Complete Guide to Pulp Therapy in Primary Teeth: Materials, Techniques, and Success Rates

Pulp therapy in primary teeth is a cornerstone of pediatric dentistry, aiming to maintain tooth vitality, prevent infection, and preserve arch space until natural exfoliation.

📌 Recommended Article :

Dental Article 🔽 Why Hydrogen Peroxide Should Not Be Used in Modern Endodontic Treatment: Evidence-Based Clinical Justification ... This article explains why hydrogen peroxide is no longer recommended in endodontic treatments, supported by contemporary scientific evidence.

Advances in biomaterials such as MTA, Biodentine, and improved clinical protocols have significantly increased success rates. Understanding the differences between pulpotomy, pulpectomy, indirect pulp treatment (IPT), and apexification is essential for evidence-based care.

Advertisement

✅ Pulp Therapy Techniques

➤ Indirect Pulp Treatment (IPT)
IPT is indicated when deep caries is present but the tooth remains vital and asymptomatic. Selective caries removal minimizes pulp exposure and promotes remineralization. High-fluoride glass ionomer and resin-modified glass ionomer (RMGI) are widely used as liners.

➤ Direct Pulp Cap (DPC)
Used when a small mechanical pulp exposure occurs. Bioceramics like MTA and Biodentine create a durable dentin bridge and exhibit excellent biocompatibility.

➤ Pulpotomy
Indicated in cases of carious pulp exposure with preserved radicular pulp vitality. Popular medicaments include MTA, Biodentine, and historically formocresol, although the latter is no longer recommended due to toxicity concerns.

➤ Pulpectomy
Indicated for irreversible pulpitis or necrosis. It consists of removing necrotic tissue and obturating canals with resorbable materials such as iodoform-based pastes (Vitapex, Metapex) or zinc oxide–eugenol.

➤ Apexogenesis & Apexification in Young Permanent Teeth
Although not used in primary teeth, they are fundamental when treating immature permanent teeth with open apices.

📌 Recommended Article :

Dental Article 🔽 Understanding Pulpal Diseases: Reversible Pulpitis, Irreversible Pulpitis, and Pulp Necrosis in Adults and Children ... Pulpal diseases represent a continuum of inflammatory conditions that range from reversible pulpitis to irreversible pulpitis and finally to pulp necrosis.

✅ Materials Used in Pulp Therapy

➤ Mineral Trioxide Aggregate (MTA)
Known for high biocompatibility, antibacterial properties, and superior long-term sealing.

➤ Biodentine
A bioactive dentin substitute with faster setting time and strong pulpal healing potential.

➤ Zinc Oxide–Eugenol (ZOE)
Traditional obturation material for primary teeth, but less favorable in cases requiring complete resorption.

➤ Iodoform-based Pastes (Vitapex/Metapex)
Preferred for pulpectomy due to their resorbability and antimicrobial action.

📌 Recommended Article :

Dental Article 🔽 Calcium Hydroxide in Pediatric Dentistry: Benefits and Limitations ... Its biological properties, high alkalinity, and ability to stimulate hard tissue formation have made it a cornerstone in pulp therapy procedures.

✅ Success Rates

▪️ IPT: 90–97% (AAPD, 2021)
▪️ Pulpotomy with MTA: 90–95%
▪️ Pulpotomy with Biodentine: 88–94%
▪️ Pulpectomy: 70–85%, depending on canal anatomy and material used

📊 Comparative Table: Differences Between Pulp Therapy Techniques

Aspect	Advantages	Limitations
Indirect Pulp Treatment (IPT)	High success rates; preserves vitality; minimally invasive	Requires excellent diagnosis; risk of residual caries
Direct Pulp Cap (DPC)	Promotes dentin bridge formation; effective with bioceramics	Not suitable for carious exposures; requires ideal isolation
Pulpotomy	High success with MTA/Biodentine; preserves radicular pulp vitality	Failure if radicular pulp is inflamed or infected
Pulpectomy	Indicated for necrotic teeth; removes infection; allows tooth preservation	Technique sensitive; lower success rates; requires resorbable obturants
Apexogenesis	Allows continued root development	Not applicable to primary teeth
Apexification	Induces apical closure in young permanent teeth	Long treatment time; not used in primary teeth

💬 Discussion
The choice of pulp therapy depends on diagnosis, degree of inflammation, tooth restorability, and patient behavior. Vital pulp therapies (IPT, DPC, pulpotomy) consistently show higher long-term success than pulpectomy. Modern biomaterials like MTA and Biodentine have replaced older agents due to improved healing outcomes and safety profiles.

