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

lunes, 9 de junio de 2025

Pulpotec® in Pulpotomy: Composition, Indications, Protocol & Clinical Pros and Cons

Pulpotec

Pulpotec® is a radiopaque, non‑resorbable medicament widely used for pulpotomy/pulpitis treatment in vital primary and immature permanent molars, as well as for emergency root canal dressings.

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This in-depth article reviews its composition, clinical indications, advantages, disadvantages, and a standardized application protocol. Information is supported by recent clinical evidence.

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1. Composition
Pulpotec® is a two-part resinous paste comprising:

➤ Powder: polyoxymethylene, iodoform, and zinc oxide.
➤ Liquid: dexamethasone acetate, formaldehyde, phenol, guaiacol, and excipients.

These components combine to yield antimicrobial, anti-inflammatory, hemostatic, and soothing effects.

2. Indications
Pulpotec® demonstrates broad clinical applications:

➤ Primary molars: vital or mildly infected, including cases with abscess when pulpotomy is indicated.
➤ Immature permanent molars: to facilitate continued root development.
➤ Permanent molars in adults: pulpitis treatment or as a prep for abutments in prosthetics.

It is also effective in emergency intracanal dressings to relieve pain and swelling across multiple appointments.

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Video 🔽 Technique for Primary Molar Tooth Pulpotomy ... Pulpotomy is a treatment performed on deciduous teeth, when caries has generated an infection that compromises the dental pulp and the integrity of the tooth
3. Advantages
Clinical studies support Pulpotec® due to its:

➤ High success rates: Clinical success of 93–100% and radiographic success of 83–100% in pulpotomies; compared favorably with MTA and formocresol.
➤ Rapid symptom relief: 80–100% of patients report immediate pain reduction; flare-ups post-op are rare (~1%).
➤ Ease of use and efficiency: Simplifies emergency endodontic treatment and supports long-term pulp health.

4. Disadvantages
Potential drawbacks include:

➤ Non‑resorbability: This may complicate exfoliation in primary molars.
➤ Formaldehyde content: Concerns over toxicity and rare allergic reactions.
➤ Limited histological regeneration: It promotes sclerosis rather than dentin bridge formation.
➤ Need for coronal seal: Success depends on proper restoration to prevent microleakage.

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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
5. Step-by-Step Clinical Use Protocol

Step 1. Diagnose pulpitis suitable for vital pulp therapy.
Step 2. Anesthetize and isolate the tooth (rubber dam recommended).
Step 3. Access and remove coronal pulp to canal orifice level.
Step 4. Irrigate with 5% NaOCl; dry chamber.
Step 5. Prepare a salin-damped sterile cotton pellet; confirm bleeding control.
Step 6. Insert Pulpotec® paste into chamber (or canal up to ~5 mm from apex in root-filled cases) using a file.
Step 7. Place a dry cotton pellet and temporary restorative material (e.g., IRM/Cavit).
Step 8. Schedule recall after 7 days; proceed to definitive restoration—ideally stainless steel crown or adhesive restoration.
Step 9. Evaluate post-op pain at intervals (8 h, 24 h, 48 h, 3 d, 1 wk).

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6. Clinical Evidence

➤ Prospective RCT (860 teeth): Pulpotec® intracanal dressing reduced incidence of inter-appointment flare-up to 1.16% at 24 h and 0.69% at 48 h, with complete pain relief by 7 days.
➤ Comparative pediatric studies:
° Pulpotec® and MTA showed 100% clinical success at 3–9 months; radiographic success favored Pulpotec® (100%) over MTA (92.9%) and formocresol (78.6%).
° At 24 months, radiographic success was 94.3% for Pulpotec®, 91.2% for MTA, 83.3% for formocresolile cotton pellet; confirm bleeding control.

