Pediatric pulp therapy depth

Pulpotomy belongs with vital pulp therapy for primary teeth that have normal pulp or reversible pulpitis. In vital primary incisors with carious exposures, pulpotomy is likely to have greater success than pulpectomy.

Pulpectomy is grouped with nonvital treatment when a primary tooth has irreversible pulpitis or necrotic pulp, rather than with the vital therapies used for reversible inflammation.

The amount of diseased pulp matters because the pulp health status determines which pulp therapy is indicated. A vital tooth and a tooth with necrotic pulp sit in different treatment groups.

For pulpotomy, the review identifies symptom-free teeth, sterile removal of coronal pulp, and haemostasis as prerequisites for success.

The review found that pulpectomy conditions, procedures, and evaluation were not well defined across the studies it assessed. That makes the pulp diagnosis especially important before choosing between the two approaches.

For a primary tooth with normal pulp or reversible pulpitis, other vital options include a protective liner, indirect pulp treatment, and direct pulp cap. Deep caries can also be managed with indirect pulp therapy.

The decision begins with whether the pulp is vital, reversibly inflamed, irreversibly inflamed, or necrotic. Tooth restorability and alternative treatment are also part of the assessment.