📌 Recommended Article :

Dental Article 🔽 Medications for Pulp Capping in Primary Teeth: Indications, Composition, and Clinical Management ... Its success largely depends on the material or medication used, which must be biocompatible, promote tissue repair, and provide an adequate marginal seal.

🔎 Recommendations
▪️ Prioritize vital pulp therapies when pulp vitality is preserved.
▪️ Use bioceramics (MTA, Biodentine) as first-line agents.
▪️ Perform pulpectomy only when irreversible pulpitis or necrosis is confirmed.
▪️ Seal treated teeth with stainless steel crowns for long-term success.
▪️ Follow AAPD guidelines for diagnostic criteria and material selection.

✍️ Conclusion
Pulp therapy in primary teeth is highly successful when clinicians use accurate diagnostic criteria and evidence-based materials. Modern biomaterials have improved outcomes and reduced complications, making pulp conservation the preferred approach whenever possible. A clear understanding of each technique ensures predictable and biologically sound results.

📚 References

✔ American Academy of Pediatric Dentistry. (2021). Pulp therapy for primary and immature permanent teeth. AAPD Clinical Guidelines. https://www.aapd.org
✔ Hegde, S., & Bhat, S. S. (2019). Clinical evaluation of MTA and Biodentine as pulpotomy agents in primary teeth. Journal of Indian Society of Pedodontics and Preventive Dentistry, 37(3), 307–315. https://doi.org/10.4103/JISPPD.JISPPD_217_18
✔ Jeon, H. J., Kim, J., & Kim, Y. (2020). Outcomes of vital pulp therapy using bioceramic materials. Restorative Dentistry & Endodontics, 45(3), e32. https://doi.org/10.5395/rde.2020.45.e32
✔ Nowicka, A., Lipski, M., Parafiniuk, M., et al. (2013). Biodentine vs. MTA in direct pulp capping. Journal of Endodontics, 39(6), 743–747. https://doi.org/10.1016/j.joen.2013.01.005

📌 More Recommended Items

► Best Materials for Pulpotomy in Primary Teeth: MTA vs. Biodentine vs. Ferric Sulfate
► Pulp Capping in Dentistry: How the Dental Pulp Is Protected (Updated Clinical Guide)
► CTZ Paste in Primary Teeth Pulp Therapy: Indications, Benefits and Clinical Protocol

Pulpotomy vs. Pulpectomy in Primary Teeth: A Contemporary Clinical Guide

Vital pulp therapy in primary teeth is a cornerstone of pediatric dental treatment. Among the most common procedures are pulpotomy, which conserves some of the radicular pulp, and pulpectomy, which removes all pulp tissue.

📌 Recommended Article :

Dental Article 🔽 Manual of diagnosis and pulp treatment in non-vital primary teeth ... Non-vital teeth are those whose nerves lack vitality and there is no blood flow inside. This may be due to deep caries or dental trauma that irreversibly affects the dental pulp.

Understanding the clinical indications, long-term outcomes, advantages, and limitations of each technique is essential for optimizing patient care and maintaining primary teeth until exfoliation.

Advertisement

✅ Background and Rationale
Primary teeth differ significantly from permanent teeth in morphology and physiology, notably in their root anatomy, resorption patterns, and innervation. Current pediatric dentistry guidelines (e.g., AAPD) describe pulpotomy as indicated when coronal pulp is inflamed but radicular pulp remains vital. Meanwhile, pulpectomy is generally reserved for cases with necrosis, irreversible pulpitis, or radiographic pathology.

📌 Recommended Article :

Video 🔽 Pulpectomy. Step-by-Step Procedure - Access, Preparation, and Obturation ... We share the step-by-step procedure of a pulpectomy performed with rotary files. In this video we can observe the opening, chemomechanical preparation and obturation.

✅ Clinical Evidence: Success Rates & Comparative Outcomes

➤ Randomized & Controlled Trials
▪️ A multicenter RCT comparing cervical pulpotomy (with calcium-enriched mixture cement) versus pulpectomy (Metapex) in primary molars with irreversible pulpitis found no significant difference in clinical and radiographic success rates. PubMed
▪️ In a split-mouth randomized trial on primary incisors with vital pulp exposure, pulpotomy (formocresol) and pulpectomy (zinc-oxide-eugenol) showed similar 12-month success, with survival rates of ~82% vs ~74%, respectively (not statistically significant).

➤ Observational and Cohort Studies
A retrospective cohort study of 876 primary molars reported that iRoot BP Plus pulpotomy had a significantly better long-term prognosis (survival over 48 months) than Vitapex pulpectomy.
A survival analysis of pulpectomy under general anesthesia found that failures usually stemmed from incomplete tissue removal and complexity of root canal systems in primary molars.

