Partial pulpotomy in a maxillary premolar
This is pretty amazing, I’m a last year dental student in Norway and have been taught that pulpotomy for adults is unadvisable and unpredictable. These procedural steps make it seem a lot more calculated and not “just giving it a shot”. A lot of hard tissue removed here though, use a smaller bur maybe?
I’d be interested in a 1,3 and 5 year followup on this tooth. I’ve done pulpotomies with Brassler RRM, but never one with such a large pulp exposure. I would have done endo, but I’ve been a DDS over 40 years now and that’s what I’ve always successfully done on large exposures like this. Interesting video!
This is great, I’m so concerned I went to the dentist today and said I need 13 root canals:( … I get it maybe I do I feel some sensitivity in some teeth and even having tiny holes where I can see my dentin.
I wish my dentist could have done this on me. I had NO pain or sensitivity with the tooth but was told I need a root canal. After the RC I had a lot sensitive around the tooth. If the roots aren’t infected why not try to save the teeth and blood simple and nerve.
So, what I’ve learnt so far from this video…
Indications for partial pulpotomy: irreversible pulpitis w/o any evidence of PARL or infection only limited to pulpal tissues
Partial pulpotomy procedure: ideal isolation, remove carious lesions, achieve “uniform/homogenous” look of the pulpal tissues in pulpal chamber, achieve hemostasis as in no blood gushing out of the pulpal chamber, look for “attached” pulpal tissue to dentinal/pulpal wall (not published yet)
Restorative materials used: any type of tricalcium silicate (biocompatible) materials that are easily manageable/moldable in the pulpal chamber with light pressure to not disturb healthy pulpal tissues and at the same time help healing the pulpal wound
What is the follow-up protocol? How long does it take for pulpal tissue to regenerate or “heal” even though we’re assuming we already remove infection from partial pulpotomy.
Calm yet internally screaming:
Doctor, during my practice a doctor told me that pinpoint bleeding like really small can be overcome by stopping the bleeding with a dry cotton, applying dycal and then the lining and regular restoration is completed.. Is this true? Bc I’ve done it to a patient and i feel really guilty about it.. The patient hadn’t had any pain or inflammation or anything but i don’t feel right, should i be worried? .. I’m a student still btw
If there is no apical radiolucent but there is a pain or discomfort upon percussion or biting (pulpal diagnosis is symptomatic irreversible pulpitis). Can we still do pulpotomy?
If there is no feeling in a caries tooth, is the nerve then dead? And is a root canal the only option to preventing further complications down the line? My Dr says that if I do not remove the dead nerve with a root canal the dead tissue will rot and cause an infection. He says a crown must be placed. However, I have never had pain in this tooth and I would want to avoid a root canal if possible. What would be your opinion? Many thanks