A pulpectomy is complete removal of pulp from the crown and roots. The tooth is then filled with material that can be reabsorbed by the body. It's usually performed on baby teeth.

Definition

It is procedure of removal of the entire pulp and subsequent filing of the canals of primary teeth with a suitable resorbable material

Indicabions

• Primary non-vital tooth, or irreversibly inflammed tooth
• Minimum apical or periradicular pathology (2/3 of the root should be available at least)
• Presence of pus at pulp exposure site
• Necrotic pulp

Contraindications

• Non-restorable tooth
• More than 2/3 of the tooth is resorbed
• Periapical pathology involved permanent tooth bud
• External or internal root resorption
• Tooth with extensive mobility

Pulpecbomy Procedure

Two types of Pulpectomy procedure present:

• One-visit Pulpectomy: indicated for teeth with no sign of necrosis or abscess
• Mult-visit Pulpectomy: indicated for non-vital teeth with necrotic pulp

One-visit Pulpectomy

• Prepare access cavity and extirpate all pulp tissue with barbed broaches
• Take a radiograph with a file inside 2-3 mm short of the apex to confirm working length
• Instrument the canals with files, and irrigate with sodium hypochlorite
• Fill the root with suitable obturating material and restore the tooth with final restoration

Mult-visit Pulpectomy

• Prepare access cavity and extirpate all pulp tissue with barbed broaches
• Take a radiograph with a file inside 2-3 mm short of the apex to confirm working length
• Instrument the canals with files, and irrigate with sodium hypochlorite
• Fill the root with calcium hydroxide and restore with temporary filling
• Recall patient after 1 week
• If tooth is asymptomatic, rinse the canal from calcium hydroxide, fill it with suitable obturation material and restore permanently.

Obturation Materials

Since we are obturating a primary tooth that will be resorbed and shed eventualy, it is critical to fill the canal with resorbable obturating material
Never obturate a primary tooth with Gutta-Percha, because it is not resorbable.

Recommended obturation materials:
Zinc Oxide Eugenol, lodoform, or Vitapex (Calcium hydroxide mixed with iodoform)

Pulpectomy Procedure