➤ Systematic Reviews & Meta-Analyses
▪️ A large Cochrane-type review concluded that MTA (mineral trioxide aggregate) is superior to formocresol and calcium hydroxide for pulpotomy in primary teeth.
▪️ Another systematic review and meta-analysis demonstrated high clinical and radiographic success for pulpotomy in primary teeth with irreversible pulpitis, suggesting that inflammation might be confined to the coronal pulp in many cases.

📊 Comparative Table: Pulpotomy vs Pulpectomy in Primary Teeth

Aspect	Advantages	Limitations
Tissue preservation	Maintains some vital radicular pulp, encouraging natural resorption	May leave inflamed tissue if diagnosis is incorrect
Procedure time & behavior	Generally faster and less technically demanding; better tolerated in uncooperative children	Hemostasis must be achieved; persistent bleeding may complicate treatment
Long-term survival	High survival rates over several years (e.g., > 70% at 48 months with bioceramic pulpotomy) :contentReference[oaicite:9]{index=9}	Success depends on correct diagnosis and use of proven medicaments (e.g., MTA) :contentReference[oaicite:10]{index=10}
Indications	Irreversible pulpitis with vital radicular tissue; minimal radiographic pathology	Not suitable if necrosis, internal/external resorption, or periapical infection present :contentReference[oaicite:11]{index=11}
Risks & complications	Lower risk of overfilling; less risk to developing permanent tooth bud	Risk of failure if improper agent or poor seal; possible internal resorption
Restoration after treatment	Can be restored with stainless steel crowns or other durable restorations with good retention :contentReference[oaicite:12]{index=12}	Coronal leakage or microleakage can compromise outcome if restoration fails

💬 Discussion
The body of evidence suggests that pulpotomy and pulpectomy both have clinically acceptable success in primary teeth when properly indicated. Notably:

▪️ Pulpotomy, especially when using modern materials like MTA or bioceramic cements (e.g., iRoot BP Plus), demonstrates excellent long-term survival.
▪️ Pulpectomy, while more invasive, remains critical in cases of necrosis or when radiographic signs of pathology are present. However, it is technically demanding, particularly due to the complex canal anatomy of primary molars.
▪️ Systematic reviews consistently favor MTA over traditional agents like formocresol or calcium hydroxide for pulpotomy, due to better clinical and radiographic outcomes.
▪️ Patient-centered outcomes also favor more conservative therapy: pulpectomy has been associated with improved quality of life and lower dental anxiety compared to extraction, making it preferable over tooth loss.

Additionally, a recently registered RCT protocol aims to provide more rigorous evidence by comparing pulpotomy vs pulpectomy in primary molars with irreversible pulpitis over two years. This trial could potentially shift paradigms if pulpotomy proves non-inferior, given its lower invasiveness and patient burden.

📌 Recommended Article :

Dental Article 🔽 Mineral Trioxide Aggregate (MTA) in Pediatric Dentistry: Uses, Benefits, and Clinical Evidence ... Among them, Mineral Trioxide Aggregate (MTA) has emerged as a gold standard for pulp therapy, especially for its regenerative properties and sealing capability.

✅ Recommendations for Clinical Practice

1. Case Selection Is Key
▪️ Use pulpotomy when the pulp is vital, bleeding is controlled, and no periapical pathology is evident.
▪️ Reserve pulpectomy for cases with necrosis, internal/external resorption, or evidence of interradicular/periapical disease.

2. Material Choice
▪️ Prefer MTA or bioceramic materials (e.g., iRoot BP Plus) for pulpotomy due to demonstrated higher success rates.
▪️ For pulpectomy, use resorbable filling materials compatible with primary tooth anatomy (e.g., Metapex, Vitapex), though evidence does not strongly favor one over another.

3. Behavior Management & Procedural Efficiency
▪️ Because pulpotomy is generally faster and less technique-sensitive, it may be better suited for younger or less cooperative children.
▪️ Ensure accurate diagnosis (clinical + radiographic) to minimize risk of failed treatment.

4. Follow-up Protocol
▪️ Schedule periodic clinical and radiographic reviews (e.g., 6 months, 12 months, annually) to monitor for signs of failure or resorption.
▪️ Optimize restorative sealing (e.g., stainless-steel crown) to reduce risk of microleakage.

5. Research and Continuous Learning
▪️ Stay updated with ongoing trials (e.g., the non-inferiority RCT of pulpotomy vs pulpectomy in primary molars) for evidence that may refine treatment guidelines.
▪️ Contribute to or audit long-term outcomes in your own practice to inform future decisions.

📌 Recommended Article :

Dental Article 🔽 Partial Pulpotomy in Pediatric Dentistry: Technique, Benefits, and Key Differences ... Partial pulpotomy offers a biologically favorable approach in cases of limited pulp inflammation, especially in traumatic pulp exposures or shallow carious lesions, promoting healing and long-term tooth survival.

