Pulpotomy is not indicated in-
Correct Answer: Small pulp exposure since 1 hour
Description: If the patient is seen within an hour or two after the injury, if the vital exposure is small, and if sufficient crown remains to retain a temporary restoration to support the capping material and prevent the ingress of oral fluids, the treatment of choice is direct pulp capping.
If the pulp exposure in a traumatized, immature permanent (open apex) tooth is large, if even a small pulp exposure exists and the patient did not seek treatment until several hours or days after the injury, or if there is insufficient crown remaining to hold a temporary restoration, the immediate treatment of choice is a shallow pulpotomy or a conventional pulpotomy.
A shallow or partial pulpotomy is preferable if coronal pulp inflammation is not widespread and if a deeper access opening is not needed to help retain the coronal restoration.
Pulpotomy is also indicated for immature permanent teeth if necrotic pulp tissue is evident at the exposure site with inflammation of the underlying coronal tissue, but a conventional or cervical pulpotomy would be required.
Yet another indication is trauma to a more mature permanent (closed apex) tooth that has caused both a pulp exposure and a root fracture. In addition, a shallow pulpotomy may be the treatment of choice for a complicated fracture of a tooth with a closed apex when definitive treatment can be provided soon after the injury.
Category:
Dental
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