💡 Conclusion
Pulpotec® is an effective and efficient pulpotomy and intracanal medicament providing high clinical and radiographic success, rapid pain relief, and broad indications. However, formaldehyde content and non-resorbability in primary teeth demand careful case selection and precise restoration. Clinicians should weigh its benefits and limitations against alternatives such as MTA or Biodentine.

📚 References

✔ Al-Dahan, Z. A. A., Zwain, A. M., & Haidar, A. (2013). Clinical and radiographical evaluation of pulpotomy in primary molars treated with Pulpotec®, Formocresol, and Mineral Trioxide Aggregate (MTA). Journal of Bagh College Dentistry, 25(4), 164–170.

✔ Faraj, B. M. (2013). Four years of clinical experience with the efficacy of Pulpotec® as a root canal dressing for the management and control of odontogenic pain: A prospective randomized clinical trial. Open Access Emergency Medicine, 12(4), 280–283.

✔ Karrem, M. A. (2012). Clinical and histopathological evaluation of different pulpotomy agents in primary teeth. Iraqi Academic Scientific Journal.

✔ Maslak, E. E., et al. (2020). Pulpotomy efficiency in primary molars: Outcomes of 24‑month randomized clinical trial. Tanta Dental Journal, 17(1), 9–14.

✔ Pulpotec®. (n.d.). Scientific data about Pulpotec® – Swiss solution for pulpotomy. Retrieved from pd-pulpotec.com

✔ Sandhu, S. S., & Nanda, S. (2013). Dental pulp response to collagen and Pulpotec cement. Journal of Conservative Dentistry, PMC3778626.

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viernes, 6 de junio de 2025

Medications Used in Pulpotomies: Properties, Drawbacks, and Brand Names

Pulpotomy

Pulpotomy is a conservative dental procedure aimed at preserving the vitality of the radicular pulp after removing the affected coronal pulp. This treatment is common in primary teeth and young permanent teeth.

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Selecting the right medication is crucial for clinical success. Below is an overview of the most commonly used pulpotomy agents, their properties, drawbacks, and commercial names.

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1. Formocresol

➤ Brand Name: Buckley’s Formocresol
➤ Composition: 19% formaldehyde, 35% cresol, 15% glycerin, 21% water
➤ Properties:
° Bactericidal and tissue-fixative agent
° Mummifies remaining pulp tissue
° Easy to handle and low cost
➤ Drawbacks:
° Potentially carcinogenic and mutagenic
° Cytotoxic and allergenic
° Does not promote pulp tissue regeneration
➤ Clinical Notes:
° Although historically effective, its use has declined due to toxicity concerns.

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2. Ferric Sulfate

➤ Brand Name: Astringedent®
➤ Composition: 15.5% aqueous solution of ferric sulfate (pH 1.0)
➤ Properties:
° Effective hemostatic agent
° Forms a protein barrier sealing blood vessels
° Affordable and easy to apply
➤ Drawbacks:
° Does not promote pulp regeneration
° May cause radicular inflammation and resorption
➤ Clinical Notes:
° A less toxic alternative to formocresol, but with variable long-term success.

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3. Calcium Hydroxide (Ca(OH)₂)

➤ Brand Name: Dycal®
➤ Properties:
° Stimulates reparative dentin formation
° Highly alkaline with bactericidal effect
° Biocompatible
➤ Drawbacks:
° May cause superficial pulp necrosis
° Lower success rate in primary teeth
° Tends to dissolve over time
➤ Clinical Notes:
° More suitable for young permanent teeth; limited use in primary dentition.

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4. Mineral Trioxide Aggregate (MTA)

➤ Brand Name: ProRoot® MTA
➤ Composition: Tricalcium silicate, dicalcium silicate, tricalcium aluminate, bismuth oxide
➤ Properties:
Highly biocompatible
Stimulates dentin formation
Excellent sealing and antimicrobial properties
➤ Drawbacks:
High cost
Difficult manipulation and long setting time
➤ Clinical Notes:
Studies report a 97.9% clinical success rate in pediatric pulpotomies, outperforming other agents.

