Obturation Techniques for Pulpectomy
Pulpectomy is the removal of the inner contents of the pulp along with the roof so that to gain access to root canals that are enlarged, debrided and disinfected. This can be done using various techniques. The obturation techniques for pulpectomy are discussed below in this article. Let us examine them.
Obturation techniques for Pulpectomy
Several techniques have been used for the filling of materials into the deciduous teeth canals.
- 1. The primary teeth with their larger canals may be filled with a thin mix coating on the walls of the root canal with the help of a reamer in a anti-clock wise direction while taking it out slowly followed by the placement of the thicker mix which is then pushed manually.
- 2. Pastes can also be filled by means of a Lentulo spiral mounted on the micro motor hand piece. The direction of rotation needs to be checked for the material to properly flow into the canal.
- 3. The endodotic pressure syringe is also effective for placing the ZEO into the canals. The Vitapex system also uses a syringe with the material in it. The syringe is introduced up to 1/5th the distance from the apex of the canal and the material is slowly injected as the syringe is withdrawn from the canal.
Regardless of the method adopted to fill the canals care should be used to prevent extrusion of the materials into the periapical tissues. The adequacy of the obturation is checked by radiographs. In the event a small amount of the ZOE is inadvertently forced through the apical foramen, it is left alone since the material is resorbable.
When the canals are satisfactorily obturated, fast-set temporary cement is placed in the pulp chamber to seal the ZEO canal filling. The primary tooth is restored with a stainless steel crown.
Follow-up after primary pulpectomy
The rate of success following primary pulpectomy is high. However, these teeth should be periodically checked for success of the treatment and to intercept any problem associated with failure. While resorbing normally without interference with eruption of the permanent tooth, the primary tooth should remain asymptomatic, firm in the alveolus, and free from pathosis. If evidence of pathosis is detected, extraction and conventional space maintenance are recommended.
It has been pointed out that pulpally treated primary teeth may occasionally present a problem of overretention. After normal physiologic resorption of the root reaches the pulp chamber, the large amount of ZEO present may impair the resorption and lead to prolonged retention of the crown. Treatment usually consists of a simple removal of the crown and allowing the permanent tooth to erupt.
The above article discusses briefly about the
obturation techniques for pulpectomy