The Europeans were the first to introduce pulpotomy procedure.
1885 – Leptowski: introduced formalin as fixative and mummifying agent.
1886 – Gold foil was used to cover the exposed vital pulp.
1898 – Gysi: Introduced paraformaldehyde as a pulpotomy medicament.
1904 – Buckley: Introduced formocresol for pulpotomy.
1930 – Hermann: Introduced calcium hydroxide as calxyl for pulpotomy.
1975 – S’Gravemade: used gluteraldehyde which replaced formocresol.
1983 – Reumping et al: demonstrated the use of electrosurgery for pulpotomy.
1985 – Shoji: used carbon dioxide laser in pulpotomy.
1991 – Nakashima used bone morphogenic protein.
1993 – Torabinejad: MTA was used
CLASSIFICATION
Pulpotomy can be classified according to treatment objectives (Don M. Ranly 1994).
1.Devitalization pulpotomy (Mummification, cauterization)
Formocresol pulpotomy
Electrosurgical pulpotomy
Laser pulpotomy
2. Preservation (minimum devitalization, non inductive)
Gluteraldehyde
Ferric sulfate
3. Regeneration (Inductive & Reperative)
Calcium hydroxide
Bone morphogenic protein
Depending upon the size of exposure
1. Partial pulpotomy (shallow, low level or Cvek’s pulpotomy)
2. Cervical pulpotomy (deep, high level total or conventional pulpotomy)
Classified depending upon the number of visits
1. Single visit pulpotomy
2. Multiple visit pulpotomy
INDICATIONS
Mechanically exposed vital primary teeth.
Caries exposure in vital asymptomatic primary tooth
In the treatment of pulpally involved primary teeth with clinical manifestations of inflammation confined to coronal pulp.
In the treatment of pulpally involved permanent teeth with open apices and vital pulp.
In the treatment of fracture permanent teeth with pulp exposure >1sqmm.
CONTRAINDICATIONS
Spontaneous pain
Abnormal sensitivity to heat or cold / chronic pulpalgia
Tenderness to percussion
Swelling / sinus
Pus or serous exudates at the exposure site
Pathological mobility
Uncontrolled hemorrhage from the amputated pulp stumps
Pathological external root resorption
Periapical or inter radicular radiolucency
Internal root resorption
Pulp calcification / constriction of pulp chamber
MATERIALS USED BY DENTISTS
Formocresol
Gluteraldehyde
Devitalizing paraformaldehyde paste
Gysi paste
Easlicks paraformaldehyde paste
Paraform devitalizing paste
Camphorated paramonochlorophenol
Cresol
Metacresyl acetate
Oxypara
N2 Compound
Zinc oxide eugenol
Ferric sulphate
Calcium hydroxide
Enriched collagen solution
Collagen calcium phosphate gel
Dimethyl subirridemate
Tetrandrine
Freeze dried bone
Tricalcium phosphate
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