Pulpotomy Versus Pulpectomy: An Endodontist’s Perspective

a brief review of the two procedures

Pulpotomy and Pulpectomy are both procedures that aim to remove infected or inflamed tissue from the pulpal area of the tooth. The most essential difference between the two is that pulectomy removes tissue from the pulp chamber AND the root canal system of the tooth, while pulpotomy focuses solely on tissue in the pulp chamber. These two procedures are the preferred treatments for both symptomatic irreversible pulpitis (SIP) and symptomatic apical periodontitis, in children. It is important to be able to distinguish which treatment is needed because it can have a profound impact on the maturation of the tooth.

Diagnostic Criteria

As mentioned, symptomatic irreversible pulpitis and symptomatic apical periodontitis are the most common reasons for pulectomy or pulpotomy. Here is a brief definition of the diagnostic terms:

Symptomatic Irreversible Pulpitis (SIP)– This occurs when there is evidence that decay has caused the vital inflamed pulp to be incapable of healing. However, the inflammation has not yet reached the periapical tissues.

Symptomatic Apical Periodontitis (SAP)– This occurs when infection has caused inflammation of tissue within the pulpal area of the tooth, as well as the tooth’s root canal system AND the periapical tissues.

Both SIP and SAP involve symptoms that may include pain upon thermal stimulus, and possibly pain accentuated by postural changes, such as lying down or bending over. However, patients with SAP will experience pain during percussive activities, like biting, whereas patients with SIP will not. The similarities between the two make it difficult to diagnose, and radiographic evaluation may be inconclusive, which may lead to over treatment. That’s why it is beneficial to have us evaluate the problem.

Pulpotomy

Pulpotomy is a potential treatment method for emergency cases of SIP due to caries, large restorations, cracked tooth syndrome or trauma. The procedure requires adequate removal of the inflamed pulp tissue, leveling at the canal opening followed by placement of Mineral Trioxide Aggregate (MTA) directly on the exposed pulp tissue. This is followed by a restotation with IRM or Glass Ionomer. After emergency pulpotomy takes place, the patient will need endodontic follow up, to monitor healing.

Pulpectomy

Pulpectomy is a form of root canal therapy recommended when the infection has traveled throughout the pulpal area and into a tooth’s root canal system. The procedure requires the removal of all tissue within the pulpal area, as well as in the root canals. The resulting space is then filled with special, medicated, dental materials, which while fill not allowing further maturation restore the tooth to its normal function.

It should be noted that in many cases this procedure can be replaced with traditional root canal therapy.

If you have questions about what treatment is best us call and talk to one of our doctors.

About Professional Endodontics

Professional Endodontics has been exceeding the standard of care in Wayne and Macomb counties for over 50 years. The team specializes with treating issues with the inside of the tooth and goes out of its way to provide a safe easy environment for patients. Each member of the practice is dedicated to providing excellence in patient care and values high-quality relationships with referring dentists and specialists. Each endodontist at Professional Endodontics has been individually chosen as Best Dentists. Thanks to contemporary advances in endodontics, Professional Endodontics is able to use innovative technology to treat and save teeth that have suffered damage to the soft tissue within the roots of the tooth.

Professional Endodontics now offers three state-of-the art facilities in Clinton Township, St. Clair Shores, and a fully renovated Southfield location in the Comerica Tower. All locations offer the latest in advanced dental deliver systems, microscopy, and digital radiography.

Professional Endodontics

29201 Telegraph Road

Suite 110

Southfield, MI 48034

(248) 358-2910

http://www.profendo.com

 

2018-02-01T11:47:54+00:00

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