a pulpotomy is the removal of a portion of the pulp , including the diseased aspect , with the intent of maintaining the vitality of the remaining pulpal tissue by means of a therapeutic dressing .

a healthy tooth has a space inside it called the " pulp space " which is filled with soft tissues - nerves , blood vessels , and pink connective tissue .

if a tooth gets a large cavity , the bacteria in the decay can damage the pulp , which is often what causes toothache .

damage to the pulp of permanent teeth usually requires a root canal treatment or endodontic therapy .

the pulp of primary or deciduous teeth , which only have to survive until an adult teeth come in , and because they have a better blood supply , can sometimes be saved .

pulpotomy

types of pulpotomies non - vital pulpotomy ( mortal pulpotomy ) electrosurgical pulpotomy laser pulpotomy preservation pulpotomy gluteraldehyde . ferric sulphate partial / cvek’s pulpotomy cervical –webbers pulpotomy regenerative pulpotomy
depending upon the size of exposure 1 . partial pulpotomy ( shallow , low level or cvek’s pulpotomy ) 2 . cervical pulpotomy ( deep , high level total or conventional pulpotomy ) classified depending upon the number of visits 1 . single visit pulpotomy 2 . multiple visit pulpotomy
1 . devitalization pulpotomy ( mummification , cauterization ) formocresol pulpotomy electrosurgical pulpotomy laser pulpotomy 2 . preservation ( minimum devitalization , non inductive ) gluteraldehyde ferric sulfate 3 . regeneration ( inductive & reperative ) calcium hydroxide bone morphogenic protein
in the study conducted by mack and dean , the success rate for electrosurgical pulpotomy was significantly higher than that for formocresol pulpotomy .
vital pulpotomy is a single - stage procedure defined as the surgical amputation of the coronal portion of exposed vital pulp . various pulpotomy - covering medications have been used in the pulpotomy of primary teeth .
this study was designed to compare the clinical and radiographic success of electrosurgical and formocresol pulpotomy techniques used on human primary molar teeth requiring vital pulpotomy .
a pulpotomy is the removal of the nerve inside the tooth . pulpotomy is indicated when tooth decay breaches the pulp of the primary tooth . traditional pulpotomy gets the job done , but there’s a smarter way to work .
ruemping dr , morton th jr , anderson mw . electrosurgical pulpotomy in primates–a comparison with formocresol pulpotomy . pediatr dent . 1983 ; 5 : 14–8 .
favourable clinical and radiographic success rates of ferric sulphate pulpotomy , comparable to formocresol were obtained . therefore , ferric sulphate can be recommended as a pulpotomy medicament .
calcium hydroxide became recognized as a valuable pulpotomy material after its use by miomir cvek for performing pulpotomy in 1978 . [ 1 ] calcium hydroxide has several disadvantages :
an adult tooth cannot be saved with a pulpotomy plus a filling / crown .
fs and es can be considered alternative materials for the pulpotomy of primary molars .
liu jf , chen lr , chao sy . laser pulpotomy of primary teeth .
ruemping dr , morton th jr , anderson mw . electrosurgical pulpotomy in primates : a comparison with formocresol pulpotomy . pediatr dentist 1983 ; 5 : 14 - 8 .
this study evaluated the clinical outcome of pulpotomy of primary teeth with three different methods .
sheller b , morton th jr . electrosurgical pulpotomy : a pilot study in humans .
our results showed the failure rates for electrosurgical pulpotomy to be equal to those for formocresol pulpotomy . although electrosurgical pulpotomy is a nonpharmacological technique giving favorable results , it is still a preservative technique . further studies using larger samples and longer evaluation periods are recommended .
pulpotomy can be classified according to treatment objectives ( don m . ranly 1994 ) .
concluded that it was premature to recommend pulpotomy using the electrosurgical approach . we do not believe this to be the best conclusion as their study was intended to compare two pulpal medications following electrosurgical pulpotomy , and not to compare the success rates for electrosurgical vs formocresol pulpotomy .
our findings also support the hypothesis that the success rate for electrosurgical pulpotomy is comparable to that for formocresol pulpotomy . although electrosurgical pulpotomy is a nonpharmacological and easy technique with favorable results , it is still a preservative technique and the cost of electrosurgical equipment is a drawback .
] . we report a case of complicated crown fracture who was treated with partial pulpotomy .
mejàre i , cvek m . partial pulpotomy in young permanent teeth with deep carious lesions .
the tooth is immature and root formation is incomplete . the partial pulpotomy can offer a superb
the results of our study indicate that the fs and electrosurgical pulpotomy appears comparable to the fc pulpotomy for human primary molars . further studies are needed to evaluate the histological effect of these methods as well as compare these methods to pulpotomy with new bioregenerative materials . moreover , other factors that affect the success of the pulpotomy such as coronal seal need to be analyzed .
] . in endodontic terms ( american association of endodontists ) , partial pulpotomy ( shallow pulpotomy ; cvek pulpotomy ) can be defined as “the surgical removal of a small portion of the coronal portion of a vital pulp as a means of preserving the remaining coronal and radicular pulp tissues” .
el - melgy et al , compared pulpal and periapical tissue reactions to electrosurgery vs formocresol pulpotomy in the primary teeth of dogs . they found that the teeth treated by electrosurgery pulpotomy with either mechanical or electrosurgical coronal pulp removal exhibited less histopathological reactions than the teeth treated by formocresol pulpotomy .
