Abstract
Background: Exposure of the pulp by caries is often accompanied by chronic inflammation in the immediate area of the carious lesion and localized abscess formation. Direct pulp capping and vital pulpotomy are two accepted clinical modalities to preserve tooth vitality in cases of pulp exposure in carious young permanent teeth but the success rates are often less than 50%. Case report: A 13 year old boy presented with an immature and grossly carious 37. Having already lost 36 a decision was made to maintain 37. Treatment: A cervical pulpotomy was initiated using local analgesia. All the inflamed, contaminated pulp tissue in the pulp chamber to the level of the radicular pulp stumps was removed and a cervical pulpotomy was carried out. Following haemostasis the radicular pulp stumps were coveredwith non-setting calcium hydroxide then setting calcium hydroxide, and the tooth restored temporarily with zinc oxide and eugenol cement. Follow-up: At 26 months following the pulpotomy, the molar had been symptomless and there were no clinical signs of infection or inflammation. Radiographically root development of 37 was complete, the lamina dura was continuous apically and the root canals were partially sclerosed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Barthel CR, Rosenkranz B, Luenberg A, Roulet JF. Pulp capping of carious exposures: treatment outcome after 5 and 10 years: a retrospective study. J Endod 2000 Sep;26(9): 525–528.
Baume LJ and Holz J. Longterm clinical assessment of direct pulp capping. Int Dent J 1981 Dec;31(4): 251–60.
Cox CF. Bergenholtz G, Fitzgerald M, et al. Capping of the dental pulp mechanically exposed to the oral microflora. A 5 week observation of wound healing in the monkey. J Oral Pathol 1982 Aug;11(4): 327–39.
Cox CF. Bergenholtz G, Heys DR, et al. Pulp capping of dental pulp mechanically exposed to oral microflora:-a 1–2 year observation of wound healing in the monkey. J Oral Pathol 1985 Feb;14(2): 156–68.
Cvek M. A clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fracture. J Endod 1978 Aug; 4(8): 232–237.
Cvek M, Granath L, Cleaton-Jones P, Austin J. Hard tissue barrier formation in pulpotomised monkey teeth capped with cyanoacrylate or calcium hydroxide for 10 and 60 minutes. J Dent Res 1987 Jun;66(6): 1166–74.
Hallett GE, Porteous JR. Fractured incisors treated by vital pulpotomy. A report on 100 consecutive cases. Br Dent. J.1963; 115: 414–26.
Jacobsen I, Kerekes K. Longterm prognosis of traumatized permanent anterior teeth showing calcifying processes in the pulp cavity. Scand J Dent Res 1977 Nov;85(7): 588–98.
Klein H, Fuks A, Eidelman E, Chosack A. Partial pulpotomy following complicated crown fracture in permanent incisors: A clinical and radiographic study. J Pedod 1985 Winter; 9(2): 142–147.
Langeland K, Dowden WE, Tronstad L, Langeland LK. Human pulp changes of latrogenic origin. Oral surg Oral Med Oral Pathol 1971 Dec; 32(6): 943–80.
Lundberg M, Cvek M. A light microscopy study of pulps from traumatized permanent incisors with reduced pulpal lumen. Acta Odontol Scand 1980; 38(2): 89–94.
Mass E and Zilberman U. Clinical and radiographic evaluation of partial pulpotomy in carious exposure of permanent molars. Paediatr Dent 1993 Jul–Aug; 15(4): 257–259.
Mass E, Zilberman U, Fuks AB: Partial pulpotomy: Another treatment option for cariously exposed permanent molars. J Dent Child 1995 Sept–Oct; 62(5): 342–5.
Massler M. Preserving the exposed pulp. J Pedod 1978 Spring; 2(3): 217–27.
Massler M. Pulp curettage: A review. J Dent Child 1959 26: 154–157
Mejare I, Cvek M. Partial pulpotomy in young permanent teeth with deep carious lesions. Endod Dent Traumatol 1993 Dec; 9(6): 238–42.
Patterson SS. Pulp calcification due to operative proceedures — pulpotomy. Int. Dent. J. 1967 Jun;17(2): 490–505.
Robertson A. Andreasen FM Bergenholtz G, Andreasen JO, Noren JG. Incidence of pulp necrosis subsequent to pulp canal obliteration from trauma of permanent incisors. Endod 1996 Oct; 22(10): 557–60.
Schroder U, Szpringer-Nodzak M, Janicha J, et al. A one year follow-up of partial pulpotomy and calcium hydroxide capping in primary molars. Endod Dent Tramatol 1987 Dec; 3(6): 304–6.
Seltzer S, Bender IB The dental pulp, 2nd ed., Philadelphia, JB Lippincott Co, pp 172–176, 252–256, 318–320, 1975
Zilberman U, Mass E, Sarnat H. Partial pulpotomy in carious permanent molars. Am J Dent 1989 Aug; 2(4):147–50.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mc Donnell, S.T., Kinirons, M.J. Case Report: Pulpotomy in an Immature Cariously Exposed Second Permanent Molar. Eur Arch Paediatr Dent 8 (Suppl 1), 26–29 (2007). https://doi.org/10.1007/BF03262606
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03262606