Pulpotomy is a dental procedure that includes removing only the coronal part of the dental pulp, followed by applying a therapeutic agent. This procedure is performed in order to maintain the vitality of the other part of the pulp that is present in the root canals. It is very commonly used for primary teeth if they cannot be extracted at the time, teeth without abscess, vital teeth with healthy periodontium, no persistent pain and more.
This is a procedure that is meant to remove only the affected part of the pulp, without damaging the part in the root canals. That way the tooth stays connected to the blood vessels and nerve endings and is still considered to have vital functions. If the dentist extirpates the whole pulp, the tooth will not be vital anymore. The thing about pulpotomy is that dentist cannot be always sure whether a certain tooth can be saved with this procedure. The can’t be 100% sure whether the inflammation and infection are only localized and limited to the coronal part of the pulp. If they are, then a pulpotomy can be performed. Pulpotomies of permanent teeth are not as popular as the ones performed on baby teeth.
The most common use of is for primary teeth. These teeth are very easily affected by caries because of their large pulp. Bacteria can easily reach the pulp and cause inflammation and infection. Once this happens, primary teeth cannot be treated the same way as the adult. This is because deciduous teeth have numerous functions in the mouth and have to stay there until the time when they will be replaced with adult ones. Also, the roots of baby teeth start erupting at one point, so all of the materials used have to be biocompatible in order to prevent damage to the gem of the permanent tooth. The only way to do it is to perform a pulpotomy. All of the medicaments used for this procedure are perfectly safe and serve as a therapeutic dressing that protects the remaining pulp tissue.
Other uses include a tooth that has a perfectly healthy surrounding periodontal tissue, artificially exposed pulp, teeth with a root length of 2/3 if the pulp communication is minimal and not infected and more.
There are two types of pulpotomy: vital and non-vital. The first one is preferable because it shows higher scientific success rates if it is possible to use it. The materials used are formocresol, Gysi paste, MTA, Ferric Sulfate, glutaraldehyde, and more. The first thing the dentist will do is to remove caries if present and form a cavity to access the coronal pulp. The following step includes the removal of the coronal pulp and covering the radicular entrances with a medicament. These medicaments are supposed to support and stimulate the health of the remaining vital tissue. There are also two other ways to perform a pulpotomy. One of those includes a surgical electro knife, while the other one is the most advanced way by using a dental laser.