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When the dental pulp became infected or affected, and the coronal portion of the pulp lost its vitality, while the radicular portion is still vital… Amputation of the coronal portion and treatment of the remaining radicular portion should preserve the vitality of the remaining pulp tissue.

So that it is considered "vital pulp therapy", as the remaining pulp tissue is still vital.

Contents 1 Indications 1.1 Primary teeth 1.2 Permanent teeth 2 Different types of pulpotomy 2.1 Partial Pulpotomy for Carious Exposures 2.2 Partial Pulpotomy for Traumatic Exposures (Cvek Pulpotomy) 3 Medicaments can be used in pulpotomy 4 Alternative pulpotomy techniques 4.1 Electro-surgery pulpotomy 4.2 Laser pulpotomy 5 Objectives 6 See also 7 References

[edit] Indications

[edit] Primary teeth

When the coronal tissue is infected, it can be amputated and the remaining radicular tissue is judged to be intact, or affected but still vital.

A suitable base is applied to the coronal part, and the tooth restored.

[edit] Permanent teeth

Pulpotomy is undertaken in permanent teeth when time constraints or economic reasons prevent immediate conventional root canal therapy.

[edit] Different types of pulpotomy

[edit] Partial Pulpotomy for Carious Exposures

In a young permanent tooth for a small carious pulp exposure and the tooth is diagnosed to be vital. If the tooth was having immature roots, after partial pulpotomy it should successfully complete its development.

[edit] Partial Pulpotomy for Traumatic Exposures (Cvek Pulpotomy)

it is indicated for a vital, traumatically exposed, primary teeth or young permanent teeth. Traumatic exposure may occur as a result of accidents, sports or any other cause that may lead to fracture and pulp exposure of the tooth.

[edit] Medicaments can be used in pulpotomy

In primary teeth… medicaments such as 1. formocresol 2. Ferric sulphate 3. Calcium hydroxide can be used in pulpotomy.

Although, clinical and radiographic success rate of ferric sulphate is higher than the other materials.

[edit] Alternative pulpotomy techniques

[edit] Electro-surgery pulpotomy

It is known as non chemical devitalization. Its mechanism of action is the cauterization of the pulp tissue. It carburizes heat denaturated pulp and bacterial contamination.

[edit] Laser pulpotomy

This technique overcomes histological effect of electro surgery. It creates superficial zone of coagulation necrosis that remain compatible with underlying tissue& isolate pulp from vigorous effects of the sub-base.

[edit] Objectives

1. Maintenance of radicular portion vitality.

2. Clinical and radiographic evaluation should show no complications such as, pain, swelling, internal resorption or abnormal canal calcification.

3. Neither breakdown of the supporting tissue, nor trauma to succedaneous teeth should be detected.

[edit] See also

Pulpectomy

Root canal therapy

[edit] References

American Academy of Pediatric Dentistry website [1] [2]