1904 – buckley : introduced formocresol for pulpotomy . 1930 – hermann : introduced calcium hydroxide as calxyl for pulpotomy . 1975 – s’gravemade : used gluteraldehyde which replaced formocresol . 1983 – reumping et al : demonstrated the use of electrosurgery for pulpotomy . 1985 – shoji : used carbon dioxide laser in pulpotomy . 1991 – nakashima used bone morphogenic protein . 1993 – torabinejad : mta was used
fong cd , davis mj . partial pulpotomy for immature permanent teeth , its present and future .
frequently , pulpotomy procedure is suggested therapy of primary teeth with deep cavities impacting pulp above the tooth roots . pulpotomy procedure is an typical procedure in kids and carries a fairly sound medical diagnosis .
the purpose of this clinical trial was to compare the clinical and radiographic success of fc , fs and electrosurgical pulpotomy used for pulpotomy of human primary molar teeth requiring vital pulp therapy secondary to carious involvement .
successful outcomes have been demonstrated for ch partial pulpotomy in curiously exposed young permanent teeth . dentin bridging and pulp health were more predictable with mta pulpotomy ( 18 , 27 ) . however , there are as yet the only two following studies evaluated the outcome of mta pulpotomy in symptomatic mature permanent teeth with carious exposure .
calcium - enriched mixture cement and mta showed similar performance in pulpotomy of immature caries - exposed permanent molars .
evidence of pulpotomy in primary teeth comparing mta , calcium hydroxide , ferric sulphate , and electrosurgery with formocresol .
to examine the success of the one - appointment pulpotomy technique with three different medicaments on primary molar teeth .
, the tooth is prepared for stainless steel crown full coverage and wide access is made for the pulpotomy procedure .
u . zilberman , e . mass , and h . sarnat , “partial pulpotomy in carious permanent molars , ”
hydrophilic nature and requires moisture to cure , making it a suitable material for procedures like pulpotomy . [ 10 ]
asgary s . calcium - enriched mixture pulpotomy of a human permanent molar with irreversible pulpitis and condensing apical periodontitis .
king sr , mcwhorter ag , seale ns . concentration of formocresol used by pediatric dentists in primary tooth pulpotomy .
dean and colleagues did not find any significant difference between the success rates for the electrosurgical and formocresol pulpotomy techniques .
the results of this investigation show that the treatment success rate with cem cement was similar to the electrosurgical pulpotomy .
a study published in the journal of endodontics revealed that the success rate of laser pulpotomy was significantly higher than that of formocresol pulpotomy , and the permanent successors of the laser - treated primary teeth erupted without any complications . yay !
cvek m . a clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fracture .
the following case reports describe the technique of biodentine pulpotomy in mature permanent teeth following several days of traumatic pulpal exposure .
cvek m . a clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fractures .
dean ja , mack rb , fulkerson bt , sanders bj . comparison of electrosurgical and formocresol pulpotomy procedures in children .
yakuschji m . pulpotomy of primary teeth by means of electrosurgery . shoni shikagaku zasshi . 1975 ; 13 : 213–9 .
e . mass and u . zilberman , “clinical and radiographic evaluation of partial pulpotomy in carious exposure of permanent molars , ”
in this article we report two cases of traumatized maxillary permanent central incisors , which were treated with mta following partial pulpotomy .
just came across this term , and it seems as if a pulpotomy is part of rct , yet i see it described as an additional option . can a tooth be saved with a pulpotomy and a filling / crown ? advantages ? disadvantages ?
fei al , udin rd , johnson r . a clinical study of ferric sulfate as a pulpotomy agent in primary teeth .
the europeans were the first to introduce pulpotomy procedure . 1885 – leptowski : introduced formalin as fixative and mummifying agent . 1886 – gold foil was used to cover the exposed vital pulp . 1898 – gysi : introduced paraformaldehyde as a pulpotomy medicament .
pulpotomy in caries - exposed immature permanent molars using calcium - enriched mixture cement or mineral trioxide aggregate : a randomized clinical trial .
evidence of pulpotomy in primary teeth comparing mta , calcium hydroxide , ferric sulphate , and electrosurgery with formocresol . - pubmed - ncbi
redig df . a comparison and evaluation of two formocresol pulpotomy technics utilizing “buckley’s “formocresol . j dent child 1968 ; 35 : 22–29 .
c . d . fong and m . j . davis , “partial pulpotomy for immature permanent teeth , its present and fixture , ”
eghbal mj , asgary s , baglue ra , parirokh m , ghoddusi j . mta pulpotomy of human permanent molars with irreversible pulpitis .
barrieshi - nusair km , qudeimat ma . a prospective clinical study of mineral trioxide aggregate for partial pulpotomy in cariously exposed permanent teeth .
ibricevic h , al - jame q . ferric sulphate and formocresol in pulpotomy of primary molars : long term follow - up study .
mack rb , dean ja . electrosurgical pulpotomy : a retrospective human study . asdc j dent child . 1993 ; 60 : 107–14 .
formocresol was first used for pulpotomy by sweet ( 1904 ) and since then , it has been the drug of choice in pulpotomy of primary teeth due to the ease of use and high clinical success rate . nevertheless , formocresol is under close observation due to safety considerations .
mejare i . pulpotomy of primary molars with coronal or total pulpitis using formocresol technique . scand j dent res 1979 ; 87 : 208–216 .
to evaluate the clinical and radiographic outcomes of pulpotomy treatment with mineral trioxide aggregate ( mta ) in symptomatic mature permanent teeth with carious exposure .
malhotra r , singh s , grover npartial pulpotomy for complicated crown fractures in immature permanent teeth . jcr 2013 ; 3 : 419 - 423
subay rk , ilhan b , ulukapi h . mineral trioxide aggregate as a pulpotomy agent in immature teeth : long - term case report .
mack rb , dean ja . electrosurgical pulpotomy : a retrospective human study . asdc j dentist child 1993 ; 60 : 107 - 14 .
sheller b , morton th jr . electrosurgical pulpotomy : a pilot study in humans . j endodont 1987 ; 13 : 69 - 76 .
pulpotomy is defined as the surgical removal of infected coronal pulp and its objectives are preservation of the radicular pulp vitality and relief of pain .
fuks ab , bimstein e . clinical evaluation of diluted formocresol pulpotomy in primary teeth of school children . pediatr dent 1981 ; 3 : 321–324 .