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5. Biodentine

➤ Brand Name: Biodentine®
➤ Composition: Tricalcium silicate, dicalcium silicate, calcium oxide, calcium chloride, zirconium oxide
➤ Properties:
° Bioactive dentin substitute
° Mechanical properties similar to natural dentin
° Fast setting time and good radiopacity
➤ Drawbacks:
° High cost
° Limited long-term clinical evidence compared to MTA
➤ Clinical Notes:
° A promising MTA alternative with easier handling and shorter setting time.

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6. Zinc Oxide Eugenol (ZOE)

➤ Brand Name: IRM® (Intermediate Restorative Material)
➤ Properties:
° Soothing effect on dental pulp
° Antimicrobial and anti-inflammatory properties
° Easy to handle and inexpensive
➤ Drawbacks:
° Does not induce reparative dentin formation
° May dissolve over time
➤ Clinical Notes:
° Commonly used as a base or sealing material in pulpotomies.

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7. Pulpotec® Paste

➤ Brand Name: Pulpotec®
➤ Composition:
° Powder: Polyoxymethylene, iodoform
° Liquid: Dexamethasone, formaldehyde, phenol, guaiacol
➤ Properties:
° Induces healing of the pulp stump
° Aseptic and quick treatment
° Effective in both primary and permanent teeth
➤ Drawbacks:
° Contains formaldehyde, which has cytotoxic potential
° Not resorbable
➤ Clinical Notes:
° Long-term success reported in studies, though formaldehyde content limits its use in some cases.

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💡 Conclusion
The choice of pulpotomy medication must be based on a careful evaluation of its properties, disadvantages, and available clinical evidence. While formocresol has been widely used, toxicity concerns have led to the rise of safer and more effective alternatives like MTA and Biodentine. The ideal agent depends on factors such as the patient's age, tooth condition, and specific clinical considerations.

📚 References

✔ Holguin Garcia, S. G. (2019). Eficacia clínica del MTA en Pulpotomías de pacientes pediátricos: Una Revisión Sistemática. Revista de Odontopediatría Latinoamericana, 11(1). https://doi.org/10.47990/alop.v11i1.228

✔ Wikipedia. (2025). Pulpotomía. Retrieved from https://es.wikipedia.org/wiki/Pulpotom%C3%ADa

✔ Apuntes De Odontología. (2015). Pulpotomía. Retrieved from https://apuntes-de-odontologia.blogspot.com/2015/04/pulpotomia.html

✔ Studocu. (2018). Terapia Pulpar I – Dra. Andrea Cárdenas Antonieta Montero. Retrieved from https://www.studocu.com/cl/document/universidad-finis-terrae/odontopediatria/terapia-pulpar-i/4935194

✔ Revista Odontopediatría. (2014). Tratamiento Endodóntico no Instrumentado en dientes deciduos. Retrieved from https://backup.revistaodontopediatria.org/ediciones/2014/1/art-6/

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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.

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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.

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

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📌 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

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jueves, 16 de junio de 2022

What is the best pulp dressing for pulpotomies in primary teeth? - Review

Pulpotomy

Caries is an infectious process that affects the dental structure and compromises the pulp, putting the vitality and permanence of the tooth at risk. Pulpal therapies in primary dentition have as main objective to maintain the tooth until its natural exfoliation.

Pulpotomy removes the pulp from the pulp chamber and places a dressing to stop bleeding and mummify the entrance to the radicular pulp. This procedure maintains the vitality of the primary tooth.

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Different pulp dressings have been used in pulpotomies, each with different characteristics and properties. The article we share compares all pulp dressings to determine which is the most effective.

