Pulpitis treatment

Most often used necrotization pulp arsenic paste (Ac. arsenicosi 3,0, Cocaini hydrochlorici, Thymoli aa 0,5) with subsequent complete or partial removal of necrotic pulp. A technique for applying the paste: after preparation of the cavity of the tooth isolated from saliva cotton rollers, carious cavity are dried on its bottom put a tampon with twilight liquid for 2-3 minutes, then a small spherical sterile boron or sharp tip draw out the pulp. Paste is applied on the tip of the probe in the amount equal to the volume of the largest globular head of boron №1, and from above impose the loose cotton swab with the anesthetic substance (cocaine, clove oil, eugenol and other).
The carious cavity is closed without pressure liquid mixed with artificial dentin. Special attention should be paid to the bandages on the cavity located on the contact surfaces (pradeshiya). When megerotica imposed bandage arsenious acid can get on the surrounding tooth tissue that causes necrosis of them. The second visit appointed within 24 hours after applying the paste in cases of treatment of single-rooted teeth and after 48 hours. in the treatment of malocclusion.
Treatment is carried out by the method of partial (amputation) or full (extirpation), the removal of the pulp. Amputation method is usually carried out in the teeth of rugged root canals. Remove only the crown part of the pulp after its leaf tissue becoming necrotic. Radicular pulp is exposed to various pastes containing principally formaldehyde, which should prevent the spread of the inflammatory process on the periodontium. Where possible, remove the entire pulp and root canals after mechanical and medical treatment sealed (see the Fillings).
Remove the pulp and can under local anesthesia. The advantage of this method is the ability to finish the treatment of pulpitis in one visit. The disadvantages of the method is the possibility of haematoma in okolovrusno field as a result of bleeding.
A widely used method leaf tissue becoming necrotic pulp diathermocoagulation (see) is especially effective when pulpitis in single-rooted teeth, because thanks to the wide channels pulp can coagulate completely (coagulation pulp is only in place of direct contact with her electrode). After anesthesia dissect carious cavity and reveal the cavity, remove the crown pulp and coagulated root, for which an active electrode (root needle )is introduced into the mouth of the channel and includes talk. The passive electrode fixed on the wrist. The needle to promote apical opening of the channel and display back, after which the current is switched off. The whole process of coagulation of the pulp lasts 2-3 seconds. In molars pulp coagulated separately in each of the root canal. After coagulation pulp in the form of a white strand delete pulextrusion, the canals are treated with hydrogen peroxide, alcohol, ether and sealed.
Noteworthy method of treatment of pulpitis, contributing to the relief of the inflammatory process and the conservation of pulp,is the so-called biological method. It is based on the use of antibiotics, calcium hydroxide, etc. Before carrying out such a method of treatment, you must first explore elektrovozoremontnij pulp of the tooth. The method shown in the cases of normal excitability or not so sharp it falls.
Antibiotics (penicillin bicillin, syntomycin, biomitsin and others) used in the form of paste. After mechanical treatment of carious cavity her wash solution antibiotic. The solution take arbitrary concentrations of distilled water or 2% solution novokaina. On the question about the necessity of exposure pulp before applying antibiotic no consensus. Most authors do not consider the opening of dental cavity required. After applying the paste to the bottom processed carious cavity or on Nude pulp her cover with a sterile piece of asbestos and impose a temporary seal (dressing) of liquid implicated dentin. When using antibiotics desirable definition of antibiogramme, which reduces the number of failures.
In the treatment process may have pain, especially from temperature irritators, resulting in the need to re-imposition of the antibiotic. In these cases, to prevent injury pulp remove only the surface layer of the paste, and then impose a fresh portion of the antibiotic. Repeat 2 times. If the pain is still present after a double shift pastes, it should go to leaf tissue becoming necrotic and remove the pulp.
The effect of calcium hydroxide in the treatment of pulpitis, as I suppose, is to enhance regenerative processes of the pulp; the drug has also expressed bactericidal action. The use of calcium hydroxide is basically the same as imposing paste from the antibiotic.