qudeimat ma , barrieshi - nusair km , owais ai . calcium hydroxide vs mineral trioxide aggregates for partial pulpotomy of permanent molars with deep caries .
no study reached the high quality level . twelve were of moderate quality . the overall evidence was insufficient to assess which of indirect pulp capping , stepwise excavation , direct excavation and pulp capping / partial pulpotomy , pulpotomy or pulpectomy is the most effective treatment approach for teeth with deep caries .
holan g , eidelman e , fuks ab . lon - term evaluation of pulpotomy in primary molars using mineral trioxide aggregate and formocresol . pediatr dent 2005
markovic d , zibojinovic v , bucetic m . evaluation of three pulpotomy medicaments in primary teeth . eur j paediatr dent 2005 ; 6 : 133–138 .
saltzman b , sigal m , clokie c , rukavina j , et al . assessment of a novel alternative to conventional formocresol - zinc oxide eugenol pulpotomy for the treatment of pulpally involved human primary teeth : diode laser - mineral trioxide aggregate pulpotomy . int j paediatr dent 2005 ; 15 : 437–447 .
smith nl , seale ns , nunn me . ferric sulfate pulpotomy in primary molars : a retrospective study . pediatr dent 2000 ; 22 : 192–199 .
e . mass , u . zilberman , and a . b . fuks , “partial pulpotomy : another treatment option for cariously exposed permanent molars , ”
koch g , nyborg h . correlation between clinical and histological indications for pulpotomy of deciduous teeth . j int assoc dent child 1970 ; 1 : 3–10 .
ong cd , davis mj . partial pulpotomy for immature permanent teeth , its present and future . pediatr dent . 2002 ; 24 : 29 - 32 .
king sr , mcwhorter ag , seale ns . concentration of formocresol used by pediatrics in primary tooth pulpotomy . pediatr dent . 2002 ; 24 : 157–9 .
pulpotomy was performed for 102 primary second molars in 51 children aged between 4 and 6 years . considering a split - mouth design , for each patient the right and left second primary molars randomly underwent pulpotomy using cem cement or es / zoe . all teeth were restored using preformed metal crowns . following pulpotomy procedure , teeth were blindly evaluated for clinical and radiographic success after 6 , 12 and 24 months . mcnemar test and spss 16 software were used for the statistical analysis .
pulpotomy in caries - exposed immature permanent molars using calcium - enriched mixture cement or mineral trioxide aggregate : a randomized clinical tr . . . - pubmed - ncbi
bahrololoomi z , moeintaghavi a , emtiazi m , hosseini g . clinical and radiographic comparison of primary molars after formocresol and electrosurgical pulpotomy : a randomized clinical trial .
our findings were similar to those of dean et al , who demonstrated the clinical and radiographic success rates for electrosurgical pulpotomy to be comparable to those for formocresol pulpotomy . clinical and radiographic success rates were 96 and 84 % , respectively in the electrosurgical group , and 100 and 92 % , respectively in the formocresol group .
zinc oxide - eugenol ( zoe ) is used as a base in pulpotomized teeth . in a prospective human study of electrosurgical pulpotomy conducted by fishman and colleagues ,
just came across this term , and it seems as if a pulpotomy is part of rct , yet i see it described as an additional option . can a tooth be saved with a pulpotomy and a filling / crown ? advantages ? disadvantages ? pulpotomy = partial removal of the pulp . done in primary ( children ' s ) teeth . sometimes done as a seperate procedure to start rct in adult teeth . pulpectomy is complete removal of the pulp . both terms are used in conjunction with pediatric dentistry . an adult tooth cannot be saved with a pulpotomy plus a filling / crown . complete root canal therapy should be performed on all pathologically exposed teeth .
fei al , udin rd , johnson r . a clinical study of ferric sulfate as a pulpotomy agent in primary teeth . pediatr dent 1991 ; 13 : 327–332 .
gruythuysen rj , weerheijm kl . calcium hydroxide pulpotomy with a light - cured cavity - sealing material after two years . j dent child 1997 ; 64 : 251–253 .
thompson ks , seale ns , nunn me , huff g . alternative method of hemorrhage control in full strength formocresol pulpotomy . pediatr dent 2001 ; 23 : 217–222 .
dean ja , mack rb , fulkerson bt , sanders bj . comparison of electrosurgical and formocresol pulpotomy procedures in children . int j paediatr dent 2003 ; 12 : 177–182 .
i . v . nosrat and c . a . nosrat , “reparative hard tissue formation following calcium hydroxide application after partial pulpotomy in cariously exposed pulps of permanent teeth , ”
farooq ns , coll ja , kuwabara a , shelton p . success rates of formocresol pulpotomy and indirect pulp therapy in the treatment of deep dentinal caries in primary teeth .
aroglu si , sonmez h . long - term follow - up of a complicated crown fracture treated by partial pulpotomy . international endodontic journal . 2007 ; 40 : 398–403 .
abarajithan m , velmurugan n , kandaswamy d . management of recently traumatized maxillary central incisors by partial pulpotomy using mta : case reports with two - year follow - up .
this study did not show any significant difference between the clinical and / or radiographic success rates for electrosurgical vs formocresol pulpotomy . further studies with longer evaluation periods are warranted .
mesbahi m , ardakani z . clinical and radiographical evaluation of pulpotomy treatment for primary teeth with electrosurgery . j dent shiraz univ med sci . 2007 ; 8 : 96–104 .
pulpotomy is an accepted treatment for the management of cariously exposed pulps in symptom free primary molars . the purpose of this study was to compare the clinical and radiological outcomes of three different single - visit vital pulp therapies including pulpotomy with electrosurgery ( es ) , formocresol ( fc ) and ferric sulfate ( fs ) in cariously exposed primary molar teeth .
holan g , fuks ab , keltz n . success rate of formocresol pulpotomy in primary molars restored with stainless steel crowns vs amalgam . pediatr dent 2002 ; 24 : 212–216 .
