Removal of the tooth pulp treatment of pulpitis

Removal of the tooth pulp is a necessary measure aimed at preventing further spread of the infection outside the root and its complications, until the removal of the tooth. The dental pulp is considered a neurovascular bundle located in the cavity of the tooth. Thanks to him, the tooth is nourished with nutrients, is formed dentin happens cavity protection from various infections.

The structure and functions of pulp

Each tooth consists of bone tissue, enamel, crowns, gums, root, dentine and pulp. The latter is formed from the nerve endings, connective tissue, lymphatic vessels and blood vessels.

The appearance in the tooth inflammation, the pain signal at the nerve endings of the pulp is fed into the brain. Also it has a generating function, which may form an additional layer of tissue — the dentin. With the help of blood vessels is the hydration of the tooth and its power. Protects the pulp against penetration of infection into the inner part of the periodontal space along the root channels. The integrity of the pulp is important. At its violation or destruction increases the likelihood of tooth loss, mineralization stops, the blood flow.

Inflammation of the pulp

Under pulpitis refers to the inflammation of the pulp (nerve) of the tooth. The main causes of the disease are:

  1. untreated tooth decay;
  2. incorrect or incomplete treatment of the tooth.

The main symptom is pain, which can manifest itself in different ways and depend on the condition of the tooth. When exposed to temperatures, there is a slight pain, in advanced cases — paroxysmal extreme pain.

Depending on the pain there are two forms of inflammation of the pulp:

  • The acute form. It is characterized by acute pain in the form of attacks, especially at night. The pain increase, become more frequent and appear spontaneously without thermal irritation. After elimination of irritant symptoms persist for 10-15 minutes. This distinguishes pain when pulpitis pain when the caries. After cessation of exposure stimuli with deep caries and the pain stops immediately.
  • A chronic form. In this form the inflammation is not acute. Occurs slightly aching from the effects of heat or cold. Also pain may never be observed. The chronic form of the disease tend to periodically worsen, while symptoms typical of the acute form.

Contraindications for tooth pulp

The treatments of the tooth pulp there are contraindications, which include:

  1. all acute infectious diseases;
  2. stomatitis;
  3. pus formation and inflammation in the mouth;
  4. infectious hepatitis;
  5. cardiovascular disease;
  6. leukemia in the acute form;
  7. mental illness.

Indications for removal of tooth pulp

Treatment of the pulp is its resection, which is needed to rid the tooth from the source of the infection and avoid spread of bacteria through the root in the gum. It is often used deponirovanie. The purpose of the procedure is complete removal of inflamed dental pulp with all the nerve and vascular bundles.
The main indications:

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  • dentures certain types;
  • severe destruction by caries;
  • the exposure of the substance of the pulp due to the breaking off of the tooth;
  • deep inflammation of the pulp;
  • periodontitis, severe;
  • pulpitis caused by trauma;
  • crowns below the position;
  • congenital anomaly of the dentition;
  • the huge dimensions of the chamber the pulp.

Ways to remove pulp

There are two ways to uninstall:

  • vital method;
  • devital method.

Vital amputation is used to treat the disease at an early stage during infection and destruction only of the crown pulp. By the way, treat baby pulpitis.
By using devital method is to remove the root and crown parts of the pulp. It is used in exceptional cases. For example, if a radical treatment of the disease in a state of neglect.

The sequence of actions when vital hysterectomy

Surgical resection vital method begins with local anesthesia. After the introduction of anesthetic waits the period of time prior to the beginning of action of the drug. After sufficient anesthesia will begin immediately the removal of the pulp. This happens with a sterile burs dental drill. Ruined the enamel of the tooth is removed along with the dentin. Next, cut off a portion of the dental cavity with captured the crown area of the inflamed pulp. In the tooth cavity the drug is placed, and on top of the temporary seal.
For some time, the dentist performs palpation and tapping of the painful tooth to detect painful sensations.

To establish a permanent seal, a temporary one is removed. Treatment of the tooth cavity with antiseptic solutions. Only after this seal is set to a constant way of light curing. Then, a grinding and polishing. The final step in vital treatment — fluoridation, giving the enamel increased strength.

The sequence of actions when devital hysterectomy

This method of removing the pulp is also carried out with anesthesia. A drill removed the damaged dentin and enamel. The cavity is washed with antiseptic. Then, a drying of the dental cavity and the room in her medication with arsenic for 1-2 days. The number of days depends on the presence of the tooth roots. Arsenic calms the nerve fibres of the pulp. Next, set a reliable temporary seal.

