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Pediatric Endondontics Ling Zheng- yu Pedo Department Guanghua Colledge of Stomatology Sun Yat-Sen University Goals of pulp therapy Diagnosis Indications and types of pulp treatment for primary and young permanent teeth Procedure of pulp treatments Goals of Pulp Therapy Allowing the tooth to remain in the mouth in a nonpathologic state Maintenance of arch length and tooth space Restoration of comfort with the ability to chew Prevention of speech abnormalities and abnormal habits Diagnosis of Primary Teeth Several diagnostic considerations should be evaluated the length of time the tooth in question the health of the patient the status of the remaining dentition the restorability of the tooth in question patient and parent cooperation Clinical assessment Radiographic assessment Clinical Assessment Pain history Spontaneous discomfort at night Is the tooth influenced by thermal or chemical stimuli or percussion? Have no pain history Time Frequency Pain intensity Pain location Are soft tissue swelling or a fistulous tract present ? Is the tooth Excessively mobile? Pulpal exposure and hemorrhage Vitalometer tests are very unreliable Radiographic Assessment The depth of carious process related to pulpal tissue The presence of the calcified bodies in the pulpal tissue indicates chronic inflammation Involvement of the bifurcation and trifurcation regions of the primary molars Radiographic Assessment Pathologic external root and bone resorption The presence of internal root resorption in the coronal or apical portion of the involved tooth The development of the dental bud The inflammation may influence dental sac Indications and types of pulp treatment for primary teeth Direct pulp capping It is the placement of pulp-cap on a small, mechanically induced pulpal exposure. Its use should be limited to permanent teeth. Indications and types of pulp treatment for primary teeth I
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