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Flashcards in Pulp Deck (54)
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31

What is a pulpotomy?

removal of inflamed coronal pulp tissue leaving the intact radicular pulp, medicament then placed on top

32

When the coronal pulp is removed in a pulptomy how should you stop the bleeding of the radicular pulp?

direct pressure with sterile saline soaked cotton wool pledget

33

What is the potential problem if bleeding of the radicular pulp fails to halt following application of cotton wool and sterile saline? What are the options following this?

the radicular pulp is likely to be irreversible inflamed

vital pulpectomy or XLA/GA

34

What will happen if a pulpotomy is carried out on an inflamed radicular pulp?

internal resorption will occur

35

Which two things would indicate the need for pulpectomy or extraction following opening up of the pulp chamber?

no pulp in the canal and unable to get haemostasis

36

Which medicatments can you use for a pulpotomy?

ferric sulphate (15.5%)
formocresol used to be used no longer now

37

How do you perform a ferric sulphate pulpotomy?

Apply ferric sulphate on cotton wool to the pulp and obtain haemostasis
apply once for 15 seconds and then again for 15 seconds, if bleeding not controlled with this then need to perform pulpectomy or XLA

38

By what method does formocreosol work?

It works by fixing the pulp tissue

39

What is the success rate for ferric sulphate pulpotomy?

Coll et al 2008

70-95% success

40

Which material should be used to fill then pulp chamber?

Doyle et al 2010
Zn O Eugenol

CaOH (high failure rate)

MTA shows the best outcome with 2 year survival median value. DOyle et al 2010

41

What should be placed over the crown following the Zn O Eugenol?

SSC

Waterhouse et al 2000

42

What is essential after pulpotomy and SSC placement?

follow up

absence of signs and symptoms
radiograph shows no evidence of bone loss in the furcation
no evidence of internal resorption

43

When should you do further treatment on a tooth which has had a pulpotomy and internal resorption is now present radiologically?

If the resorption extends on to the external root surface
if the patient is experiencing any signs and symptoms

44

What is a desensitising pulpotomy?

hyperalgesic pulp
poor compliance

45

What is the rationale behind a desensitising pulpotomy?

Reduce pulpal inflammation symptoms to facilitate pulp therapy later on

46

How do you perform a desensitising pulpotomy?

ledermix and GIC temp

47

How do you perform a pulpectomy? When is it indicated?

extirpate the soft tissue contents from the coronal pulp chamber and root canal

indicated when there is evidence of irreversible pulpitis or necrosis
hyperaemic pulp

48

What material is placed in the root canals following pulpectomy?

resorbable dressing

Pure ZOE
Iodoform
CaOH
Ledermix

49

What is the success rate for pulpectomy?

86% at 36months

Casas et al 2004

50

What is a potential complication following pulpectomy?

Savage et al 1986

well recognised complication is that a radicular cyst can develop therfore need radiographic monitoring

51

What is the success rate for an indirect pulp cap?

CaOH 94% Al Zayer at al 2003

52

How far from the radiographic apex do you instrument in a pulpectomy?

2mm

Welbury 2012

53

What is the evidence behind the toxicity of formocreosol? paper?

IACR (international agency for cancer reserach) 2004 showed a causal relationship between creosol and nasophryngel cancer

generally accepted that formaldehyde is toxic at the site of contact

54

What are the two options for performing a pulpectomy?

Carrotte and waterhouse 2008

one stage: if the root canals are irreversibly inflamed but no evidence of peri-radicular inflammation then one stage
two stage: if the root canals are necrotic and evidence of peri-radicular root resorption, then need to do a two stage