Pulpectomy Procedure Explained in brief

This lecture, which oriented to the level of mind of undergraduate students, discuss the topic of pulpectomy, its indications, contraindications, and procedural steps.
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1. Pulpectomy

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2. Definition

Itis procedure of removal of the entire pulp
and subsequent filling of the canals of primary

teeth with a suitable resorbable material.

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3. Indications

= Primary non-vital tooth, or irreversibly inflammed
tooth

= Minimum apical or periradicular pathology
(2/3 of the root should be available at least)

= Presence of pus at pulp exposure site

= Necrotic pulp

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4. Contraindications

# Non-restorable tooth

= More than 2/3 of the tooth is resorbed

= Periapical pathology involved permanent tooth bud

= External or internal root resorption

= Tooth with extensive mobility

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5. Pulpectomy Procedure

Two types of Pulpectomy procedure present:

One-visit Pulpectomy: indicated for teeth with
no sign of necrosis or abscess

Multi-visit Pulpectomy: indicated for non-vital
teeth with necrotic pulp

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6. One-visit Pulpectomy

x Prepare access cavity and extirpate all pulp tissue
with barbed broaches

= Take a radiograph with a file inside 2-3 mm short
of the apex to confirm working length

= Instrument the canals with files, and irrigate with
sodium hypochlorite

u Fill the root with suitable obturating material
and restore the tooth with final restoration

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7. Obturation Materials

Since we are obturating a primary tooth that will
be resorbed and shed eventually, it is critical to fill
the canal with resorbable obturating material

Never obturate a primary tooth with Gutta-Percha,
because it is not resorbable.

Recommended obturation materials:
Zinc Oxide Eugenol, lodoform, or Vitapex (Calcium

hydroxide mixed with iodoform)

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8. Mulbi-visit Pulpectomy

= Prepare access cavity and extirpate all pulp tissue
with barbed broaches

= Take a radiograph with a file inside 2-3 mm short
of the apex to confirm working Length

= Instrument the canals with files, and irrigate with
sodium hypochlorite

a Fill the root with calcium hydroxide and restore
with temporary filling
= Recall patient after 1 week

a If tooth is asymptomatic, rinse the canal from
calcium hydroxide, fill it with suitable obturation
material and restore permanently.

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9. Pulpectomy Procedure

Necrotic pulp

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10. Pulpectomy Procedure

Instrumentation
of
canals

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11. Pulpectomy Procedure

Tweezers

1)_- Cotton wool

ZOE/Vitapex™

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12. Pulpectomy Procedure

Stainless steel
crown

Hard-setting

zinc oxide/
eugenol cement

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13. Pulpectomy Summary

alt is complete removal of pulp, followed by obturation
= Indication: Non-vital primary tooth

= Contraindication: Non-restorable tooth or possibility
of damage to permanent tooth germ

= Procedure:
One-visit Pulpectomy: Non-vital non-necrotic tooth
Multi-visit Pulectomy: Non-vital necrotic tooth

= Obturation materials: ZOE, lodoform, Vitapex

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14. THANK YOU
+ EB

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