Mostrando entradas con la etiqueta Pulpectomy. Mostrar todas las entradas
Mostrando entradas con la etiqueta Pulpectomy. Mostrar todas las entradas

lunes, 21 de julio de 2025

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

Endodontics

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

miércoles, 4 de junio de 2025

Clinical Pulpectomy Protocol: Updated Step-by-Step Guide

Pulpectomy

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

miércoles, 18 de octubre de 2023

Pulpotomy and pulpectomy procedures. Indications and Differences

Oral Cancer

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

lunes, 18 de abril de 2022

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

Pulpectomy

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.

Pediatric Dentistry


👉 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

martes, 8 de marzo de 2022

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

Pulpectomy

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.

Pulpectomy


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

lunes, 21 de febrero de 2022

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

Pulpectomy

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.

Pulpectomy


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

miércoles, 4 de noviembre de 2020

Pulpectomy: Clinical Tips and Tricks in Paediatric Dentistry

Pulpectomy

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.

Webinar


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

lunes, 20 de julio de 2020

PULPECTOMY procedures in primary molar teeth

Pulpectomy

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.

Oral Medicine


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?

sábado, 13 de junio de 2020

Management of Endodontic Emergencies: Pulpotomy Versus Pulpectomy

Endodontic

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.

Endodontic


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?

martes, 2 de junio de 2020

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

Pulp Therapy

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.

Endodontics


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

viernes, 22 de mayo de 2020

What is the difference between pulpotomy and pulpectomy?

Endodontics

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.

Endodontics


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