+ 1 a 99 % pulpotomy success rate means 1 of 2 things . 1 ) you ' re doing pulpotomies on teeth that will naturally exfoliate within the next week or 2
shulman er , mciver ft , burkes ej jr . comparison of electrosurgery and formocresol as pulpotomy techniques in monkey primary teeth . pediatr dentist 1987 ; 9 : 189 - 94 .
dean ja , mack rb , fulkerson bt , sanders bj . comparison of electrosurgical and formocresol pulpotomy procedures in children . int j paediatr dent . 2002 ; 12 : 177–82 .
1 . pulpotomy < br / > by - < br / > dr . sumeet vincent tigga < br / > ( g . d . c raipur ) < br / >
ibrevic h , al - jame q . ferric sulfate as pulpotomy agent in primary teeth : twenty month clinical follow - up . j clin pediatr dent 2000 ; 24 : 269–272 .
naik s , hegde am . mineral trioxide aggregate as a pulpotomy agent in primary molars : an in vivo study . j indian soc pedod prev dent 2005 ; 23 : 13–16 .
shumayrikh nm , adenubi jo . clinical evaluation of glutaraldehyde with calcium hydroxide and glutaraldehyde with zinc oxide eugenol in pulpotomy of primary molars . endod dent traumatol 1999 ; 15 : 259–264 .
nunn jh , smeaton i , gilroy j . the development of formocresol as a medicament for primary molar pulpotomy procedures . asdc j dentist child 1996 ; 63 : 51 - 3 .
dean ja , mack rb , fulkerson bt , sanders bj . comparison of electrosurgical and formocresol pulpotomy procedures in children . int j pediatr dentist 2002 ; 12 : 177 - 82 .
to compare clinical and radiographic outcomes of pulpotomy treatment using calcium - enriched mixture ( cem ) cement and mineral trioxide aggregate ( mta ) in carious - exposed vital immature permanent first molars .
the aim of this study was to evaluate the scientific evidence of pulpotomy in primary teeth comparing mineral troxide aggregate ( mta ) , calcium hydroxide , ferric sulphate , and electrosurgery with formocresol .
casas mj , kenny dj , johnston dh , judd pl . long - term outcomes of primary molar ferric sulfate pulpotomy and root canal therapy . pediatr dent 2004 ; 26 : 44–48 .
holan g , e . eidelman e , fuks a . long - term evaluation of pulpotomy in primary molars using mineral trioxide aggregate or formocresol . pediatric dentistry 2005 ; 27 : 129–136 .
huth kc , paschos e , hajek - al - khatar n , hollweck r , crispin a , hickel r , folwaczny m . effectiveness of 4 pulpotomy techniques - randomized controlled trial .
success or failure of pulpotomy is dependent upon an accurate diagnosis at the time of treatment . it is worth noting that all teeth treated in this study were affected by caries . it is necessary for the radicular pulp to be healthy at the time of treatment for electrosurgical pulpotomy to achieve a successful outcome as electrosurgery cannot be expected to penetrate and sterilize the contaminated radicular tissue .
jabbarifar se , khademi aa , ghasemi d . success rate of formocresol pulpotomy versus mineral trioxide aggregate in human primary molar tooth . j res med sci . 2004 ; 6 : 304–7 .
molla asadollah f , vahid golpayegani m , alexanian s . histologic comparison of electrosurgery and formocresol pulpotomy technique in human primary teeth . beheshti univ dent j . 2000 ; 4 : 347–58 .
laser pulpotomy offers a more biologically acceptable and effective alternative to chemicals like formocresol . not only does laser treatment offer a non - pharmacologic hemostatic technique , it has a higher success rate .
joa & el : the calcium hydroxide partial pulpotomy developed and analyzed by the late dr . m . cvek has been the standard procedure for crown fractures with pulp exposures for decades . lately this status has been challenged by other techniques such as mta and other materials . this review article represents a very informative reference when future pulp capping or pulpotomy materials are challenged against calcium hydroxide .
farooq ns , coll ja , kuwabara a , shelton p . success rates of formocresol pulpotomy and indirect pulp treatmentof deep dentinal caries in primary teeth . pediatr dent 2000 ; 22 : 278–286 .
loh a , o’hoy p , tran x , et al . evidence - based assessment . evaluation of the formocresol versus ferric sulfate primary molar pulpotomy . pediatric dentistry 2004 ; 26 : 401–409 .
asgray found pulpotomy as a promising alternative endodontic treatment in mature permanent teeth using calcium - enriched mixture ( cem ) cement in treatment of a mature molar associated with irreversible pulpitis . [ 18 ]
the aim of this paper was to review the history and the scientific literature published on pulpotomy medicaments and to present the findings of these studies . the review showed that pulpotomy of primary teeth has been treated with many different techniques and medicaments , that some of these approaches are controversial and that their results have presented variables of success rates in term . . . [ show full abstract ]
nematollahi h , sahebnasagh m , parisay i . comparison of electrosurgical pulpotomy with zinc oxide eugenol or zinc polycarboxylate cements sub - base . j clin pediatr dent . 2011 ; 36 : 133–7 .
sonmez d , sari s , cetinbas t . a comparison of four pulpotomy techniques in primary molars : a long - term follow - up . j endod . 2008 ; 34 : 950–5 .
tabarci b , parirokh m , eghbal mj , et al . a comparative study of dental pulp response to different pulpotomy agent in dogs . int endod j . 2010 ; 43 : 565–71 .