✍️ Conclusion
In modern pediatric dentistry, both pulpotomy and pulpectomy remain viable options for managing pulpally involved primary teeth. While pulpotomy offers a more conservative and less time-consuming approach with excellent long-term survival—especially when using materials like MTA or bioceramics—pulpectomy remains irreplaceable in cases of necrosis or advanced pathology. Clinicians should base their choice on careful diagnosis, patient behavior, material selection, and a commitment to follow-up. Together, these strategies help preserve primary teeth, maintain arch integrity, and support the well-being of pediatric patients.

📚 References

✔ Holan, G., & Fuks, A. B. (2015). The role of pulpectomy in the primary dentition. Pediatric Dentistry, 37(6), 559–566.
✔ Philip, N., Cherian, J. M., Mathew, M. G., et al. (2024). Treatment outcomes of pulpotomy versus pulpectomy in vital primary molars diagnosed with symptomatic irreversible pulpitis: protocol for a non-inferiority randomized controlled trial. BMC Oral Health, 24, 626. https://doi.org/10.1186/s12903-024-04411-6
✔ Li, J., Fan, W., Zhou, Y., Wu, L., Liu, W., & Huang, S. (2024). Pulpotomy versus pulpectomy in carious vital pulp exposure in primary incisors: a randomized controlled trial. BMC Dentistry.
✔ Xu, X., Chen, X., Wang, X., & Chen, J. (2023). Survival analysis of pulpotomy versus pulpectomy in primary molars with carious pulp exposure. International Endodontic Journal.
✔ Walsh, T., Clarke, M., Tsang, A., Marshman, Z., & Petrou, K. (2016). Pulp treatment for extensive decay in primary teeth. Cochrane Database of Systematic Reviews, (4), CD003220.
✔ American Academy of Pediatric Dentistry. (n.d.). Pulp Therapy for Primary and Immature Permanent Teeth. AAPD Policy.

📌 More Recommended Items

► Management of Pulpal Infections in Primary Teeth: Evidence-Based Protocols 2025
► Calcium Hydroxide in Pediatric Dentistry: Benefits and Limitations
► Partial pulpotomy vs. Conventional (full) pulpotomy in primary teeth — a comparative, evidence-based review

Irrigants in Pediatric Pulpectomies: Key Benefits, Properties, and U.S. Commercial Brands

Pulpectomy is a critical endodontic procedure in pediatric dentistry, particularly for primary teeth with necrotic pulps. One of the essential components for success is the use of appropriate irrigating solutions, which aid in disinfection, debris removal, and preparation of the root canal system.

📌 Recommended Article :

Video 🔽 Pulpectomy. Step-by-Step Procedure - Access, Preparation, and Obturation ... We share the step-by-step procedure of a pulpectomy performed with rotary files. In this video we can observe the opening, chemomechanical preparation and obturation.

This article explores the properties, benefits, and most commonly used irrigants in pediatric pulpectomies, including top commercial products used in the United States.

Advertisement

✅ Importance of Irrigants in Pulpectomy
Endodontic irrigation plays a pivotal role in eliminating microorganisms, dissolving organic tissues, and flushing out dentinal debris and toxins from the canal system. In primary teeth, due to their complex morphology, presence of accessory canals, and physiological root resorption, the choice of irrigant must be both effective and biocompatible.

📌 Recommended Article :

Video 🔽 What is the difference between apexogenesis and apexification? ... In the presence of an open apex, apexogenesis (apicoformation) or apexification can be used. Both treatments have differences that will be resolved with the video that we show below.

✅ Key Functions of Irrigants:

° Antimicrobial activity: Reduces the bacterial load within the canal.
° Tissue dissolution: Facilitates removal of necrotic pulp tissue.
° Debris removal: Prevents blockage and improves shaping.
° Lubrication: Aids in smooth instrumentation.

📌 Recommended Article :

Video 🔽 Pulpectomy: Clinical Tips and Tricks in Paediatric Dentistry ... Pulpectomy is performed when there is an infectious process (fistula or abscess), chronic inflammation, or pulp necrosis. The objective of this treatment is to maintain the tooth to avoid problems of poor dental position of the permanent teeth.

✅ Commonly Used Irrigants and Their Properties

1. Sodium Hypochlorite (NaOCl)

➤ Concentration in pediatric use: 0.5% – 2.5%
° Antibacterial Effectiveness: Broad-spectrum antimicrobial activity.
° Tissue Dissolution: Excellent for organic material.
° Drawbacks: Cytotoxicity if extruded; requires controlled use in children.
➤ Popular Brands in the U.S.:
° Chlor-XTRA® (Vista Apex)
° UltraClenz® (Ultradent Products Inc.)

