PDO 315 Pulp Therapy

What is the purpose of pulp therapy in primary teeth?

What is the purpose of pulp therapy in primary teeth?

To eliminate pain and infection, maintain integrity and health of teeth, and preserve tooth form and function.

What are common indications for performing a pulpotomy?

Caries removal resulting in pulp exposure in a tooth with normal or reversible pulpitis.

What is the key difference between reversible pulpitis and irreversible pulpitis?

Reversible pulpitis is characterized by inflamed pulp capable of healing, while irreversible pulpitis involves inflamed pulp that cannot heal.

What is the role of MTA in pulp therapy?

MTA is a biocompatible material used in various pulpal therapies including pulp capping and pulpotomy for its ability to induce dentin bridging.

What is the primary treatment for a diagnosis of necrotic pulp in primary teeth?

Non-vital pulp therapy, typically through pulpectomy.

How is irreversible pulpitis typically diagnosed?

Through clinical and radiographic examination revealing signs like spontaneous pain and non-responsive to analgesics.

What is a common medicament used in pulpotomy?

MTA or formocresol are recommended as medicaments of choice.

What are potential signs of necrotic pulp observed during diagnosis?

Sinus tract, excessive mobility, and radiolucency on a radiograph.

What is the effect of Calcium Hydroxide in pulp therapy?

It acts as a mineralizing/bacteriostatic agent but can cause superficial necrosis when in contact with vital pulp.

When is indirect pulp treatment indicated?

For deep carious lesions approximating the pulp without pulpitis.

What is the Wong-Baker pain scale used for?

To help patients describe their pain intensity.

What does a protective liner do in vital pulp therapy?

It serves as a barrier to protect the pulp while promoting healing and minimizing postoperative sensitivity.

When should pulp therapy be done in primary teeth?

When diagnosed as healthy, reversible, or irreversible pulp requiring treatment.

What materials are typically used in indirect pulp treatment?

Biocompatible materials such as resin-modified glass ionomer or calcium hydroxide.

What indicates a need for extraction rather than pulp therapy?

When the infectious process can't be arrested or when there's excessive pathologic root resorption.

What is the significance of apical physiologic resorption in primary teeth?

It is a normal process where the roots of primary teeth resorb as the permanent teeth develop.

What are the two main types of non-vital pulp therapy mentioned?

Pulpectomy and lesion sterilization/tissue repair (LSTR).

What is the main goal of apexogenesis in immature permanent teeth?

To promote continued root development and formation of the apex.

What is one major contraindication for the use of calcium hydroxide in pulpotomy?

Calcium hydroxide is NOT recommended for pulpotomy due to its unreliable outcomes.

What is typically the first step in pulpotomy procedures?

Establishing pulpal diagnosis.

Name one method for pain evaluation during pulp therapy.

Asking patients to describe the type of pain (sharp, dull, throbbing, etc.).

What does LSTR stand for, and when is it indicated?

Lesion Sterilization/Tissue Repair; indicated for primary teeth with irreversible pulpitis or necrosis when to be maintained less than twelve months.

What should be done if pulp bleeding persists after treatment?

Persistent bleeding may indicate hyperemia, necessitating non-vital pulp therapy or extraction.

What are the main steps in performing a pulpectomy?

Pulp access, complete pulpal debridement, irrigation with sodium hypochlorite, and filling with resorbable material.

In partial pulpotomy, what depth of inflamed pulp tissue is usually removed?

To a depth of 1-3mm or deeper to reach healthy pulp tissue.

What is the significance of thermal pain in diagnosing pulp conditions?

Thermal pain helps differentiate between types of pulpitis during clinical evaluation.

What are the two forms of treatment in non-vital pulp therapy?

Pulpectomy and apexification.

What should be monitored in pulp therapy patients after treatment?

Abnormal root resorption, abscess occurrence, and signs of early exfoliation or over retention.

What is the typical follow-up schedule for patients who underwent non-vital pulp treatments?

At least every 12 months considering clinical and radiographic evaluations.

What material is often used to fill the remaining canal space during apexification?

Gutta percha.

What are clinical tests used during pulpal diagnosis?

Palpation, percussion, mobility assessments, and pulp testing (though they may be unreliable in primary teeth).

What types of teeth may require vital pulp therapy?

Primarily primary teeth with healthy or reversible pulp conditions.

Despite its caustic nature, why is formocresol used?

It has fixative and bactericidal actions, although it does not promote healing.

For which dental condition is MTA preferred over calcium hydroxide?

For use in pulpotomy procedures due to superior outcomes.

What aspect of dental history is essential for pulpal diagnosis?

History of chief complaint relating to dental pain.

What is a major concern associated with the use of formocresol?

Potential toxicity and caustic effects on gingival tissues.

What role does restorative material play following vital pulp therapy?

To seal the tooth from microleakage and protect the pulp.

What outcomes signify success in a pulpotomy procedure?

Absence of sensitivity, pain, swelling, and no evidence of pathologic external root resorption.

Why are primary teeth important in a child's overall development?

They are crucial for maintaining the space for the permanent teeth and aiding proper dental arch development.

What does the term 'apical barrier' refer to in apexification?

The closure induced at the root end with a biocompatible agent (like MTA) to facilitate root end development.

What can cause pain that is not resolved by conventional analgesics in irreversible pulpitis?

Spontaneous or nocturnal pain which indicates more serious pulp condition.

What is the primary reason for performing a pulpotomy instead of extraction?

To maintain the tooth in the arch for continued development and to prevent mesial drift of permanent teeth.