Читать книгу Endodontic Materials in Clinical Practice - Группа авторов - Страница 34

For completeness, this procedure is considered here as it is a form of VPT. In treating cases where it is determined that the pulp is not viable as it appears to be severely inflamed or contaminated and haemostasis is unachievable or the pulp appears necrotic, a pulpectomy may be indicated. It has been shown that success rates are higher when the pulpectomy and RCT are completed in one visit, and the clinician should adopt a cautious approach with length control. Pulpectomy is defined as total removal of the pulp from the root canal system followed by RCT (Figure 2.7).

Figure 2.6 Full pulpotomy. (a) Deep carious lesion extending to the pulp. (b) Removal of the whole of the coronal portion of the pulp. (c) Calcium silicate cement directly interfacing with pulp stumps at the canal orifice following definitive restoration.

Figure 2.7 Pulpectomy. (a) Deep carious lesion extending to the pulp, resulting in irreversible change. (b) Complete removal of the pulp tissue and cleaning and preparation of the root canal system prior to root filling. (c) Obduration of the root canals with gutta‐percha following definitive restoration.