2. Chlorhexidine Gluconate (CHX)

➤ Concentration: 0.12% – 2%
° Advantages: Substantivity (residual antimicrobial effect), less cytotoxic than NaOCl.
° Limitations: Lacks tissue dissolution capability, may form precipitate when mixed with NaOCl.
➤ Popular Brands:
° Consepsis® (Ultradent)
° Peridex® (3M)

3. Ethylenediaminetetraacetic Acid (EDTA)

➤ Concentration: 17%
° Function: Removes inorganic smear layer, opens dentinal tubules.
° Use in pediatrics: Often used after NaOCl or CHX to improve canal cleanliness.
➤ Popular Brands:
° SmearOFF® (Vista Apex)
° File-Eze® (Ultradent)

4. Saline or Sterile Water

° Used as a final rinse to minimize residual irritants and cytotoxicity.
° Non-toxic and neutral, but lacks antimicrobial action.

📌 Recommended Article :

PDF 🔽 Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions ... The AAPD (American Academy of Pediatric Dentistry) presents a guide to pulp treatment in pediatric dentistry, with the aim of optimizing treatment care and results.

✅ Emerging Irrigants in Pediatric Dentistry

° Silver nanoparticles and herbal irrigants (e.g., propolis, Morinda citrifolia) are under research for their biocompatibility and antibacterial properties. While not yet mainstream, they represent promising adjuncts in the future of pediatric endodontics.

💬 Discussion
The ideal irrigant for pulpectomy in children should possess a strong antimicrobial effect, ability to dissolve tissue, and minimal toxicity to periapical tissues. While NaOCl remains the gold standard due to its powerful tissue dissolution and antibacterial properties, its cytotoxicity and risk of extrusion necessitate careful handling, especially in children. CHX offers a safer profile but lacks the tissue dissolving action of NaOCl. Therefore, a sequential irrigation protocol, often involving NaOCl followed by EDTA or CHX, is recommended for enhanced efficacy.
Commercial products tailored for pediatric and adult endodontics in the U.S. market offer buffered, pre-mixed, and safer formulations to ensure optimal clinical outcomes.

📌 Recommended Article :

Video 🔽 Pulpotomy of Deciduous Molar - Step by step ... We share an interesting video that shows us how to perform a pulpotomy step by step, indicating the materials and the steps that we must follow.

💡 Conclusion
Effective irrigation is fundamental to the success of pulpectomies in pediatric dentistry. A proper selection and sequence of irrigants can significantly enhance the debridement and disinfection of root canals in primary teeth. U.S.-market products such as Chlor-XTRA, Consepsis, and SmearOFF provide accessible and reliable options for clinicians. Ongoing research into biocompatible and innovative irrigants will continue to shape the future of pediatric endodontic care.

📚 References

✔ Mohammadi, Z., & Shalavi, S. (2014). Is chlorhexidine an ideal irrigant in endodontics? Journal of Dental Research, Dental Clinics, Dental Prospects, 8(2), 71–79. https://doi.org/10.5681/joddd.2014.013

✔ Pimenta, L. A. F., et al. (2021). Antimicrobial activity of different endodontic irrigants in primary teeth: A systematic review. Pediatric Dentistry, 43(1), 13–19.

✔ Hülsmann, M., & Hahn, W. (2000). Complications during root canal irrigation—Literature review and case reports. International Endodontic Journal, 33(3), 186–193. https://doi.org/10.1046/j.1365-2591.2000.00291.x

✔ American Academy of Pediatric Dentistry (AAPD). (2024). Guidelines on Pulp Therapy for Primary and Immature Permanent Teeth. Retrieved from https://www.aapd.org

✔ Haapasalo, M., et al. (2010). Irrigation in endodontics. Dental Clinics of North America, 54(2), 291–312. https://doi.org/10.1016/j.cden.2009.12.001

📌 More Recommended Items

► Clinical Pulpectomy Protocol: Updated Step-by-Step Guide
► What is the best pulp dressing for pulpotomies in primary teeth? - Review
► Pulpotomy and pulpectomy procedures. Indications and Differences

Clinical Pulpectomy Protocol: Updated Step-by-Step Guide

Pulpectomy is a fundamental procedure in pediatric dentistry for treating primary teeth with pulp inflammation or necrosis.

📌 Recommended Article :

PDF 🔽 Pulpotomy Medicaments used in Deciduous Dentition: An Update ... This step is generally followed by the placement of a particular medicament over the intact stump to fix, mummify or stimulate repair of the remaining radicular pulp

Its main goal is to eliminate infection, maintain tooth functionality until natural exfoliation, and preserve dental space.

