Pulpectomy

Question 1

When would a pulpectomy be indicated?

Answer 1

• when patient co-operation is very good
• non vital pulp
• hyperaemic pulp when attempting pulpotomy
• irreversible pulpitis
• periapical periodontitis

Question 2

What are signs of a non-vital pulp?

Answer 2

Non-responsive to vitality / sensibility testing
PA pathology
Chronic or acute abscess w/lump on gum

Question 3

When would extraction be indicated?

Answer 3

Facial swelling and infection

Question 4

What is the procedure for a pulpectomy?

Answer 4

Periapical radiograph to get WL, set files to -2mm WL or can damage developing tooth below

1 - remove caries and access pulp and remove so canals are visible

2 - clear canals with files at -2mm WL

3 - irrigate with chlorhexadine and dry with paper points

4 - obturate with vitapex and seal with ZOE gel or GIC and place metal crown

Question 5

What should be done int he follow up appt?

Answer 5

Check signs of failure

• mobility of pathology
• fistula or chronic sinus pain

Radiographic signs of failure
- apical radiolucency

• internal or external resorption
• furcation bone loss