PDENT800: Pulp Therapy I

The primary goal of pulp therapy is to maintain the ___ and ___ of the teeth and the supporting tissues while maintaining the vitality of the pulp of a tooth affected by caries, traumatic injury, or other causes.

integrity

health

Using ___ is the gold standard for pulp treatment?

rubber dam

Normal Pulp

symptom free and normally responsive

Reversible Pulpitis

pulp is capable of healing

Irreversible Pulpitis

symptomatic or asymptomatic (vital inflamed pulp is INCAPABLE of healing)

T/F: Primary teeth are GREAT at pulp testing with Endo Ice and EAL

FALSE

T/F: Immature teeth are consistent with pulp testing

FALSE

What is the most reliable pulp test for children?

Percussion (if child can differentiate)

History of Pain

duration

frequency

stimulated/unstimulated

T/F: Child are great historians at telling us clinical history

FALSE

The Best Diagnostic tool is ____

history

Always do clinical tests on the ___ side of the tooth in question for children

opposite

Infection spreads faster in children due to ___ bone

thin

Tooth Mobility can be indicative of .....

root resorption

bifurcation pathology

T/F: Radiographs are not necessary in clinical diagnosis

FALSE

Characteristics of Irreversible Pulpitis

Spontaneous

Prolonged

Nocturnal

Therapies of Irreversible Pulpitis

Extraction

Non-Vital Pulp Therapy

Characteristics of Reversible Pulpitis

Thermal

Chemical

Intermittent

Therapies of Reversible Pulpitis

Vital Pulp Therapy

T/F: Direct Pulp Caps are recommended in primary teeth

FALSE

T/F: VPT is good if there is percussion sensitivity

FALSE

What is the purpose of liners?

preserve pulpal vitality

promote pulpal healing

promote tertiary dentin formation

Indications of Protective Base (Liner)

Normal Pulp

Exposed Dentin Tubules

All Caries removed

minimize injury to the pulp

Liner Materials

CaOH

RMGI

Calcium Silicate

MTA

Indirect Pulp Treatment is when there is ___ removal of carious dentin in order to avoid a pulp exposure

incomplete

When do we do an Indirect Pulp Treatment?

reversible pulpitis

no signs of pulpal degeneration

GOAL of Indirect Pulp Treatment

promote pulp healing

tertiary dentin formation

T/F: Do VPT in the presence of mobility, parulis, thickened PDL, bone loss, etc.

FALSE

In an Indirect Pulp Treatment, completely remove the caries at the level of ____

DEJ

What bur do you use for an Indirect Pulp Treatment?

slow speed round bur #4 or 6

Which caries have high bacterial load?

soft, leathery caries

What is normally the final restoration for Indirect Pulp Treatment?

SSC

Why are Direct Pulp Caps not recommended for primary teeth?

high rate of inflammatory resorption

T/F: Use RMGI on the pulp

FALSE

***inflammation

Pulpotomy medicants

MTA

Formocresol

T/F: You want to remove ALL the caries before opening the pulp chamber

TRUE

T/F: Remove the pulp chamber with a slow-speed bur

FALSE

high-speed

Which wall should be removed first for the pulp tissue?

lateral

Which wall is last for pulptomy?

Pulpal Floor

T/F: You want a small access to the pulp chamber

FALSE

WIDE ACCESS*****

Maxillary Primary Molar Access is wider ___

B-L

For pulp chamber access, start at the level of exposure and go ____

around

Light Red Pulp

easily arrested

less inflammation

Deep Red

profuse hemorrhage

Increased inflammation

What do you do if you have uncontrolled hemostasis?

pulpectomy

EXT

Why do we not use CaOH for pulpotomy?

internal root resorption of teeth

Evaluate pulpotomy every ___ months

6 months