Advertisement

✅ 1. Case Selection

➤ Indications:
° Necrotic pulp or irreversible inflammation.
° Primary tooth with deep caries, abscesses, or fistulas.
° Persistent pain or prolonged sensitivity.
➤ Contraindications:
° Advanced pathological root resorption.
° Severe tooth mobility.
° Loss of bone support or involvement of the permanent tooth germ.

📌 Recommended Article :

Video 🔽 Pulpectomy: Clinical Tips and Tricks in Paediatric Dentistry ... Pulpectomy is performed when there is an infectious process (fistula or abscess), chronic inflammation, or pulp necrosis

✅ 2. Step-by-Step Procedure

➤ a. Anesthesia and Isolation:
° Administer appropriate local anesthesia (4% Articaine with 1:100,000 epinephrine).
° Place rubber dam isolation to prevent contamination.
➤ b. Caries Removal and Pulp Access:
° Remove caries using high-speed burs and open the pulp chamber to fully expose the canals.
° Rinse with sterile saline solution or 2% chlorhexidine.
➤ c. Instrumentation and Disinfection:
° Instrument canals using manual or rotary files up to the apical limit (2 mm before the radiographic apex).
° Irrigate abundantly with 1–2.5% sodium hypochlorite, followed by saline solution to neutralize.
➤ d. Drying and Obtaining Clean Canals:
° Dry canals with sterilized paper points.
° Confirm absence of necrotic debris or bleeding before obturation.
➤ e. Obturation:
° Select appropriate obturation material:

• Zinc oxide and eugenol (ZOE): Traditional material.
• Iodoform-based pastes (Metapex™ or Vitapex™): For better resorption and antimicrobial properties.
• MTA or Biodentine: In cases with apical perforations or significant bone involvement.

° Insert material using a syringe or condenser, ensuring a hermetic seal.
➤ f. Final Restoration:
° Restore the tooth with suitable material like composite resin or place a stainless steel crown to ensure function and prevent reinfection.

📌 Recommended Article :

Video 🔽 Pulpectomy, everything you need to know: Diagnosis, indications, and filling materials ... The video that we share details everything related to pulpectomy: diagnosis, indications and contraindications, procedure, recommended filling materials, and the importance of post-treatment follow-up

✅ 3. Key Recommendations
° Radiographic Control: Perform preoperative and postoperative radiographs to verify proper sealing.
° Regular Follow-up: Schedule check-ups every 3–6 months to assess treatment success and detect possible complications.
° Material Selection: Prefer biocompatible materials like Metapex™ or Biodentine to improve clinical outcomes.

📌 Recommended Article :

Video 🔽 Effects of tobacco on the oral cavity: Nicotine Stomatitis ... We must bear in mind that smoking generates short and long-term consequences. In the oral cavity it can generate periodontitis, gingivitis and pathologies in the oral mucosa

✅ 4. Conclusions
Pulpectomy is a predictable and effective procedure when performed following a rigorous clinical protocol. The selection of obturation material plays a crucial role in the long-term success of the treatment. With the advancement of materials like Metapex™ and MTA, success rates have significantly improved. However, regular follow-up and appropriate final restoration are essential to ensure the functionality and health of the treated tooth.

📌 More Recommended Items

► What is the best pulp dressing for pulpotomies in primary teeth? - Review
► Myths About Root Canal Treatment
► Management of Endodontic Emergencies: Pulpotomy Versus Pulpectomy

Pulpotomy and pulpectomy procedures. Indications and Differences

Pulpotomy and pulpectomy are treatments performed on primary teeth that are affected by deep caries and that compromise the dental pulp.

📌 Recommended Article :

VIDEO 🔽 What is the difference between apexogenesis and apexification? ... In the presence of an open apex, apexogenesis (apicoformation) or apexification can be used. Both treatments have differences that will be resolved with the video that we show below.

Clinical and radiological evaluation are necessary to determine appropriate treatment. Pulpectomy is recommended when it is necessary to completely remove the affected dental pulp, and pulpotomy partially removes the dental pulp.

Advertisement

We share the similarities, differences, indications, contraindications and step-by-step procedures of pulpotomy and pulpectomy.

📌 Recommended Article :

Video 🔽 Pulpectomy: Clinical Tips and Tricks in Paediatric Dentistry ... Pulpectomy is performed when there is an infectious process (fistula or abscess), chronic inflammation, or pulp necrosis

📌 Watch video 1 "PULPOTOMY AND PULPECTOMY. DEFINITION.INDICATIONS.CONTRAINDICATIONS."

