Tooth Cavity – Partial Pulpotomy #2 (Healed Without a Root Canal!) – Dr. Ricucci

Partial pulpotomy in a maxillary premolar

Comments:

Christoffer A:

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?

Bill L:

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!

Elly Cruz:

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.

Ash2theB:

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.

Mike Cheng:

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

Azerhaf:

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?

Scandinavian Import:

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