9 . king sr , mcwhorter ag , seale ns . concentration of formocresol used by pediatric dentists in primary tooth pulpotomy . pediatr dent . 2002 ; 24 ( 2 ) : 157 - 159 .
kalaskar rr , damle sg . comparative evaluation of lyophilized freeze dried platelet derived preparation with calcium hydroxide as pulpotomy agents in primary molars . j indian soc pedod prev dent 2004 ; 22 : 24–29 .
myers dr , shoaf hk , dirksen tr , pashley dh , whitford gm , reynolds ke . distribution of 14c formaldehyde after pulpotomy with formocresol . j am dent assoc 1978 ; 96 : 805–813 .
all pulpotomy procedures were performed by the principal investigator or co - investigators of the study to ensure consistency in the two techniques . the experimental technique of the investigators was standardized by an experienced clinician .
ibricevic h , al - jame q . ferric sulphate and formocresol in pulpotomy of primary molars : long term follow - up study . eur j pediatr dentist 2003 ; 4 : 28 - 32 .
shaw dw , sheller b , barrus bd , morton th jr . electrosurgical pulpotomy : a 6 - month study in primates . j endod 1987 ; 13 : 500 - 5 . [ pubmed ]
nematollahi h , sahebnasagh m , parisay i . comparison of electrosurgical pulpotomy with zinc oxide eugenol or zinc polycarboxylate cements sub - base . j clin pediatr dent 2011 ; 36 : 133 - 7 .
in a group of images dr . sarkissian demonstrates how a pulpotomy is performed on a child ' s primary molar . ( warning : there is a bit of blood visible in those images . )
es as a non pharmacological pulpotomy technique that has been well - documented and has proven to have great merits [ 15 ] . es leads to good visualization and homeostasis and is less time consuming than the fc approach [ 16 ] . dean and colleagues did not find any significant difference between the success rates for the electrosurgical and fc pulpotomy techniques [ 3 ] . rivera et al . evaluated postoperative clinical and x - ray film findings from 80 molars after fc and es vital pulpotomy . they did not find any significant difference between the two techniques after six - months follow up [ 17 ] .
a pulpotomy is performed only when the inflamed pulp is confined to the crown . the tooth also has to be restorable . if it’s too damaged or weak , the dentist will have to extract it .
casas mj , layung ma , kenny dj , johnston dh , judd pl . two - year outcomes of primary molar ferric sulfate pulpotomy and root canal therapy . pediatr dent 2003 ; 25 : 97–102 .
casas m j , kenny dj , johnston dh , judd pl et al . outcomes of vital primary incisor ferric sulfate pulpotomy and root canal therapy . j can dent assoc 2004 ; 70 : 34–38 .
huth kc , paschos e , hajek - al - khatar n , hollweck r , et al . effectiveness of 4 pulpotomy techniques - randomized controlled trial . j dent res 2005 ; 84 : 1144–1148 .
sasaki h , ogawa t , koreeda m , ozaki t , et al . electrocoagulation extends the indication of calcium hydroxide pulpotomy in the primary dentition . j clin pediatr dent 2002 ; 26 : 275–277 .
this procedure is known widely as the cvek pulpotomy , deriving its name from dr . miomir cvek , who in 1978 reported a high success rate for partial pulpotomies following complicated crown fractures in permanent incisors [
upon enrollment , the children ' s parents signed letters of informed consent . the patients had no contraindications to pulpotomy in their medical history and were willing to submit to periodic examinations of the pulpotomised teeth .
electrosurgical pulpotomy has gained popularity due to its nonpharmacological nature , ease of use , and favorable results . the results of our study are comparable to others reported in the literature comparing electrosurgical and formocresol pulpotomies .
33 . non - vital pulpotomy < br / > ideally , a non - vital tooth should b treated by pulpectomy or root canal filling < br / > however , pulpectomy of a primary molar may sometime be impracticable due to non - negotiable root canals and also due to limited patient co - operation . < br / > hence , a two - stage pulpotomy technique is advocated . < br / >
an older pediatric dentist taught me that formocresol was not needed in on a pulpotomy on a childs tooth . i have just put zoe in them for the past 7 years and have had only 1 fail .
fc was an extremely popular medicament for pulpotomy of primary teeth . vital pulpotomy teaching protocols’ in the uk and ireland indicate that fc is becoming less popular [ 2 ] . concerns about fc safety have been published in dental and medical literature for the past 30 years and have led clinicians to use alternative methods that have more tissue compatibility [ 1 ] [ 2 ] [ 10 ] [ 11 ] [ 12 ] .
success or failure of pulpotomy treatment depends upon an accurate diagnosis . however , fc has proven to be a more forgivable technique that helps to retain primary teeth even with chronic , silent inflammation . on the other hand , pulpotomy with es appears to require more sensitive diagnosis . however , electrosurgical procedure has two distinct advantages : it is a swifter and drug free procedure with no known undesirable systemic effects [ 16 ] .
peng l , ye l , guo x , tan h , zhou x , wang c , li r . evaluation of formocresol versus ferric sulphate primary molar pulpotomy : a systematic review and meta - analysis .
success or failure of pulpotomy treatment is dependent upon an accurate diagnosis at the time of treatment . formocresol has proven to be a forgiving technique where teeth are maintained in the arch with chronic , silent inflammation .
nematollahi h , tajik a . comparison of clinical and radiographic success rates of pulpotomy in primary molars using formocresol , ferric sulfate and mineral trioxide aggregate ( mta ) . jdt . 2006 ; 3 : 6–14 .
shabzendedar m , mazhari f , alami m , talebi m . sodium hypochlorite vs formocresol as pulpotomy medicaments in primary molars : 1 - year follow - up . pediatr dent . 2013 ; 35 : 329–32 .
the best candidate for a pulpotomy will be a child in good overall health . children with chronic health conditions that increase their susceptibility to bacterial infections are not good candidates . examples include children with leukemia or tumors .
if the decay or trauma is confined to the crown of the tooth , a pulpotomy may be recommended . when a cavity gets really deep , close to the pulp of a tooth , or even into the pulp , the pulpal tissue becomes irritated and inflamed . a pulpotomy is when the inflamed pulp chamber , usually on a baby molar , is removed . the dentist will remove all the infected material in the pulp of the crown only , leaving the living tooth root intact . after a pulpotomy on a baby molar , the empty space will be filled with dental cement and a stainless steel crown will be placed to restore the tooth .