Youtube / Dr Teeth

📌 Watch video 2 "WHAT IS THE DIFFERENCE BETWEEN A PULPECTOMY AND PULPOTOMY?"

Youtube / Top Doctors UK

📌 More Recommended Items

► Apexogenesis: Step by step procedure
► Pulp Therapy Procedures Manual for Primary and Immature Permanent Teeth
► What is the best pulp dressing for pulpotomies in primary teeth? - Review

Manual of diagnosis and pulp treatment in non-vital primary teeth

Non-vital teeth are those whose nerves lack vitality and there is no blood flow inside. This may be due to deep caries or dental trauma that irreversibly affects the dental pulp.

A correct history, clinical and radiographic evaluation is necessary in these cases to determine the appropriate treatment for these cases (dental extraction, pulpectomy, lesion sterilization tissue repair).

Advertisement

We share a guide that helps us identify the signs and symptoms of a non-vital tooth, and evaluates the pulp treatment options in non-vital primary teeth.

RECOMMENDED ARTICLE
Management of acute orofacial infection of odontogenic origin in children - Diagnosis, clinic and pharmacology

👉 READ AND DOWNLOAD "Manual of diagnosis and pulp treatment in non-vital primary teeth" IN FULL IN PDF👈

Coll JA, Dhar V, Vargas K, et al. Use of Non-Vital Pulp Therapies in Primary Teeth. Pediatr Dent 2020;42(5):337-49.

You may also like :
► Pulpectomy, everything you need to know: Diagnosis, indications, and filling materials
► Pulpotomy of Deciduous Molar - Step by step
► Mandibular tumors in pediatric patients. Report of 04 cases of aggressive tumors

Pulpectomy. Step-by-Step Procedure - Access, Preparation, and Obturation

Pulpectomy is a dental treatment performed on primary teeth that removes the dental pulp in its entirety. The objective of this procedure is to maintain the dental piece until its natural exfoliation.

To perform this treatment it is necessary to know the anatomy of the primary teeth, as well as experience in the technique, preparation and filling.

Advertisement

We share the step-by-step procedure of a pulpectomy performed with rotary files. In this video we can observe the opening, chemomechanical preparation and obturation.

RECOMMENDED VIDEO
Pulpectomy, everything you need to know: Diagnosis, indications, and filling materials

You may also like :
► Pulpectomy: Clinical Tips and Tricks in Paediatric Dentistry
► Management of Endodontic Emergencies: Pulpotomy Versus Pulpectomy
► PULPECTOMY procedures in primary molar teeth

Source: Youtube/ AtoZ Kidsdental

Pulpectomy, everything you need to know: Diagnosis, indications, and filling materials

Pulpectomy is a dental procedure that is performed on primary teeth that are affected by an infectious process that totally compromises the dental pulp.

Pulpectomy removes all the dental pulp that is infected or affected by dental trauma. At the time of performing this procedure, a correct clinical and radiographic evaluation is necessary.

Advertisement

The video that we share details everything related to pulpectomy: diagnosis, indications and contraindications, procedure, recommended filling materials, and the importance of post-treatment follow-up.

RECOMMENDED VIDEO
Pulpectomy: Clinical Tips and Tricks in Paediatric Dentistry

You may also like :
► Management of Endodontic Emergencies: Pulpotomy Versus Pulpectomy
► What is pulp therapy? What are the pulp therapies in children?
► Root Canal Treatment for children

Source: Youtube/ Toothism

Webinar: Pulpectomy: Clinical Tips and Tricks in Paediatric Dentistry

In pediatric dentistry there are treatments that are performed when the dental pulp of the primary tooth is affected by caries or an accident, they are: pulpotomy (partial removal of the nerve), pulpectomy (total removal of the nerve), direct and indirect pulp lining.

We invite you to our English-only dental publishing groups

🎯 WhatsApp Group All Odontology
🎯 Telegram Group All Odontology
🎯 Facebook Group All Odontology

Pulpectomy is performed when there is an infectious process (fistula or abscess), chronic inflammation, or pulp necrosis. The objective of this treatment is to maintain the tooth to avoid problems of poor dental position of the permanent teeth.

Advertisement

We share a webinar dictated by Dr Shah and published on The Kenya Association of Pediatric Dentists channel, which tells us about pulpectomies, its importance and tips for implementation.

RECOMMENDED VIDEO
Guideline on Pediatric Oral Surgery

You may also like :
► Management of Endodontic Emergencies: Pulpotomy Versus Pulpectomy
► What is pulp therapy? What are the pulp therapies in children?
► Root Canal Treatment for children

Source: Youtube/ The Kenya Association of Paediatric Dentists

PULPECTOMY procedures in primary molar teeth

Premature loss of primary molars can cause a number of undesirable consequences including loss of arch length, insufficient space for erupting premolars and mesial tipping of the permanent molars.

