Ahmed Abdulwahab UG: 1330095

SURGICAL METHODS TREATMENTS OF

PULPITIS

SURGICAL METHODS TREATMENTS OF PULPITIS Belong: Vital Extirpation (an exception of pulp is under anesthesia) Devitalization(Mechanism of action of arsenic paste)

VITAL EXTIRPATION Advantages of vital extirpation:

• absence of the toxic operating of arsenic;

• treatment is carried out in one session;

• manipulations in a tooth are not sickly.

Disadvantages of vital extirpation :• a risk of complications is during conducting of anesthesia

• bleeding from a channel

• origin of pain at bitibg as a result of formation of hematoma in a periapical

• development of remaining root pulpitis

Indications of Vital Extirpation o all total forms of pulpitiso pulpits which treated oneself biological methods, but there was complication;

o at localization of carious cavity in a vestibular area or in cement of root of tooth;

o intact teeth which it is necessary depulpation after orthopaedic

o at treatment of teeth under bridge prosthetic appliances;

o general paradontitis especially before surgical interference.

Contraindication of Vital Extirpation • unbearable to apply anesthetics

• grave somatic condition of patient, declining years;

• for patients with the broken psyche;

• in the last and in the first weeks of pregnancy (if there is a threat of abortion)

• for patients with the viral and bacterial infections of oral mucous membrane and nose;

• children with the uncompleted forming of roots;

• anatomic features of roots (curvature, bend) of some groups of teeth.

Methods of vital extirpation • hygiene of cavity of mouth

• anaesthetizing

• Rubber dum

• a carious cavity is prepared and wash

• perforation the vault of cavity the sterile spherical drill and fissured extend it

• by antiseptic solutions wash blood, tailings of pulp

• extend the channels of roots;

• by pulpextractor (files) extraction the pulp.

The index of complete exception of pulp is:• a) presence of whole pulp.

• b) absence of pain.

• c) absence of bleeding.

DEVITALIZATION

Arsenic acid (As2O3) is one of strong poisons

Arsenic acid (anhydride) is used as paste.

Such components enter in composition of arsenic paste:

- antiseptics;

- anesthetic matters (cocaine and other);

- arsenic acid;

- astringent facilities

Directions for use:• Before usage good mixing of the paste is recommended.

• Apply arsenic paste to the opened pulp of the tooth: one-rooted tooth for 24 hour, multiple rooted 48 hour.

• The paste is well-absorbed both direct contact with the pulpar tissue

• Apply little quantity of the paste on bottom of the tooth cavity, near the mouth.

• Cover carious cavity of the tooth without pressure with semiliquid artificial dentin.

• Open after 24/48 hour and remove the pulp.

THANK YOU FOR YOUR ATTENTION