16 . doyle tl , casas mj , kenny dj , judd pl . mineral trioxide aggregate produces superior outcomes in vital primary molar pulpotomy . pediatr dent . 2010 ; 32 ( 1 ) : 41 - 47 .
farooq ns , coll ja , kuwabara a , shelton p . success rates of formocresol pulpotomy and indirect pulp capping in the treatment of deep dentinal caries in primary teeth . padiatr dent 2000 ; 22 : 278–286 .
the study was conducted on 104 primary molars in 104 children with an indication for pulpotomy treatment on at least one primary molar . primary teeth were treated with either formocresol ( fc ) ( 34 teeth ) , calcium hydroxide ( ca ) ( 33 teeth ) or ferric sulphate ( fs ) ( 37 teeth ) using standardised criteria for the pulpotomy procedures . teeth were clinically and radiographically evaluated during the examination period of 18 months .
myers dr , shoaf hk , dirksen tr , pashley dh , whitford gm , reynolds ke . distribution of 14c - formaldehyde after pulpotomy with formocresol . j am dent assoc 1978 ; 86 : 805 - 13 .
malekafzali b , shekarchi f , asgary s . treatment outcomes of pulpotomy in primary molars using two endodontic biomaterials . a 2 - year randomised clinical trial . eur j paediatr dent . 2011 ; 12 : 189–93 .
25 . partial pulpotomy < br / > the partial pulpotomy for traumatic exposures is a procedure in which the inflamed pulp tissue beneath an exposure is removed to a depth of 1 - 3 mm to reach the deeper healthy tissue < br / > - indicated for a vital , traumatically exposed , young permanent tooth , especially one with an incompletely formed apex . < br / > - calcium hydroxide or mta is used < br / >
15 . ansari g , ranjpour m . mineral trioxide aggregate and formocresol pulpotomy of primary teeth : a 2 - year follow - up . int endod j . 2010 ; 43 ( 5 ) : 413 - 418 .
24 . holan g , fuks ab , keltz n , success rate of formocresol pulpotomy in primary molars restored with stainless steel crown vs amalgam . pediatr dent . 2002 ; 24 ( 3 ) : 212 - 216 .
pulpotomy using mta could be a good alternative for root canal therapy ( rct ) for managing symptomatic mature permanent teeth with carious exposure , however further large - scale multicenter clinical trials are highly encouraged to confirm this hypothesis .
malhotra r , singh s , grover npartial pulpotomy for complicated crown fractures in immature permanent teeth . jcr [ serial online ] 2013 [ cited 2018 jul 10 ] ; 3 : 419 - 423 . available from : urltoken
if the tooth is necrotic , pulpotomy will not relieve patient ' s symptoms . you need to do a pulpectomy and debride canals as best as you can and then place caoh2 in canals until you can finish rct .
bahrololoomi z , moeintaghavi a , emtiazi m , hosseini g . clinical and radiographic comparison of primary molars after formocresol and electrosurgical pulpotomy : a randomized clinical trial . indian j dent res . 2008 ; 19 : 219–23 .
a pulpotomy is a procedure used to try to save a badly decayed tooth with an infected pulp . it is sometimes called a “baby root canal , ” for it is more commonly performed on baby teeth , especially molars .
) . the patients were informed regarding the pulpotomy treatment using mta in case the pulp exposure happened . the department board adopted this procedure as an alternative to the rct in such cases . each patient signed an informed consent .
background : vital pulpotomy is a single - stage procedure defined as the surgical amputation of the coronal portion of exposed vital pulp , usually as a means of preserving the vitality and function of the remaining radicular portion . objectives :
rivera et al , evaluated postoperative clinical and x - ray findings from 80 primary molars after formocresol and electrosurgery vital pulpotomy . they did not find any significant difference between the two techniques after six months of follow - up .
in traumatized , young , permanent teeth , pulpotomy is classically undertaken to promote apexogenesis . the objective is to promote root development and apical closure . once root end development and apical closure is achieved , the root canal treatment is completed . however , it has been suggested that mere pulp exposure does not cause pulpitis in the absence of bacteria . recent studies have proposed that as long as a good seal is ensured , root canal treatment may not be necessary following pulpotomy . in this article we report two cases of traumatized , fully matured , maxillary permanent central incisors , which have been treated with mineral trioxide aggregate following partial pulpotomy , with a two - year follow - up .
19 . sakai v , moretti a , oliviera t , et al . pulpotomy of human primary molars with mta and portland cement : a randomised controlled trial . br dent j . 2009 ; 207 ( 3 ) : e5 .
please cite this paper as : barngkgei im , halboub es , alboni rs . pulpotomy of symptomatic permanent teeth with carious exposure using mineral trioxide aggregate . iran endod j . 2013 ; 8 ( 2 ) : 65 - 8 .
i gotta call bs on this one . i do p / ssc every day . pulpotomies in primary teeth have a success rate in the 80 ' s . whether you are using formo or ferric sulfate or simple pressure pulpotomy ,
during a consultation with our specialist at ashburn children’s dentistry , you can learn more about pediatric dentistry and some of the signs that your child may require a pulpotomy . your child may need professional help if he or she experiences :
in conclusion , pulpotomy using mta could be a good alternative for rct for managing symptomatic mature permanent teeth with carious exposure . since samples treated in this study were limited in number , large - scale multicenter clinical trials are highly encouraged .
vizero nda r , bresciani e , francischone ce , franco eb , pereira jc . partial pulpotomy and tooth reconstruction of a crown - fractured permanent incisor : a case report . quintessence int . 2003 ; 34 : 740 - 747 .
any contraindication to formocresol pulpotomy in adult teeth ? not young permanent teeth , i ' m talking mature adult teeth ? anyone know what ' s the standard of care , formo vs . partial pulpectomy ? just a question , thanks .
