Partial pulpotomy for carious exposures
The partial pulpotomy for carious exposures is a procedure in which the inflamed pulp tissue beneath an exposure is removed to a depth of 1 to 3 mm or deeper to reach healthy pulp tissue. Pulpal bleeding must be controlled by irrigation with a bacteriocidal agent such as sodium hypochlorite or chlorhexidine before the site is covered with calcium hydroxide or MTA. While calcium hydroxide has been demonstrated to have long-term success, MTA results in more predictable dentin bridging and pulp health. MTA (at least 1.5 mm thick) should cover the exposure and surrounding dentin followed by a layer of light cured resin-modified glass ionomer. A restoration that seals the tooth from microleakage is placed.
• Indications: A partial pulpotomy is indicated in a young permanent tooth for a carious pulp exposure in which the pulpal bleeding is controlled within several minutes. The tooth must be vital, with a diagnosis of normal pulp or reversible pulpitis.
• Objectives: The remaining pulp should continue to be vital after partial pulpotomy. There should be no adverse clinical signs or symptoms such as sensitivity, pain, or swelling. There should be no radiographic sign of internal or external resorption, abnormal canal calcification, or periapical radiolucency postoperatively. Teeth having immature roots should continue normal root development and apexogenesis.
