Difference between pulpotomy and pulpectomy

1. Difference between pulpotomy and pulpectomy M.Owais Final year BDS

2. Pulpotomy It is defined as the removal of coronal portion of pulp followed by placement of medicament

3. Indications Large proximal carious lesion with involvement of marginal ridge No history of spontaneous pain Absence of abscess or fistula Where extraction is contraindicated Vital tooth with healthy peridontium

4. Procedure Apply L.A and rubber dam Remove the carious lesion Access the pulp chamber As soon as dip is felt don’t go deep but side to side to extend roof Remove coronal pulp by round bur or excavator Apply medicament

5. Remove cotton pledget and check for excessive haemorrhage Fill chamber with zinc oxide eugenal Place coronal restoration Place stainless steel crown

6. Materials use for medicament Formocresol Ferric sulphate

7. Contraindications Presence of abscess and fistula Radicular pulp involvement Inter radicular bone loss Caries penetrating to floor of pulp chamber

8. Pulpectomy A pulpectomy is a dental procedure in which all of the material in the pulp chamber and root canal of a tooth is removed.

9. Indications Irreversible pulpitis involving both coronal and radicular pulp Non-vital primary molars or incisors that need to be maintained in arch Abscessed primary molars Primary molars with radiographic evidence of furcation pathology

10. Procedure

11. Contraindications Teeth with non-restorable crowns Extensive pulp floor opening into the bifurcation Excessive internal resorption Primary teeth with underlying dentigerous or follicular cysts