After 1-2 days, the dentist removes the temporary filling and amputate the coronal part of the pulp. Processed root channels and clean them from the remnants of the nerve fibers. Prepared channels is well-processed with antiseptics.

Removal of the pulp with the nerve bundles in full influence the perception of pain sensitivity. A tooth without nerves cease to feel pain.

From the root portion of the pulp is carried out mummification. This again put a temporary filling, which for several days to help identify the presence of painful symptoms. If nothing is specified, temporary filling replaced by a permanent one.

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After the tooth pulp is an x-ray of the troubled tooth. In the presence of complaints of tooth pain, and if the deficiencies noticeable in the picture x-rays, the dentist performs the required correction before establishing a strong permanent seal.

In the end is the grinding surface of the permanent fillings and fluoridation of tooth enamel.

New treatment methods and modern devices

Dental companies annually produce advanced equipment and medications, as well as develop a method of treatment of pulpitis, which can be used to keep the teeth of almost all his life.

The strongest disinfection channels by ultrasonic and laser equipment. Effective treatment is depothresis of copper-calcium.

General indications for depoforez hydroxide of copper-calcium:

  1. the functional ability of the tooth;
  2. the stability of the tooth, despite the presence of pathological changes;
  3. restoration of the anatomical shape;
  4. the General condition of the patient satisfactory.

Special indications for the procedure:

  • curved and deformed root of the tooth;
  • channels with gangrenous content.
  • obliteriruuchi root of the tooth;
  • vital extirpation;
  • after inefficient treatment or repeat treatment (if the main part of the root fillings may be removed);
  • breakage of the tool;
  • channels with the unformed apex to the end.

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Hydroxide of copper-calcium protects against bacteria, killing the spores and fungi even in the smallest branches of the root canal.

Possible errors that occur during treatment and their consequences

In certain situations when removal of the nerve can occur medical errors that lead to tragic consequences for tooth. In most cases, during amputation of the pulp occurs break off the handle of a dental instrument and heavy bleeding.

Bleeding from the root canal is difficult to predict. The separation of the pulp at the time of extraction polypoetry can happen very deep. For this reason, many dentists tend not to take the risk and give preference to another is a gradual cutting the soft tissue of the file with the abundant phased meatal cleansing with antiseptics.

Break off the handle of polypoetry happens because of the violation of technique or using defective tools. The chip extraction is a complex procedure, requiring skill and special equipment.

Complications after the procedure the tooth pulp


After removal of the pulp in the tooth may experience severe pain. The main causes of this condition include:

  1. The response of the organism to dental procedures. After the expiration of painkillers, the pain is felt in the area being treated. This condition continues for 3 days, and then subsides. To relieve pain you can rinse your mouth with a solution of salt and baking soda with the addition of iodine. A good helping of painkillers.
  2. If the pain does not abate, but rather increased, this indicates the development of inflammation, and further education of suppuration in the place depulpatsii. Such a reaction can cause trapped in the cavity an infection during the manipulation or is not cured until depulpatsii. Rinse and painkillers do not help.
  3. Violation of the integrity of the channel. The creation of false openings in the beginning, end, or middle of the root. This pathology complicates normal handling and filling of the root canal and causes inflammation in these areas.
  4. Not until the end of the sealed channel. Ideally, it is sealed to physiological contractions. If this is not adhered to, there is inflammation of the root.
  5. More than normal sealed channel. In contact with significant quantities of filling material beyond the root there is severe pain and problems associated with the perception of it as a foreign body. The reaction should be a response and there is inflammation of the tissues that surround the root. Dangerous ingress of the filling material in the maxillary sinus and mandibular canal that leads to the development of sinusitis and numbness of the jaw for a long time.
  6. Substandard cleaning out the channels.
  7. Professionally installed permanent seal.
  8. Rejection by the body of materials from which the seal is made.
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If you have any disturbing symptoms after depulpatsii should immediately consult a doctor. Especially if the pain persists more than 3 days.

Effects of tooth pulp

After depulpatsii consequences occur during the first few months. The tooth becomes more brittle. This condition is due to the fact that the tooth along with the nerve is removed the blood vessels, which in turn leads to a loss of power to the internal tissues of the tooth. Pulpless tooth with the change of its color. He becomes grey and loses its gloss (enamel becomes dimmer). Sometimes, after removal of the nerve, the teeth become bluish unnatural color. This is due to the gross errors of the dentist when the root canal filling. This especially happens when at the time of application of the filling material in the root canal were present in the blood.
For the prevention of dental diseases must from childhood carefully monitor the oral hygiene, eat right and undergo regular examination at the dentist. Treatment of diseased teeth should be carried out in time. Only in this case it is possible to avoid removal of tooth pulp.