The pulp is the innermost tissue present inside the tooth. It consists of nerves and blood vessels that provide vitality to the tooth. In case of extensive tooth decay or injury, there is a chance of pulp exposure. To maintain the health and integrity of the tooth and the supporting tissues, your dentist may recommend a pulp therapy known as a pulpotomy.
A pulpotomy is generally performed on young children, as the pulp is an integral part of healthy development for the apex of the tooth’s root. Pulpotomies are typically performed on deciduous teeth, but some recent studies have concluded that it can be performed on adult teeth as well. Let’s continue to know about pulpotomy in detail.
What is pulpotomy?
Pulpotomy can be defined as the removal of a portion of the pulp in the crown, followed by placement of suitable dressing or medicament that will promote healing and preserve the vitality of the tooth.
You may need endodontic follow up to monitor healing.
Indications for pulpotomy
Pulpotomy can be performed in the following cases:
- Cariously exposed primary teeth when their retention is more advantageous than extraction
- A vital tooth with healthy periodontium
- If pain is present, even after the removal of stimulus
- A tooth with 2/3 rd root length
- If bleeding from pulp exposure is pale red and easy to control
Contradictions for pulpotomy
Pulpotomy should not be performed in the following cases:
- Evidence of internal resorption
- Presence of inter radicular bone loss
- Abscess, fistula concerning teeth
- Radiographic sign of calcific globules in the pulp chamber
- Caries penetrating the floor of the pulp chamber
- Deciduous tooth close to natural exfoliation
Types of pulpotomy
Pulpotomy for carious exposures
It is done in cases where the pulp within the root of a tooth is still healthy despite carious exposure of the pulp chamber. It allows for the roots to develop fully. (1)
Pulpotomy of traumatic exposures
It is also known as Cvek pulpotomy. It is done in cases where the pulp is exposed after a traumatic injury. The procedure can help the tooth finish developing and help save it. (2)
Pulpotomies in an adult tooth is less invasive and less expensive than root canal treatments, but it is less effective. Pulp tissue in adults is more fibrous with less blood supply than the pulp in deciduous teeth. It makes the tooth less vital and less likely to get a successful outcome.
It is also known as non-chemical devitalization and involves cauterization of the pulp tissue.
It overcomes the histological effects of electro-surgery and creates a superficial zone of coagulation or necrosis that remains compatible with the underlying tissues.
Pulpotomy vs. Pulpectomy
Pulpotomy and pulpectomy may sound similar, but they are performed for different reasons. Both procedures aim to remove infected or inflamed tissue from the pulp chamber of the tooth.
Pulpectomy involves the removal of entire pulp tissue from the pulp chamber and the roots of the tooth.
A pulpotomy involves the removal of pulp tissue from the pulp chamber only.
Procedure of Pulpotomy
A pulpotomy is also referred to as a ‘baby tooth root canal.’ A baby tooth is not as strong and hard as an adult tooth, and the nerve in the tooth is much closer to the outside. It makes the tooth more sensitive and susceptible to decay and tooth pain.
During a pulpotomy, the dentist will remove the diseased pulp within the crown of the tooth and place a special medicated filling to keep the healthy and unaffected pulp root alive.
The filling will prevent further growth of bacteria and also calm the nerves of the tooth. Finally, a crown is placed on the tooth to minimize the risk of future fractures and protect it from further infections.
Cost of Pulpotomy procedure
A pulpotomy can cost around $80- $300 on a primary molar. The total costs can be $750- $3400 per tooth with sedation and filling or a crown.
A pulpotomy on an adult tooth can cost about $90- $250. The total costs can be around $750- $3900 or more, with the exam, x-rays and crown or filling.
As an alternative to pulpotomy, the dentist may advise you to extract the tooth. It can cost around $75- $650. A space maintainer may be installed which can cost about $200- $400.
Take away message
Pulpotomy can be done in both permanent and deciduous teeth. But the results are more successful in young children than adults.
It is a common and routine procedure and is necessary to maintain the integrity and health of the tooth and the surrounding tissues.
Once the procedure is complete, it is imperative to maintain an effective oral hygiene routine at home and visit your dentist regularly to monitor the health of the tooth.