of inflammation extending beyond the coronal pulp is a contraindication for a pulpotomy
5 Pulpotomy - Indications When the pulp is exposed (either through carious exposure or through trauma)When it is desirable to maintain tooth (primarily for space, function, guidance of permanent teeth)When there are no contraindications to pulpal therapyIn a 1995 landmark article, Edelstein and Douglass successfully dispelled the myth that tooth decay is no longer a serious public health problem for US childrenTooth decay in fact remains one of the most common diseases of childhood.And children from low-income families are disproportionately affected.When it comes to “cavities” low-income children get hit earlier, and they get hit harderAnd the tooth decay they experience is not incidental.OPPOSITE PICTURE FROM PUBLIC HEALTH REPORTS
6 Pulpotomy Procedure Rubber Dam Isolation Remove caries Open pulp chamber and de-roofAmputate pulp with round bur in slow speed running in reverseControl hemorrhage with dry cotton pelletPlace Endo Bleach or FMC?????Place Glass Ionomer over floor?????
7 Although the Medicaments and Materials May Change… The Access Opening Technique Will Remain the Same