Pulpotomy
Pulpotomy is a dental procedure that involves 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. This procedure is often performed on primary teeth (baby teeth) and immature permanent teeth in children and has a reasonably good prognosis of success.
Procedure
A pulpotomy is performed under local anesthesia. The decay and the coronal pulp is removed, and the area is sterilized. A therapeutic dressing of formocresol or ferric sulfate is applied to the remaining pulp to prevent bacterial invasion and to promote healing and repair. The tooth is then restored with a stainless steel crown or a composite restoration.
Indications
Pulpotomy is indicated in cases of extensive caries that have extended into the pulp but have not resulted in a bacterial invasion of the radicular pulp. It is also indicated in cases of traumatic exposure of the pulp in a carious primary tooth.
Contraindications
Contraindications for pulpotomy include a fistula, an abscess, or pathological mobility of the tooth. It is also contraindicated if the tooth is non-restorable or if the patient has systemic conditions that would contraindicate the procedure.
Complications
Possible complications of a pulpotomy include failure of the remaining pulp to heal, which would necessitate a pulpectomy or extraction. There may also be postoperative discomfort or infection.
See also
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Contributors: Prab R. Tumpati, MD