7 . hunter ml , hunter b . vital pulpotomy in the primary dentition : attitudes and practices of specialists in paediatric dentistry practising in the united kingdom . int j paediatr dent . 2003 ; 13 ( 4 ) : 246 - 250 .
in our present case , we performed partial pulpotomy procedure as it was quick and easy to perform . it allowed the tooth to maintain its vitality and continue its root development . we also found that partial pulpotomy was a better choice when compared with cervical pulpotomy because the cell - rich coronal pulp tissue is preserved which provides a better healing potential ; physiologic apposition of dentin in the cervical area is maintained ; there is no need for subsequent endodontic treatment ; the natural color and translucency of the tooth is preserved ; it is possible to perform pulp sensitivity tests ; the pulp is not deprived of continued physiologic dentin production in the crown and at the cervical area of the tooth ; and it is a relatively simple procedure .
seriously thought , i had a discussion about this topic with the endodontist attending in my aegd residency . he agrees with its use for a sedative pulpotomy on permanent teeth with an acute irreversible pulpitis (
hot tooth
) as discussed above . realize however that a sedative pulpomy is different than a therapeutic pulpotomy that you would do on a primary tooth . it is should be followed by an rct asap . it is only intended to temporarily get the patient out of pain .
el - meligy o , abdalla m , el - baraway s , el - tekya m , dean ja . histological evaluation of electrosurgery and formocresol pulpotomy techniques in primary teeth in dogs . j clin pediatr dent . 2001 ; 26 : 81–5 .
pulpotomy is defined as the amputation of damaged and inflammed vital pulp from the coronal chamber followed by placement of a medicament over the radicular pulp stumps to stimulate repair , fixation or mummification of the remaining vital radicular pulp . – braham & morris 1985
in young permanent teeth , pulpotomy is classically undertaken to promote apexogenesis . the objective is to promote root development and apical closure . once root end development and apical closure are achieved , the root canal treatment is completed . [ 2 ] however , it has been proved that mere pulp exposure does not cause pulpitis in the absence of bacteria . [ 3 ] recent studies have proposed that as long as a hermetic seal is ensured , root canal treatment is not necessary following pulpotomy . [ 4 ]
17 . godhi b , sood pb , sharma a . effects of mineral trioxide aggregate and formocresol on vital pulp after pulpotomy of primary molars : an in vivo study . contemp clin dent . 2011 ; 2 ( 4 ) : 296 - 301 .
is it true you can use viscostat for pulpotomy on primary teeth instead of formocresol ? i have heard this from some practicing pediatric and general dentists - - i have not tried it myself since formocresol is the gold standard . what does everyone think ?
how to cite this article : bahrololoomi z , moeintaghavi a , emtiazi m , hosseini g . clinical and radiographic comparison of primary molars after formocresol and electrosurgical pulpotomy : a randomized clinical trial . indian j dent res 2008 ; 19 : 219 - 23
el - meligy o , abdalla m , el - baraway s , el - tekya m , dean ja . histological evaluation of electrosurgery and formocresol pulpotomy techniques in primary teeth in dogs . j clin pediatr dentist 2001 ; 26 : 81 - 5 .
preserving the dental pulp , or part of it , is important when treating a vital tooth with an exposed pulp , particularly if the tooth is immature and root formation is incomplete . the partial pulpotomy can offer a superb outcome for the treatment of complicated crown fractures of the young permanent tooth . the procedure is often used for traumatic injuries in children where the major aim of treatment is to preserve tooth vitality while providing a favorable environment for continued root development . in following article , a review of partial pulpotomy and management of case of a vital permanent maxillary incisor with complicated crown fracture and pulp exposure is discussed . this was treated by partial pulpotomy with calcium hydroxide and assessed clinically through pulpal sensitivity tests and radiographically for periapical healing and continued root end closure .
the overall success rate in groups 1 , 2 and 3 was 87 . 5 % , 82 . 1 % and 83 . 3 % , respectively . favorable clinical and radiological success rates of fs and es pulpotomy was observed which was comparable to fc .
despite the fact that your teeth have a tough external surfaces layer , there is a gentle interior space called the pulp . this space is positioned above the gumline , and contains the nerves and blood vessels that supply nutrients and additional assistance for the tooth . usually , a vital pulpotomy procedure is utilized to take away contaminated parts of the pulp in an effort to stop nerve and tooth root deterioration . a pulpotomy procedure is a dental treatment that takes out a part of the tooth pulp situated in the pulp cell .
the purpose of this prospective split - mouth , randomised clinical trial was to assess the clinical and radiographic success rate of pulpotomy in primary molars using calcium - enriched mixture ( cem ) cement or placement of zinc oxide eugenol after electrosurgery ( es / zoe ) .
in group 3 , three cases exhibited spontaneous pain and one case showed furcal radiolucency . clinical and radiographic success rate were 87 . 5 % and 95 . 8 % , respectively ; concurring with other studies [ 3 ] [ 16 ] . our findings were similar to those of dean et al . that demonstrated the clinical and radiographic success rates for electrosurgical pulpotomy to be comparable to those of fc pulpotomy [ 3 ] . however , they differed from another study ; this could be attributed to the differences in the applied techniques [ 22 ] .
sarraf shirazi a , rezaifar m , talebi m , mortazavi a , safari malekabadi k . application of bonding system as a sub - base material following electrosurgical pulpotomy treatment in primary teeth : a novel technique . iran j med hypotheses ideas . 2009 ; 3 : 1–6 .
