OSS Pulpotomy

The Task:

Treating a ‘symptomatic’ URD in a 6-year-old and an ‘asymptomatic’ carious ULE

URD: Pulpotomy and conventional preformed metal crown (PMC)

Pulpotomy for primary molar (vital pulp therapy) indications:

• Pulpitis with symptoms (vital pulp_ - no radicular or intra-radicular pathology

• Primary molar with an advanced carious lesion with no clear band of dentine visible radiographically that separates the lesion and the pulp)

Contra-indications:

• Close to exfoliation

• Un-restorable

• Pre-cooperative

• Immunocompromised

• Multiple pulp therapies

ULE: preformed metal crown (PMC)

Hall crown for primary molar indication: asymptomatic, carious lesion with a sound band of dentine between radiolucency and pulp, enough structure to retain the crown.

Contra-indications: close to exfoliation/mobile, unrestorable, pre-cooperative, endocarditis, symptomatic

Task:

URD: Prepare a large access occlusal cavity using a high-speed ensuring the entire roof of the chamber is cleared. Simulate removing the contents of the pulp chamber using an excavator. Apply saline (water in sim1) to a ‘sterile’ cotton wool pellet and apply gentle pressure into pulp stumps for 3-5mins, leave the cotton wool roll in situ (do not use compressed air due to the risk of surgical emphysema) - Get the tutor to check

Dry with a clean cotton pellet. Place zinc oxide-eugenol cement on the floor of the pulp chamber, then fill the cavity with zinc oxide-eugenol - Get the tutor to check

Carry out conventional preformed metal crown prep: occlusal reduction to allow a straight probe to be passed across the tooth, then place a wedge interproximal, and reduce interproximal sites - Get the tutor to check

Size and place the PMC on the URD with airway protections (do not cement)

Size and place the PMC with hall technique on the ULE with airway protections (do not cement) - Get the tutor to check

Clear away following OSS Standards and checklist

SIgn out with LiftUpp feedback.