Indications and Objectives of Pulpotomy
- Pulpotomy is indicated for primary teeth with pulp exposure during caries removal.
- It is also indicated for young permanent teeth with normal or reversible pulpitis or traumatic pulp exposure.
- The objectives of pulpotomy include removing infected/affected pulp, preserving pulp vitality, and maintaining tooth structure integrity.
- Radiographs are used to assess the tooth condition and determine if pulpotomy can be performed.
Types of Pulpotomy Techniques and Medicaments
- Pulpotomy techniques include devitalization, preservation, and regeneration.
- Devitalization involves fixing the radicular pulp using formocresol or electrosurgical pulpotomy.
- Preservation techniques use zinc oxide-eugenol, glutaraldehyde, or ferric sulfate.
- Regeneration techniques induce dentin regeneration using calcium hydroxide or other materials.
- Medicaments used in pulpotomy include formocresol, mineral trioxide aggregate, zinc oxide-eugenol, and calcium hydroxide.
- Ferric sulfate and sodium hypochlorite can be used to arrest pulpal bleeding.
Materials Used in Pulpotomy
- Mineral trioxide aggregate (MTA) is commonly used in pulpotomy procedures.
- Calcium hydroxide is used for pulpotomy in primary incisors.
- Ferric sulfate has shown positive results as a pulpotomy agent in primary teeth.
- Sodium hypochlorite and formocresol have been compared as pulpotomy medicaments.
- Eugenol and zinc oxide-eugenol have biologic properties relevant to pulpotomy.
Success Rates and Outcomes
- Vital pulp therapy techniques, including pulpotomy, have shown high success rates.
- Apexogenesis has been successful in preserving pulp vitality in young permanent teeth.
- Partial pulpotomy has shown positive outcomes in immature permanent teeth.
- MTA has demonstrated favorable outcomes in pulpotomy procedures.
- Ferric sulfate has shown promising results in pulpotomy of primary teeth.
Controversies, Challenges, and Case Studies
- Formocresol remains controversial for pulpotomy procedures due to formaldehyde toxicity concerns.
- Carbon dioxide laser and its effect on vital human primary pulp tissue have been evaluated.
- Pulpotomy in mature carious teeth with irreversible pulpitis is a topic of debate.
- The effectiveness of different pulpotomy agents in permanent molars with irreversible pulpitis has been assessed.
- Case studies and clinical reports have documented the use and effectiveness of various pulpotomy agents and techniques.
Note: The remaining content could not be summarised into 5 subtopics with 5 bullet list items each as there were not enough relevant points.
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