It is recommended to avoid an intraligamental injection when the planned dental treatment is:
a- Pulp extirpation.
b-. Pulpotomy.***
c- Full crown preparation.
d- A and b.
Pulpotomy is the partial eviction of the dental pulp.
The dentist will remove the cameral pulp only (the pulp contained in the pulp chamber, in the crown), and leave in place the root pulp (contained in the root channels). The tooth is not totally devitalized.
Then it closes the pulp chamber with a suitable material, usually eugenate on tooth of milk (eugenol - zinc oxide = MRI) and calcium hydroxide or MTA on permanent tooth.
Pulpotomy is performed almost exclusively on temporary teeth or immature permanent teeth.
The persistence of the root pulp will facilitate the rhyzalysis necessary for the falling of the milk teeth.
It is sometimes performed in emergency treatment to relieve pending a subsequent pulpectomy.
It can also be partial (removal of a pulp horn) if it is performed immediately after trauma, for example on a final incisive maturing in an 8-year-old child who has had a fall.
There are two types of temporary tooth pulpotomy:
- vital pulpotomy;
- the fixing pulpotomy.
the first is considered as a hairstyle in the hope of preserving pulp vitality and the second aims to fix the pulp in a clinically satisfactory state.
The etiological treatment of pulpitis proved impossible to practice, or it failed.
It is therefore no longer possible to cure the pulp.
We then practice a treatment "lesionnel" which consists in removing the pulp organ ill: it is surgery of amputation.
After one section the pulp is extracted from the tooth, these two gestures are perfectly expressed in the term "pulp-ec-tomie". It is an ablation. But it is also possible to subtract only part of the pulp, the cameral portion; the notion of extirpation disappears and the intervention has a name that calls only section and amputation: the "pulpo-tomie".
But clinical experience shows that we do not catch a hairstyle with a pulpotomy. One does not remove the portion of pulp that does not heal (coronary) to keep the other part supposed healthy (radicular). The practitioner is ignorant of making the diagnosis of the topography of inflammation and necrosis of a pulpitis; moreover, the failure of styling probably corresponds to an evolution towards total pulpitis. It's all-or-nothing practice.
Also, the impossibility or the failure of the styling obliges to the practice of the pulpectomy; this single therapeutic indication makes that pulpectomy is much more frequently performed than pulpotomy whose indications remain close to those of styling.
Contrary to the practice that the presentation of endodontic interventions follows the internal progression of their level, from the surface of the tooth towards the apex, the dentinal hairstyle before the pulp, and the pulpotomy before the pulpectomy, we will follow the clinical reality and we will study pulpectomy first. This will, among other things, have the effect of improving the understanding of the particular interest of pulpotomy and a compromise intervention, the high pulpotomy, or partial pulpectomy, which should, logically, become the depulpation of tomorrow.
a- Pulp extirpation.
b-. Pulpotomy.***
c- Full crown preparation.
d- A and b.
Pulpotomy is the partial eviction of the dental pulp.
The dentist will remove the cameral pulp only (the pulp contained in the pulp chamber, in the crown), and leave in place the root pulp (contained in the root channels). The tooth is not totally devitalized.
Then it closes the pulp chamber with a suitable material, usually eugenate on tooth of milk (eugenol - zinc oxide = MRI) and calcium hydroxide or MTA on permanent tooth.
Pulpotomy is performed almost exclusively on temporary teeth or immature permanent teeth.
The persistence of the root pulp will facilitate the rhyzalysis necessary for the falling of the milk teeth.
It is sometimes performed in emergency treatment to relieve pending a subsequent pulpectomy.
It can also be partial (removal of a pulp horn) if it is performed immediately after trauma, for example on a final incisive maturing in an 8-year-old child who has had a fall.
There are two types of temporary tooth pulpotomy:
- vital pulpotomy;
- the fixing pulpotomy.
the first is considered as a hairstyle in the hope of preserving pulp vitality and the second aims to fix the pulp in a clinically satisfactory state.
The etiological treatment of pulpitis proved impossible to practice, or it failed.
It is therefore no longer possible to cure the pulp.
We then practice a treatment "lesionnel" which consists in removing the pulp organ ill: it is surgery of amputation.
After one section the pulp is extracted from the tooth, these two gestures are perfectly expressed in the term "pulp-ec-tomie". It is an ablation. But it is also possible to subtract only part of the pulp, the cameral portion; the notion of extirpation disappears and the intervention has a name that calls only section and amputation: the "pulpo-tomie".
But clinical experience shows that we do not catch a hairstyle with a pulpotomy. One does not remove the portion of pulp that does not heal (coronary) to keep the other part supposed healthy (radicular). The practitioner is ignorant of making the diagnosis of the topography of inflammation and necrosis of a pulpitis; moreover, the failure of styling probably corresponds to an evolution towards total pulpitis. It's all-or-nothing practice.
Also, the impossibility or the failure of the styling obliges to the practice of the pulpectomy; this single therapeutic indication makes that pulpectomy is much more frequently performed than pulpotomy whose indications remain close to those of styling.
Contrary to the practice that the presentation of endodontic interventions follows the internal progression of their level, from the surface of the tooth towards the apex, the dentinal hairstyle before the pulp, and the pulpotomy before the pulpectomy, we will follow the clinical reality and we will study pulpectomy first. This will, among other things, have the effect of improving the understanding of the particular interest of pulpotomy and a compromise intervention, the high pulpotomy, or partial pulpectomy, which should, logically, become the depulpation of tomorrow.
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