Pulpotomy vs Pulpectomy
A pulpotomy and a pulpectomy are both procedures designed to preserve the tooth whilst maintaining it for optimal function and aesthetics. Depending on the condition of the tooth and the patient’s symptoms, slight differences may be seen in their respective treatment processes.
A pulpotomy involves the removal of the coronal or upper section of a tooth’s pulp.
The coronal pulp is the region of the tooth located above the gumline.
A Pulpotomy procedure can be performed on teeth that are still viable and show signs of life. This implies there is no:
- Abscess or fistula
- Radiographic analysis revealed bone loss in the areas underneath the roots.
- Spontaneous pain
A pulpotomy, also known as vital pulp therapy, is a procedure designed to restore a tooth to its healthy state.
A Pulpectomy is a dental procedure that involves the thorough removal of infected pulp from all portions of the tooth, including both the pulp chamber and its roots.
A pulpectomy is performed on teeth that have been identified as necrotic or dead.
Irreversible pulpitis is a condition in which a tooth experiences spontaneous pain and bone loss.
Both procedures seek to aid in the restoration of a tooth to its natural functionality, providing an alternative to dental extraction.
What is a Pulpotomy?
A pulpotomy is a common dental procedure employed in pediatric dentistry which is utilized to help preserve primary and permanent teeth that have been severely decayed or cracked.
When a tooth experiences a carious exposure that is deep enough to reach the coronal pulp, or “nerve,” of the tooth, it can lead to the development of pulpitis.
Pulpitis is a condition characterized by inflammation of the dental pulp, which can lead to:
- Sensitivity to hot or cold
- Discomfort when chewing.
A pulpotomy is a procedure that is performed to treat pulpitis, which is:
- Remove the tooth’s dental pulp
- Quickly relieve pain
- Avoid a potential dental infection
What Is a Pulpectomy?
Every tooth consists of an innermost layer known as the pulp, which contains vital elements such as nerves, blood vessels, connective tissues, and other cells. The pulp chamber is vulnerable to infection if the enamel and dentin of the teeth are compromised. It is important to note that the pulp chamber itself is highly sensitive and can be easily affected.
A pulpectomy is a dental procedure that dentists use to remove the pulp from the crown and roots of a patient’s tooth when necessary, such as in cases of severe decay, trauma, or infection. This procedure is often used to save a tooth in these cases.
During a pulpectomy, the dentist will remove all pulp tissue from within the crown and roots of the tooth in order to ensure thorough cleaning. This procedure is followed by filling these areas with a therapeutic filling material.
Pulpectomies, sometimes referred to as “baby root canals” in pediatric dentistry, are procedures performed on children to treat infected primary teeth. A pulpectomy performed by a general dentist may be necessary to save a baby tooth that reserves space for a permanent tooth. If a baby tooth is prematurely lost, it can lead to issues involving chewing, speech development, and shifting teeth.
Pulpotomy Procedure Steps
A pulpotomy treatment may be performed by a:
- General dentist
- Pediatric dentist
The type of dental professional who performs a pulpotomy procedure will depend on the age of the patient and the tooth that requires treatment.
The pulpotomy technique includes the following steps:
- Dental x-ray: A dental x-ray is required to properly assess the need for a pulpotomy and identify any signs of decay in the pulp. Additionally, the x-ray can help determine if a pulpectomy is necessary should there be evidence of bone or tissue loss.
- Local anesthetic: Your dentist will administer a local anesthetic to reduce discomfort during the procedure.
- Isolation: Dentists often utilize an isolation device to prevent the contamination of saliva or blood around an infected tooth. This device may be an intraoral suction tool or rubber dam, which work to separate the afflicted tooth from the rest of the mouth.
- Removal of decay: The decayed area of the tooth will be removed in order to expose the pulp chamber. Subsequently, the coronal pulp shall be amputated. A cotton pellet soaked with ferric sulfate or formocresol may be applied to help regulate bleeding.
- Sealing the tooth: The infected pulp will be removed and the remaining portion of the tooth will be sealed using pulpotomy materials, such as Mineral Trioxide Aggregate (MTA) or Calcium Hydroxide. Clinical studies demonstrate that MTA is a biocompatible material with a high success rate in endodontic treatments, which can be used effectively to restore tooth structure and bone.
- Full coverage: Many patients require a stainless steel crown as a final restoration to protect the tooth, and to provide stability and support when the tooth is weakened or prone to fracture.
Pulpectomy Procedure Steps
A dentist performing a pulpectomy may follow these steps:
- The dentist will take X-rays of the tooth to assess the presence of any infection in the surrounding areas and ascertain the form of the tooth’s root canal system.
- The dentist will administer local anesthesia to ensure the tooth is numb and any discomfort is minimized during the procedure. Some patients may choose to receive sedation such as nitrous oxide or general anesthesia due to dental anxiety.
- The Dentist will typically isolate the targeted tooth by utilizing a rubber dam or intraoral suction device.
- A dental handpiece and instruments will be utilized to remove the decayed portion of the tooth.
- The dentist will then utilize a spoon excavator and other dental instruments to extract the infected pulp from the tooth’s crown and root canal.
- The dentist will clean and disinfect the tooth once all of the pulp has been removed.
- The dentist will then fill the tooth with a material that is compatible with the body.
- The dentist will conclude the pulpectomy by securing a crown, such as a stainless steel or glass ionomer crown, on the tooth in order to avoid any potential infections.
What to Expect After Treatment
The local anesthetic used during treatment may take a few moments to wear off and some sensitivity around the treated tooth can be expected for the next few days. A pulpectomy typically results in a patient being able to return to normal activities involving chewing, eating, and speaking without delay. To manage any post-procedure pain, patients may take an over-the-counter analgesic and apply ice to the treatment site.
If the infection in your tooth is particularly severe, a prescription for antibiotics may be provided following pulpectomy. Additionally, a follow-up appointment may be necessary if the infection is severe.
It is essential to practice good dental care habits by brushing your teeth, flossing, and refraining from chewing hard foods such as candy that may crack your teeth.