[Pulpectomy. Why? When?]. 1990

J Vreven, and P Jones, and J P van Nieuwenhuysen, and J J Lasfargues
Ecole de Médecine Dentaire et Stomatologie UCL, Bruxelles, Belgique.

There are many circumstances under which the condition of the pulp calls for root canal work, due to the real or potential risk of pain, infection, inflammation or functional difficulties (acute, irreversible pulpitis, chronic pulpitic conditions, necrosis and its consequences, etc.). Other circumstances exist in which injury to the pulp is not necessarily irreversible: initial pulpitis, iatrogenic fracture of the pulp, traumatisms, dystrophic deteriorations. The high success rate for endodontic therapy could argue for elimination of impaired or necrose-prone pulp. In fact, however, unsuccessful pulpectomies often lead to loss of the dental organ and successful endodontic treatment severely weakens the whole tooth structure and often implies prosthetic restoration, with the consequent increase in tissular loss. In order to preserve pulp and crown tissues, pulpal vitality should be protected in all cases where such conservative efforts do not worsen the prognosis for maintaining the tooth on its arch or jeopardize a planned restoration. Solutions are presented for various types of situations, according to the risks encountered.

UI MeSH Term Description Entries
D011670 Pulpectomy Dental procedure in which the entire pulp chamber is removed from the crown and roots of a tooth. Pulpectomies
D011671 Pulpitis Inflammation of the DENTAL PULP, usually due to bacterial infection in dental caries, tooth fracture, or other conditions causing exposure of the pulp to bacterial invasion. Chemical irritants, thermal factors, hyperemic changes, and other factors may also cause pulpitis. Inflammation, Endodontic,Endodontic Inflammation,Endodontic Inflammations,Inflammations, Endodontic,Pulpitides
D003782 Dental Pulp A richly vascularized and innervated connective tissue of mesodermal origin, contained in the central cavity of a tooth and delimited by the dentin, and having formative, nutritive, sensory, and protective functions. (Jablonski, Dictionary of Dentistry, 1992) Dental Pulps,Pulp, Dental,Pulps, Dental
D003789 Dental Pulp Exposure The result of pathological changes in the hard tissue of a tooth caused by carious lesions, mechanical factors, or trauma, which render the pulp susceptible to bacterial invasion from the external environment. Exposure, Dental Pulp,Pulp Exposure, Dental
D003790 Dental Pulp Necrosis Death of pulp tissue with or without bacterial invasion. When the necrosis is due to ischemia with superimposed bacterial infection, it is referred to as pulp gangrene. When the necrosis is non-bacterial in origin, it is called pulp mummification. Dental Pulp Autolysis,Dental Pulp Gangrene,Necrosis, Dental Pulp,Pulp Gangrene,Pulp Mummification,Pulp Necrosis,Autolysis, Dental Pulp,Gangrene, Dental Pulp,Necroses, Pulp,Pulp Autolysis, Dental,Pulp Gangrene, Dental,Pulp Necroses,Pulp Necrosis, Dental,Autolyses, Dental Pulp,Dental Pulp Autolyses,Dental Pulp Necroses,Gangrene, Pulp,Gangrenes, Pulp,Mummification, Pulp,Mummifications, Pulp,Necroses, Dental Pulp,Necrosis, Pulp,Pulp Autolyses, Dental,Pulp Gangrenes,Pulp Mummifications,Pulp Necroses, Dental
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000075202 Contraindications A condition or factor associated with a recipient that makes the use of a drug, procedure, or physical agent improper or inadvisable. Contraindications may be absolute (life threatening) or relative (higher risk of complications in which benefits may outweigh risks). Contraindications, Physical Agent,Medical Contraindications,Agent Contraindication, Physical,Agent Contraindications, Physical,Contraindication,Contraindication, Medical,Contraindication, Physical Agent,Contraindications, Medical,Medical Contraindication,Physical Agent Contraindication,Physical Agent Contraindications
D014082 Tooth Fractures Break or rupture of a tooth or tooth root. Fracture, Tooth,Fractures, Tooth,Tooth Fracture
D014084 Tooth Avulsion Partial or complete displacement of a tooth from its alveolar support. It is commonly the result of trauma. (From Boucher's Clinical Dental Terminology, 4th ed, p312) Avulsed Tooth,Dislocation, Tooth,Tooth Luxation,Avulsion, Tooth,Avulsions, Tooth,Dislocations, Tooth,Luxation, Tooth,Luxations, Tooth,Tooth Avulsions,Tooth Dislocation,Tooth Dislocations,Tooth Luxations,Tooth, Avulsed
D014092 Tooth Root The part of a tooth from the neck to the apex, embedded in the alveolar process and covered with cementum. A root may be single or divided into several branches, usually identified by their relative position, e.g., lingual root or buccal root. Single-rooted teeth include mandibular first and second premolars and the maxillary second premolar teeth. The maxillary first premolar has two roots in most cases. Maxillary molars have three roots. (Jablonski, Dictionary of Dentistry, 1992, p690) Root, Tooth,Roots, Tooth,Tooth Roots

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