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PEDIATRIC DENTISTRY

/PEDIATRIC DENTISTRY
PEDIATRIC DENTISTRY 2018-08-04T12:05:05+00:00

PEDIATRIC DENTISTRY

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PULPOTOMY

Pulpotomy is defined as completely removing the coronal(crown) portion of the dental pulp, and placing a suitable dressing or medicament that helps in healing and hence preserving the vitality of tooth in pediatric patients.

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INDICATIONS

  1. Vital tooth with healthy periodontium.
  2. Pain if present is either spontaneous or persistent.
  3.  The tooth that is restorable.
  4. At least 2/3rd of root length is present.
  5. Also, bleeding from the amputation side is pale red and easy to control.
  6. In the mixed dentition stage, the primary tooth is preferable to a space maintainer.
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CONTRAINDICATION

  1. First of all, Evidence of internal resorption.
  2. Presence of bone loss.
  3. Presence of abscess and fistula in relation to teeth.
  4. Radiographic evidence of calcific globules in the pulp chamber.
  5. Caries reaching to the floor of the pulp chamber.
  6. And the tooth close to natural fall.
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Procedure

  • Firstly, injecting local anaesthesia to numb the tooth.

  • The second step is removing the roof of the pulp chamber.

  • A sharp spoon excavator removes the coronal pulp.
  • Cleaning and removing the pulp completely.
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  • Irrigating the pulp chamber with a light flow of water
  • A moist cotton pellet is put inside the pulp chamber and allows to remain over the pulp chamber until a clot forms
  • Drying the pulp chamber.
  • Next, a cotton pellet moistened with a 1:5 concentration of Buckley’s formocresol is put in contact with pulp stump and allows to remain for 5 min.
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  • Removing the pellet and drying the pulp chamber with a new cotton pellet.
  • A thick paste consisting of zinc oxide eugenol is made and put over the pulp chamber.
  • A zinc polycarboxylate cement is finally put over the paste
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  • finally, tooth restoration is done with a stainless steel crown.
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PULPECTOMY

Pulpectomy involves removing the roof and contents of the pulp chamber in order to gain access to the root canals and then debriding, enlarging and disinfecting; and finally filling the canals with a restorative material.

INDICATIONS

  1. Strategically important tooth (e.g. in case of deciduous second molar where the permanent first molar has not come out).
  2. Irreversible pulpitis
  3.  Minimal periapical pathology with sufficient bone support.
  4. At least 2/3rd of root length is available.
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Procedure

Step 1: Injecting local anaesthesia and isolating the tooth using the rubber dam.

Step 2: Preparing Access cavity and exposing the coronal pulp.

Then extirpation of all the accessible pulp tissue (coronal as well as radicular).

Step 3: After extirpation of pulp tissue is complete irrigation of the pulp chamber and canals with saline and then a diagnostic radiograph is taken for the working length of file.

Step 4: Shaping and irrigating the canals, and then drying the canals with paper points.

Step 5: Obturating of the canals.

Step 6: Placing the final restoration.

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