Pulpotomy is a minimally invasive procedure performed in children on a primary tooth with extensive caries but without evidence of root pathology.[1] The minimally invasive endodontic techniques of vital pulp therapy (VPT) are based on improved understanding of the capacity of pulp (nerve) tissues to heal and regenerate plus the availability of advanced endodontic materials. During caries removal, this results in a carious or mechanical pulp exposure (bleeding) from the cavity. During pulpotomy, the inflamed/diseased pulp tissue is removed from the coronal pulp chamber of the tooth leaving healthy pulp tissue which is dressed with a long-term clinically successful medicament that maintains the survival of the pulp and promotes repair.[2] There are various types of medicament placed above the vital pulp such as Buckley's Solution of formocresol, ferric sulfate, calcium hydroxide or mineral trioxide aggregate (MTA).[1] MTA is a more recent material used for pulpotomies with a high rate of success, better than formocresol or ferric sulfate. It is also recommended to be the preferred pulpotomy agent in the future.[3][4] After the coronal pulp chamber is filled, the tooth is restored with a filling material that seals the tooth from microleakage, such as a stainless steel crown which is the most effective long-term restoration. However, if there is sufficient remaining supporting tooth structure, other filling materials such as amalgam or composite resin can provide a functional alternative when the primary tooth has a life span of two years or less.[1] The medium- to long-term treatment outcomes of pulpotomy in symptomatic permanent teeth with caries, especially in young people, indicate that pulpotomy can be a potential alternative to root canal therapy (RCT).[5]
Diagram of pulpotomy
There is another term, which is also related to vital pulp therapy, which is apexogenesis.
Apexogenesis is a treatment in preserving vital pulp tissue in the apical part of a root canal to allow the completion in formation of the root apex. This clinical procedure is essentially a deep pulpotomy, aimed to preserve the pulp in immature teeth that have deep pulpal inflammation. Examples include teeth with carious exposures and trauma in which treatment of the exposed pulp is delayed and it becomes necessary to extend farther into the canal to reach healthy tissue.[6]
^Cushley, Siobhan; Duncan, Henry F.; Lappin, Mark J.; Tomson, Phillip L.; Lundy, Fionnuala T.; Cooper, Paul; Clarke, Mike; El Karim, Ikhlas A. (September 2019). "Pulpotomy for mature carious teeth with symptoms of irreversible pulpitis: A systematic review" (PDF). Journal of Dentistry. 88: 103158. doi:10.1016/j.jdent.2019.06.005. ISSN 1879-176X. PMID 31229496. S2CID 195326420.
^Ng, F. K.; Messer, L. B. (March 2008). "Mineral trioxide aggregate as a pulpotomy medicament: a narrative review". European Archives of Paediatric Dentistry. 9 (1): 4–11. doi:10.1007/bf03321589. ISSN 1818-6300. PMID 18328232. S2CID 9601597.
^Seale, N. Sue; Glickman, Gerald N. (May 2008). "Contemporary perspectives on vital pulp therapy: views from the endodontists and pediatric dentists". Pediatric Dentistry. 30 (3): 261–267. ISSN 0164-1263. PMID 18615993.
^Barngkgei, Imad Hassan; Halboub, Esam Saleh; Alboni, Roula Safouh (2013). "Pulpotomy of Symptomatic Permanent Teeth with Carious Exposure Using Mineral Trioxide Aggregate". Iranian Endodontic Journal. 8 (2): 65–68. ISSN 1735-7497. PMC 3662039. PMID 23717332.
^Cohen, Stephen (2011), "Introduction", Cohen's Pathways of the Pulp, Elsevier, pp. xvi, doi:10.1016/b978-0-323-06489-7.00037-0, ISBN 978-0-323-06489-7
Pulpotomy is a minimally invasive procedure performed in children on a primary tooth with extensive caries but without evidence of root pathology. The...
medicament. Pulpotomy is the most frequently used vital pulp therapy technique for deep dental caries in primary teeth. Medicaments used in pulpotomy include...
formalin, cresol and glycerine used in dentistry. It is used for vital pulpotomy of primary teeth and as a temporary intracanal medicament during root...
extraction of the tooth or removal of the pulp. Partial pulp amputation (pulpotomy) is the treatment of choice to preserve the pulp in teeth with open apical...
perforation Other non-surgical endodontic procedures include pulp capping, pulpotomy, apexification, and pulpal regeneration. Hemisection, where a root and...
root-end filling material and as pulp capping material. It has better pulpotomy outcomes than calcium hydroxide or formocresol, and may be the best known...
caries. Extract deciduous (baby) teeth under local anaesthetic, perform pulpotomy treatment on indicated deciduous teeth, take radiographs of the patient's...
dentin with microhybrid acid-etched flowable light-cured resin Perform pulpotomy with MTA using a modified Cvek technique For teeth with normal pulp and...
normal mobility, pulp sensitive to touch Pulp capping, partial pulpotomy or coronal pulpotomy if root of tooth still forming or root canal treatment. Review...
The types of endodontic therapy which may be undertaken are either a pulpotomy or a root canal treatment; other than restorability, the option chosen...
capping. More research will be needed to provide a comprehensive answer. Pulpotomy Stockton LW (1999). "Vital Pulp Capping: A Worthwhile Procedure (review)"...
In developing teeth, preserve pulp vitality by pulp capping or partial pulpotomy using calcium hydroxide In mature teeth, root canal treatment is usually...
indicated for permanent dentin substitute, direct and indirect pulp capping, pulpotomy, repair of furcation and root perforations, retrograde root-end filling...
unneeded dental procedures performed on children, including tooth removals, pulpotomies, and installing stainless steel crowns. The company was also accused...
performing unnecessary pulpotomies (colloquially "baby root canals"). In 2008 one patient who had received fourteen pulpotomies in one sitting sued the...
anesthesia, restore teeth, administer vital pulp treatments such as pulpotomies, extraction of deciduous (primary) teeth, provide sealants, scaling and...
050,000 and to not contest that their dentists performed unwarranted pulpotomies and placed stainless steel crowns. A Kentucky woman named Debbie Hagan...
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