Flashcards in Pulp therapy Deck (16)
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1
Aims and indications fo pulp therapy?
Maintain a disease free primary tooth until exfoliation
Maintain intact arch
Avoid physiological and psychological trauma of extraction
If extraction Control-indicated
No permanent successor tooth
Space maintenance
Cooperative child/carer
2
Contra-indications of pulp therapy
uncooperative
Child at risk f infection
Neglected dentition
Severe acute infection
Unrestorable crown
Root caries
>2/3 root resorption (near to exfoliation)
3
3 approaches to pulpotomy
Preserving radical pulp in a healthy state
Rendering radical pulp inert
Encouraging tissue regeneration and healing of radicular pulp at site of amputation
4
Describe the ideal pulp therapy
Doesn't harm pulp or surrounding tissue
No interference with physiological root resporption
Promtote healing of radicular pulp
5
Aetiology of pulp disease
Microbial infection - more rapid progression in primary
Marginal ridge collapse
6
How can pulp therapy be characterised?
Vital vs non vital pulp
Non-vital pulp = pulpectomy only
Vital = indirect pulp therapy
pulpotomy
Desensiting pulpotomy
Pulpecotmy
7
When is indirect pulp therapy used?
Deep dentinal caries, no symptoms/nocturnal pain (no irreversible inflammation), no pulp exposure, walls clean but stained cavity floor (if removed would expose pulp)
8
What is pulpotomy?
Removing irreversibly inflamed pulp and leaving normal/reversible inflammation
9
How do you know if the pulp is irreversibly inflamed?
Lots of bleeding that doesn't stop in normal time after ferric sulphate adminsteraion
10
Management if arrested bleeding in pulpotomy
Ferric sulphate for 15 seconds
11
Management of copious bleeding in pulp?
2 applications fo ferric sulphate or pulpectomy
12
Describe ferric sulphate pulpotomy?
Prepare cavity and remove caries into pulp
Apply ferric sulphate 15% for 15% to stop bleeding
GIc and pre-formed metal crown
13
When to use desisting pulp therapy?
When no LA or LA not working
14
Describe desensitising pulp therapy
expose pulp until sensitive = dress with ledermix
second visit = ferric sulphate pulpotomy
15
When is non-vital pulp therapy used?
Pulp is necrotic = no blood
or irrveeribsle pulpitis - lots of blood, not stopping
16