1. بسمِ اللهِ الرَحمنِ الرَحيم

2. PULPECTOMY

3. PULPECTOMY Justification
Pulpectomy -general
PULPECTOMY
Complete removal of necrotic pulp tissue from the root canals and coronal portion of devital primary teeth to maintain the tooth in the dental arch
Justification
Removal of diseased tissue
Space management

4. INDICATIONS 1. Strategically important tooth
Pulpectomy -general
INDICATIONS
1. Strategically important tooth
(in case of the deciduous second molar where the permanent first molar
has not erupted)
2. Irreversible pulpits
3. Minimal periapical changes with sufficient bone support
4. At least 2/3rd of the root length available
5. Internal resorption without any obvious perforation

5. CONTRAINDICATIONS 1. Excessively mobile and/or reduced bone support
Pulpectomy -general
CONTRAINDICATIONS
1. Excessively mobile and/or reduced bone support
2. Non restorable tooth
3. Internal resorption of the pulp chamber and root canal
4. Underlying dentigerous or follicular cyst
5. Pathology extending to the developing permanent tooth bud
6. Less than2/3rd of root length remaining
7. Perforation of pulpal floor
8. Medically compromised children

6. The procedure of pulpectomy can be performed in :-- 1. Single-visit
Pulpectomy -general
The procedure of pulpectomy can be performed in :--
1. Single-visit
2. Multi-visit
Single-visit Partially vital pulp
Multi-visit Non-vital pulp

10. VARIOUS CAPPING MATERIALS
REACTION OF THE PULP TO
VARIOUS CAPPING MATERIALS

11. Pulpotomy in primary teeth
Big clinical problem ?
CMCP

12. Gutta Percha 2. Iodoform paste 3. Calcium hydroxide
Filling of the primary root canals
Gutta Percha
Not indicated for primary teeth
Since it is not a resorbable material, its use is contraindicated in primary teeth
No material currently available meets al the criteria
The filling material most commonly used for primary pulp canals are :
1. Zinc oxide - Eugenol paste
2. Iodoform paste
3. Calcium hydroxide

16. Standard

17. Stainless Steel Crown

18. Introduction
It is a semi-permanent restoration used in primary & young permanent teeth .
It was introduced as chrome-steel crowns by Humphrey in 1950.
Now it is commonly called as stainless steel crown.
The stainless steel crown is used more frequently in deciduous dentition because of two reasons:-

19. 1st in a relatively small deciduous teeth neglected carious can destroy tooth’s integrity faster than in large teeth in permanent dentition.
2nd the deciduous teeth pulp is larger than permanent pulp whereas the enamel and dentin is less in thickness, thus it is difficult to make dentinal stump for a gold casting or to use a pin system of retention for more extensive amalgam restoration.

20. ? Composition Stainless Steel Crowns 17-19% chromium 10-13% nickel
67% iron
4% minor element
These crowns are available in various sizes.
Mostly these crowns are used in posterior teeth which undergone pulp therapy…....why??? ?

21. Indication of SSC Extensive decay in primary & young permanent teeth.
For teeth deformed by developmental defects or anomalies.
For teeth with hypoplastic defects.
Following pulp therapy.
As preventive restoration.
As an abutment.
Temporary restoration of a fractured tooth.
In sever cases of bruxism.

22. Factor to be considered in preoperative
Dental age of the patient.
Cooperation of the patient.
Motivation of the parents.
Medically compromised/disabled child.

23. Tooth preparation L.A. should be administrated
Isolation by rubber dam or cotton rolls
Remove the decay

25. Crown contouring
Initial crown contouring is performed with a 114 plier in the middle 1/3rd of the crown to produce a belling effect.
This will give the crown a more even curvature.
Crown crimping
The tight marginal fit aids in:
Mechanical retention of the crown.
Maintenance of gingival health.
Protect of cement from exposure to oral fluids.

26. Crown contouring

27. Cementation
SSC should be cemented only on clean dry mouth, isolation of teeth with cotton roll is recommended.
Rinse and dry the crown inside & out side and prepare to cement it.
A zinc phosphate, polycarboxylate or GIC is preferred.

28. Before the cements set ask the patient to close into centric occlusion by applying pressure through a cotton roll and confirm that the occlusion has not been altered.
Remove the excess cement by an explorer or scaler & for interproximal area can be cleaned by passing dental floss through them.

29. Clinical case

30. السلام عليكم
ورحمة الله
وبركاته