What is the Difference between Pulpotomy, Pulpectomy and Root Canal Treatment?
What is pulpotomy?
Teeth have several soft elements inside: blood vessels, nerves, and connective tissue. These inner elements together make up the pulp of the tooth. Although the enamel and dentin on the tooth's outer layers are stiff, the pulp is soft, alive, and very sensitive. When the outer layers of the tooth are damaged, the pulp may get infected. In some cases, a pulpotomy is the best option to save deciduous teeth.
Pulpotomy is a dental procedure by which the tooth decay and infected pulp inside the tooth's crown are removed. This procedure is sometimes referred to as the root canal treatment of deciduous teeth because this method is mainly used for children, especially for molar teeth. It is performed with the complete anesthesia of the tooth.
The primary purpose of the pulpotomy is to save damaged teeth and keep the vitality of the root of the damaged tooth. Pulpotomy is performed when the infected pulp only exists in the crown. If the tooth is severely damaged or the tooth structure is weakened, the tooth should be extracted.
The paediatric dentist starts with injecting local anesthesia to numb the tooth for the patient's comfort. General anesthesia is used if the child does not cooperate. Once the tooth is numbed, the dentist removes the tooth's dental decay and bacteria from the pulp. Often, they use a rubber dam to isolate the tooth from the rest of the mouth.
They open the pulp chamber by drilling through the enamel and the dentin. Once the roof of the pulp is drilled through, it will bleed. The bleeding shows that the pulp is still healthy. If the pulp chamber is filled with pus or is empty and dry, the dentist cannot continue pulpotomy. They must then either perform pulpectomy or tooth extraction.
A drug is inserted into the pulp to stop the bleeding. Bleeding should be controlled within one or two minutes. If the bleeding does not stop, it shows that the pulp in the root is no longer healthy and has probably been severely affected by tooth decay. So, a pulpectomy or tooth extraction should be performed. A tooth is filled with restorative materials. Then, the tooth is covered with an appropriate crown. In most cases, the crown is made of stainless steel.
First, the dentist injects local anesthesia to reduce pain and discomfort. Then, the dentist makes a hole in the tooth's crown by drilling to access the infected pulp chamber. The nerves inside the root are cut and removed by a tool called "a file" so that the pulp is removed from the roots. Earlier, a small diameter file was used, but gradually, larger files were used to ensure that all particles and infectious material were removed. Then, the root canal is rinsed with sodium hypochlorite to remove all contaminated particles and materials. The pulp is removed from the roots. The tooth will be cleaned, disinfected, and filled with the material. Finally, a crown will be placed to cover the tooth. The dentist may prescribe antibiotics to reduce the risk of infection.
Why not Extract a Deciduous Tooth instead of a Pulpotomy?
One of the roles of deciduous teeth is to maintain until they fall out and be replaced with permanent teeth. In addition to helping the baby eat and talk, deciduous teeth maintain the required space in the mouth for permanent teeth. If one or more deciduous teeth are extracted before the permanent teeth appear and grow, they can cause problems for permanent teeth growth.
A pulpectomy is a procedure that removes the pulp from all tooth parts, including the pulp in the roots. A pulpectomy is usually performed in children to save a severely infected primary tooth. In permanent teeth, pulpectomy is the first part of the root canal procedure.
This procedure is done on the teeth that are no longer alive. It involves removing all the infections of the tooth's chamber, and the goal is to remove bacteria from the root canal.
Who is a Pulpectomy Performed for?
A pulpectomy is usually performed on children who have irreversible pulpitis or necrosis. Pulpitis is an inflammation of the pulp tissue caused by a bacteria invasion, divided into two categories: reversible and irreversible.
Distinguish Reversible from Irreversible Pulpitis
Teeth that are triggered and get painful with cold, heat, or sweets have pulpitis. In the opposite situation, the pain is relieved a few seconds after the stimulus is removed. Still, the pain continues and bothers the patient for a while in the other situation.
Pulpotomy vs. Pulpectomy
In pulpotomy, the dentist removes the coronal pulp from a tooth. Pulpotomy is performed on vital teeth, responding to temperature and having sensation and vascular flow. No abscess or spontaneous pain must exist in the area for this procedure, and no bone loss exists under the tooth. Usually, pulpotomies are done in baby teeth with pulp damages, but they can also be done on permanent teeth with trauma or cavities that reach the pulp.
A pulpectomy is a procedure that removes the pulp from all tooth parts, including the pulp in the roots. This procedure is performed on teeth that are no longer alive. Pulpectomies can treat primary teeth with dead pulp and permanent teeth with infected pulp or abscesses. In this procedure, the dentist removes all the contents of the tooth's inner chamber, and the purpose is to clean the entire root canal to protect it from further infection.
The dentist may use X-rays, cold, or electric tests to determine whether your tooth is alive and the best treatment.
Root Canal Therapy
Root canal therapy is a dental treatment performed because of losing part of the pulp due to caries. If the tooth decay is deep and passes through the enamel and dentin and reaches the dental pulp, the presence of bacteria will cause severe pain in the pulp. At this time, the infected tissue and bacteria must be removed from the pulp.
Root Canal Treatment Steps
First, the dentist injects a local anesthetic. If the tooth that needs root canal treatment is in the maxilla, only the tooth and the surrounding tissue will be anesthetized. But the entire jaw should be anesthetized if the inflamed tooth is in the mandible.
Afterwards, the dentist separates the infected tooth from the other teeth using a rubber dam. Then, the dentist removes all caries and abscesses of tooth tissue and roots.
After that, the dentist starts cleaning and shaping procedures using files, in which all the bacteria and debris are removed. Finally, an antimicrobial solution is used to kill bacteria and cell debris.
Lastly, the dentist fills all the dental canals using active ingredients (gutta percha). In most cases, a crown is placed on the tooth. The importance and necessity of the crown are that since the enamel and dentin have been severely damaged and removed, the teeth must be protected to last longer.
Pulpotomy vs. Pulpectomy vs. Root Canal
Pulpotomy is performed on a live tooth, but pulpectomies and root canals are performed on teeth that are not vital due to trauma or an infection in the pulp. A pulpectomy is the process of removing all of the nerves in the tooth and cleaning the infection. Root canal treatment is performed by filling the emptied and sterilized canals with a sealing material.
The dentist guides the patient to choose between pulpotomy and pulpectomy. The goal of both procedures is to relieve your pain and restore your dental health and tooth function.