Pulp therapy

Pulp therapy

1. Indications

   • Maintain an intact arch
   • To avoid the physiological and psychological trauma of extraction
   • If extraction is medically contraindicated (e.g heamophilia)
   • No permanent successor tooth
   • Space maintenance (mixed dentition)
   • Cooperative child and carers

2. Contra-indications

   • Uncooperative child or carers
   • Child at risk from infection (immunosuppressed or at risk from endocarditis)
   • Neglected dentition (>3 pulpotomies required)
   • Severe acute infection
   • Unrestorable crown
   • Root caries
   • >2/3 root resorption (near to exfoliation)

3. Vital pulp therapies

   • Direct pulp cap
   • Indirect pulp
     • Indications
       • Deep dentinal caries
       • No symptoms
       • No pulp exposure
     • Layers
       • GIC
         • Composite
           • PFMC
   • Single visit pulpotomy
     • Layers
       • ZnOE
         • GIC
           • PFMC
   • Desensitising pulpotomy
   • Pulpectomy