We invite you to our English-only dental publishing groups

🎯 WhatsApp Group All Odontology
🎯 Telegram Group All Odontology
🎯 Facebook Group All Odontology

Pulpectomy of primary molar teeth is considered as a reasonable treatment approach to ensure either normal shedding or a long-term survival in instances of retention.

Advertisement

Despite being a more conservative treatment option than extraction, efficient pulpectomy of bizarre and tortuous root canals encased in roots programmed for physiologic resorption that show close proximity to developing permanent tooth buds presents a critical endodontic challenge. This article aims to provide an overview of this treatment approach, including partial and total pulpectomy, in primary molar teeth.

RECOMMENDED VIDEO
Effects of tobacco on the oral cavity: Nicotine Stomatitis

In addition, the recommended guidelines that should be followed, and the current updates that have been developed, while commencing total pulpectomy in primary molars are discussed.



° Ahmed, Hany. (2014). Pulpectomy procedures in primary molar teeth. European Journal of General Dentistry. 3. 3-10. 10.4103/2278-9626.126201.

You may also like :
► What Does Your Tongue Say About Your State Of Health?
► What are the consequences of a tooth extraction?
► ORAL MEDICINE: What are tonsil stones?

Management of Endodontic Emergencies: Pulpotomy Versus Pulpectomy

Recent studies report a 60-82% incidence of endodontic emergencies among all dental emergencies. Within this group, 20-42% of patients seek care for teeth with symptomatic irreversible pulpitis (SIP).

We invite you to our English-only dental publishing groups

🎯 WhatsApp Group All Odontology
🎯 Telegram Group All Odontology
🎯 Facebook Group All Odontology

Additionally, about 60% of SIP patients also complain of symptomatic apical periodontitis (SAP). While pain due to a severely inflamed pulp is characterized by dull, throbbing and lingering pain sensations, it can be spontaneous or in response to an external stimulus, such as hot, cold or chewing.

Advertisement

This makes SIP the bulk of the emergency cases seen in dental clinics. The goal of management of endodontic emergencies is to quickly and effectively manage pain and infections thereby also minimizing the development of persistent pain and the formation of periapical pathology.

RECOMMENDED VIDEO
Pain Post–Root Canal. What should i do?

Pharmacological management such as intramuscular or infiltration injection of ketorolac trimethamine (injectable NSAID) can significantly attenuate pain in patients with moderate to severe pulpal pain over a three-hour tested time or oral administration of ibuprofen sodium dihydrate over a one-hour time period.



Souce: aae.org / American Association of Endodontists (AAE)

You may also like :
► How to identify the early signs of oral cancer
► How to handle dental trauma?
► COVID 19: Children with asthma are at risk?

What is pulp therapy? What are the pulp therapies in children?

A good diagnosis of pulp status ensures a successful result of pulp therapy. The pediatric dentist will evaluate all the signs and symptoms that the patient refers, which together with an x-ray will determine the best treatment.

We invite you to our English-only dental publishing groups

🎯 WhatsApp Group All Odontology
🎯 Telegram Group All Odontology
🎯 Facebook Group All Odontology

Pulpotomy and pulpectomy are two of the most used procedures in the dental office. The objective of both treatments is to keep the primary tooth in the mouth and thus the patient does not lose functions such as chewing.


We share with you a video where he explains and defines what pulp therapies are for primary teeth and how they are performed.

RECOMMENDED VIDEO
What is the difference between pulpotomy and pulpectomy?

You may also like :
► Pain Post–Root Canal. What should i do?
► Signs and symptoms of TMJ disorders
► How to identify the early signs of oral cancer

Source: Youtube/ UCLAPedsDent

What is the difference between pulpotomy and pulpectomy?

When the dental caries advances infecting and compromising the dental pulp, it is necessary to carry out one of the two treatments: Pulpotomy and Pulpectomy.

We invite you to our English-only dental publishing groups

🎯 WhatsApp Group All Odontology
🎯 Telegram Group All Odontology
🎯 Facebook Group All Odontology

Both procedures work by removing the dental pulp, either partial or total. To determine the procedure, a clinical and radiographic evaluation must be performed.

Enlaces Patrocinados

These procedures are common in the dental office, and are performed on teeth that have advanced cavities or that have suffered trauma or blows. We share with you. a video where he defines the procedures and explains the difference of both.

RECOMMENDED VIDEO
Root Canal Treatment for children

You may also like :
► Pain Post–Root Canal. What should i do?
► Preparation of stainless steel crown for the rehabilitation of primary molars
► Video: Dental Abscess in 3d

Source: Youtube/ Dr Teeth