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