conventionally , few - days - old pulp exposures have been treated with root canal treatment . we report four cases of traumatized , fully matured , maxillary permanent central incisors , which have been treated by biodentine pulpotomy several days after traumatic pulp exposure . biodentine pulpotomy consisted of pulp tissue removal to a depth of 2 mm , then capping the pulpal wound with biodentine , followed by immediate restoration . the teeth were assessed clinically through pulpal sensitivity tests and radiographically for periapical healing . at each recall ( 24 hours , 1 week , 30 days , 3 , 6 , 12 , and 18 months ) , no spontaneous pain was observed ; the pulp showed signs of vitality and absence of periapical radiolucency after 18 months . biodentine pulpotomy is recommended as a treatment option for cases of vital pulp exposure in permanent incisors due to trauma .
sadly , in case the tooth root is just becoming contaminated , it might not be possible for you to discover during the procedure . when dealing with these situations , a tooth root canal might be needed down the road . however a pulpotomy procedure is usually carried out on milk teeth , it has purposes for elderly people also . when individuals demand a tooth root canal they usually are in a great deal of agony , and a pulpotomy procedure could possibly be a main action in the direction of carrying out a tooth root canal at the next point .
thus , considering the age of the patient , recently traumatized teeth with pulp exposure , if treated with partial pulpotomy within 24 – 48 hours after the injury , can act as a permanent restorative procedure , without the need for endodontic treatment , provided a bacteria - tight seal is obtained .
studies regarding the management of carious exposure in mature ( fully developed ) teeth are scare and conflicting . accordingly , the aim of this clinical trial was to evaluate the clinical and radiographic outcomes of mineral trioxide aggregate ( mta ) pulpotomy as permanent treatment of symptomatic mature permanent teeth with carious exposure .
another consideration with electrosurgical pulpotomy is lateral heat production . in this study , repetition of electrocoagulation became necessary due to the large size of the canal openings of some teeth . although a 10 - 15 second interval was given for cooling , the heat build - up might lead to side effects .
if one of your child’s teeth is showing signs of decay , schedule an appointment at ashburn children’s dentistry in ashburn to learn more about a pulpotomy procedure . our team of dental experts will be happy to address any questions or concerns you may have . contact us today to book your child’s appointment .
mta was clinically and radiographically superior to formocresol for pulpotomy of primary teeth . the other alternatives to formocresol such as electrosurgery and ferric sulphate can be used instead of formocresol since they showed success similar to formocresol . in addition , there is no evidence to support calcium hydroxide for pulpotomies in primary teeth .
a pulpotomy may be needed when a cavity caused by tooth decay goes deep and becomes close to the pulp chamber . it irritates the tissue , which becomes inflamed . this is what causes a toothache . if the tooth is not treated so that the infection is removed , it will become abscessed .
both procedures are used to try to save decayed teeth with infected pulps . in a pulpotomy , the dentist only removes the pulp in the tooth’s crown while leaving the pulp in the roots . in a pulpectomy , the dentist removes all of the pulp and replaces the pulp in the roots with cement .
evidence in the literature suggests to treat a permanent tooth with a complicated crown fracture as soon as possible to diminish the possibility of pain and prevent necrosis and infection of the pulp . delay of treatment by 9 days or less may have minimal effect on the outcome of cvek pulpotomies . while the literature indicates that pulp exposures of 4 mm or less may have a good prognosis after a cvek pulpotomy , the prognosis in teeth with pulp exposures of more than 4 mm has not yet been clarified . although the literature is not conclusive regarding a difference in the outcomes of cvek pulpotomies in teeth with open or closed apices , it appears that teeth with open apices have a better prognosis . the outcome of a cvek pulpotomy may be compromised by a luxation injury that diminishes the tooth’s blood supply and innervation . a good restoration that prevents bacterial penetration into the tooth is essential for the success of a cvek pulpotomy . see full abstract .
the teeth in which pulpotomy was carried out were asymptomatic and did not develop any tenderness to percussion . electric pulp testing revealed vital response in all the four teeth treated using biodentine pulpotomy at the end of 18 months . radiographic examination revealed absence of periapical lesion or widening . in case 1 and 2 , a well - defined radio - opaque layer formation was seen on the pulpal aspect adjacent to the layer of biodentine suggestive of a calcific barrier . although cases 3 and 4 did not reveal a distinct barrier formation , there was an increase in radio - opacity in the radicular pulp adjacent to the layer of biodentine .
i gotta call bs on this one . i do p / ssc every day . pulpotomies in primary teeth have a success rate in the 80 ' s . whether you are using formo or ferric sulfate or simple pressure pulpotomy , no one will have a 99 % success rate . that is not possible .
for young permanent vital teeth with open apices , you can attempt mta pulpotomy to see if roots will continue to form . remove all caries and superficial layer of pulp , place mta , let it set up for a few hours before restoring . dentinal bridge hopefully will form and we can avoid the rct .
pulpotomy procedure have realistically sound prognosis . it might get enough time , however can not preserve an earlier abscessed tooth . it can be sometimes shocking to me just how an obviously little part of decay can penetrate as much as necessary to get to the pulp . this could be because of the different anatomy of milk teeth along with the quick development of decay . even though this is an extremely dependable procedure , not often , a tooth with a pulpotomy procedure is going to have problems and have to be extracted . that is generally because of the residual pulp cells in the tooth root canals are producing some type of problem .
pulpotomy has been the carried out in the past successfully by several authors . witherspoon et al . in 2006 assessed 19 cases with pulpotomies using mta pulpal exposures resulting due to traumatic injuries or dental caries . he found that only one case reported with a persistent disease after a recall time of 19 months . [ 17 ]
once pulp decay is caught , pulpotomy treatment is going to stop bacterial contamination from growing in adjoining tissues . additionally , your kid might not have to go through the pain related to a tooth root canal . in a pulpotomy procedure , the dentist or perhaps endodontist drills into the tooth to eliminates decaying tooth tissue , after which accesses the pulp cell to take away all impacted nerves and pulp . the region is handled with remedy and holds stuffing put into it . as soon as therapy on the pulp cell and nerve is finished , a tooth crown is added to the tooth to stop additional decay , and in order to guard the tooth .