• Vital pulpotomy amputates the infected coronal pulp
• It neutralizes the residual infectious process
• It preserves the vitality of the radicular pulp
Who is this procedure for?
• Children with cariously exposed primary teeth, but only if their retention is more advantageous than the extraction
• Patients (mostly children) with teeth that present inflammation that has confined to the coronal portion of the pulp
• It can be the first step in a complete root canal treatment.
Who should not consider this procedure?
• It is not recommended for children with baby teeth that are to fall out soon
• Patients whose tooth crown is nonrestorable.
What happens before the procedure?
Vital pulpotomy is based on the patient’s history of pain, the examination of the teeth and X – ray results. The patient then receives a complete dental cleaning, and the mouth is rinsed with an antimicrobial mouthwash to reduce contamination. A local anesthetic is used.
What happens during the procedure?
First, the crown is lowered. Next, the dentist uses a high – speed drill to remove the diseased pulp tissue. The bleeding is controlled at all times, with sterile paper points in the canal that allow clots to form. An antibacterial (calcium hydroxide) is placed into the canal. This irritates the pulp and causes it to lay down a protective layer of tooth structure which will decrease the chance of bacterial contamination in the future. Over the calcium hydroxide the dentist places an intermediate layer that insulates the pulp and acts as a base for the permanent restoration. The tooth is then covered with a stainless steel crown. The reason behind this is that teeth that have been treated by vital pulpotomy are likely to fracture.
What happens after the procedure?
A post-op X-ray will be done to ensure proper fill. It is very likely that the patient will experience soreness after the procedure, or between the visits, if more are needed. It is only a short term discomfort that is managed with over the counter pediatric pain medications.