Endodontics


👇 READ AND DOWNLOAD THE ARTICLE "What is the best pulp dressing for pulpotomies in primary teeth? - Review" IN PDF 👇



Bossù, M., Iaculli, F., Di Giorgio, G., Salucci, A., Polimeni, A., & Di Carlo, S. (2020). Different Pulp Dressing Materials for the Pulpotomy of Primary Teeth: A Systematic Review of the Literature. Journal of clinical medicine, 9(3), 838. https://doi.org/10.3390/jcm9030838

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viernes, 25 de febrero de 2022

Pulpotomy: Diagnosis, types and procedure

Pulpotomy

Pulpotomy is a dental procedure that is performed on a primary tooth that is observed through an X-ray that the caries is close to the dental pulp. This treatment can be performed on primary dentition as well as permanent dentition.

During the procedure, the caries and the dental pulp are partially removed, thus maintaining the vitality and permanence of the primary tooth in the mouth.

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We share a video that offers us details of the pulpotomy: diagnosis, indications, contraindications, procedure and types of pulpotomy.

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lunes, 16 de agosto de 2021

Pulpotomy of Deciduous Molar - Step by step

Pulpotomy

Pulpotomy is the dental treatment that is responsible for partially removing the dental pulp affected by caries or dental trauma. Unlike the pulpectomy that completely removes the dental pulp.

We invite you to our English-only dental publishing groups

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To carry out this treatment, a clinical and radiographic evaluation must be carried out to know what the level of involvement of dental caries is. Once this treatment is finished, the restoration of the tooth must be carried out.

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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.

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martes, 11 de agosto de 2020

Pulpotomy Medicaments used in Deciduous Dentition: An Update

Pulpotomy

The aim of this paper was to review the history and the scientific literature published on pulpotomy medicaments and to present the findings of these studies.

We invite you to our English-only dental publishing groups

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The review showed that pulpotomy of primary teeth has been treated with many different techniques and medicaments, that some of these approaches are controversial and that their results have presented variables of success rates in term of clinical, radiographic and histologic observation.

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It is important that all clinicians, particularly for pediatric dentists, be up to date with the recent trends in this area of dental treatment for children. Vital pulpotomy is the clinical treatment of choice for primary teeth with exposed pulp. Pulpotomy can be defined as the surgical removal or amputation of the coronal pulp of the vital tooth.

Oral Medicine


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.



Souce / Author: Al-Dlaigan YH. Pulpotomy Medicaments used in Deciduous Dentition: An Update. J Contemp Dent Pract 2015;16(6):486-503.

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miércoles, 29 de julio de 2020

Technique for Primary Molar Tooth Pulpotomy

Pulpotomy

Pulpotomy is a treatment performed on deciduous teeth, when caries has generated an infection that compromises the dental pulp and the integrity of the tooth.

We invite you to our English-only dental publishing groups

🎯 WhatsApp Group All Odontology
🎯 Telegram Group All Odontology
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The treatment of dental pulp is not only carried out when there is caries, it is also carried out when the tooth is blown. Pulpotomy is one of the most frequent procedures performed in dental practice.

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In pulpotomy, the dental pulp must be partially removed, this treatment is performed under local anesthesia. We invite you to watch this video where the procedure of a pulpotomy is exposed.

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sábado, 20 de junio de 2020

An update on primary teeth pulpotomy medicaments

Endodontic

The aim of this paper was to review the history and the scientific literature published on pulpotomy medicaments and to present the findings of these studies.

We invite you to our English-only dental publishing groups

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

The review showed that pulpotomy of primary teeth has been treated with many different techniques and medicaments, that some of these approaches are controversial and that their results have presented variables of success rates in term of clinical, radiographic and histologic observation.

Enlaces Patrocinados

It is important that all clinicians, particularly for pediatric dentist, be up to date with the recetn trends in this area of dental treatment for children.

Endodontic


Vital pulpotomy is the clinical treatment of choice for primary teeth with exposed pulp. Pulpotomy can be defined as the surgical removal or amputation of the coronal pulp of the vital tooth.



Souce: The Journal of Contemporary Dental Practice
Author: Yousef H Al-Dlaigan

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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).

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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.

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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)

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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.

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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


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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.

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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.

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