Treatment of pulpitis in 2 visits. Treatment of pulpitis - modern methods and means

When treating pulpitis, you need to perform 3 main tasks - eliminate excruciating pain, eliminate the source of inflammation, and also restore the integrity of the tooth. If you consult a doctor at the first pain, a standard filling will be sufficient. On late stages illness can no longer be avoided surgical removal pulp.

Biological treatment of pulpitis

Biological, or conservative, therapy is aimed at preserving the viability of the pulp. This is possible at the most early stages inflammation, literally on the first day of spontaneous aching pain.

The doctor uses the slightest opportunity to save the pulp. After all, depulpation (removal of the dental nerve) leads to the fact that the tooth becomes more fragile and darkens over time.

Indications for biological therapy:

• acute stage of focal pulpitis;
• accidental exposure of the pulp, for example due to trauma or crown fracture;
• chronic fibrous pulpitis without changes in the area of ​​the apical foramen of the root (this is checked by x-ray).

The method is especially relevant for young patients under 30 years of age, as well as for children with temporary or permanent teeth.

Stages of conservative treatment of pulpitis

Typically, such therapy requires 2 visits to the dentist.

First visit:

• anesthesia;
• drilling of carious tissues;
• rinsing the dental cavity with an antiseptic without alcohol, for example, etonium solution (0.5%);
• application of a therapeutic pad and calcium-containing preparations (calcium hydroxyapatite or analogues);
• installation of a temporary filling.

After the first session, the dentist may prescribe laser therapy, as well as non-steroidal anti-inflammatory drugs. There is no need to use antibiotics.

After 2-3 days, the patient should come for a second visit, which includes:

• removal of temporary filling;
• removing medication from the cavity;
• application of a glass ionomer cement gasket;
• installation of a permanent photopolymer filling.

It is important that the doctor makes sure that the pulp is viable. For this purpose, thermal tests and electroodontodiagnostics (reaction of the dental nerve to a weak current) are carried out.

Surgical methods for treating dental pulp

Surgical (operative) treatment involves partial or complete removal of the infected pulp. This method is appropriate when conservative therapy did not give positive results, and this happens in 60% of cases. It is also indicated for diffuse, gangrenous and purulent pulpitis.

Vital way

This is a mechanical extraction of the pulp without medicinal or toxic effects on it, carried out in one or two visits:

• vital amputation - the doctor removes only the coronal part of the pulp, and preserves the root nerve. Typically this method is used to treat multi-rooted teeth;
• vital extirpation - complete removal of the pulp. Includes standard endodontic procedures: cleaning, antiseptic treatment and filling of canals with gutta-percha.

Devital method

A devitalizing mass is placed into the tooth cavity, which kills the dental nerve. As a rule, this is arsenic paste or paraformaldehyde. In 1-2 days, the pulp becomes completely necrotic, that is, it dies; the doctor removes it using a special tool and fills the tooth.

The devital method is rarely used due to the high probability of intoxication of the periodontium (periodontal tissues). However, this method is indispensable for allergies to local anesthetics.

In 80% of cases, after treatment of pulpitis, slight aching (post-filling) pain occurs. They last a day or two and go away on their own. This typical reaction the body to interfere with the deep tissues of the oral cavity.

But if the pain increases, swelling and redness of the mucous membrane near the treated tooth occurs, this indicates the development of an inflammatory process.

Main causes of complications:

To make sure that the treatment was completed correctly, the doctor is required to take a control x-ray.

Choose only proven specialists. You can find a list of the best dentists in the city on our website.

Pulpitis is an inflammation of the soft connective tissues of the tooth or pulp. It consists of blood vessels, nerve endings and promotes tissue trophism. Pathology occurs against the background of carious lesions, tooth trauma and incorrect treatment.

The methods depend on the type of pathology. There are two main forms of the disease: chronic and acute. Acute pulpitis develops quickly. It is characterized by clearly defined symptoms:

1. Severe pain when exposed to spicy, cold, hot, sour and sweet.
2. The painful sensations do not go away after eliminating the provoking factor, and intensify in the evening and at night.
3. Pain can occur on its own, without irritants.
4. The tooth reacts to touch and when chewing.
5. The pain may radiate to the temple or head on the side where the affected tooth is located.

In some cases, with acute pulpitis, conservative treatment or only partial removal of the pulp is possible.

Chronic pulpitis flows from acute form or appears against the background of deep carious lesions of the tooth. For a long time it may not make itself known and develop for several months or a couple of years. Symptoms of chronic pulpitis are mild:

Important! Often can be easily distinguished from chronic by appearance tooth In the first case, a small white spot appears on the enamel.

Treatment of chronic pulpitis always involves complete depulpation, or, simply put, removal of the nerve. It is not possible to save the pulp.

Treatment methods

Types of treatment for the disease vary depending on the possibility of preserving the pulp (partial or complete) or removing it.

There are three ways to treat pulpitis:

1. Conservative. Carried out at the initial stage acute pulpitis when the tissue is almost not affected. Often prescribed to children with baby teeth.
2. Devital. Therapy consists of using special pastes to kill the nerve. It is divided into:
   • devital amputation;
   • devital extirpation.
3. Vital. Pulp extraction is performed on the first visit under anesthesia. It is also divided into:
   • vital amputation;
   • vital extirpation.

The photo shows the canals of the tooth.

Devital amputation

Devital amputation is a partial removal of the pulp (its coronal part) with the preliminary application of necrotizing pastes. This method was popular at the end of the last century. Today it is practically not used. Exception - and cases when it is impossible to delete nerve bundle in an operative way.

After opening the cavity, a toxic drug is applied to the pulp. Afterwards, the upper, dead part is removed, and an antiseptic paste based on zinc oxide is applied to the healthy one. This “mummifies” the remaining pulp.

Important! With devital amputation, there is a high risk of repeated sluggish inflammatory process. The remaining “mummified” portion of the pulp cannot nourish the tooth. But it promotes the proliferation of microorganisms.

Devital extirpation

Stages of pulpitis treatment.

Devital extirpation is similar in method to amputation. The difference lies in the complete, rather than partial, killing of the pulp. Devital extirpation is not used for tissue necrosis or purulent pulpitis.

Removal is carried out in 3 visits:

1. Removal of tissues affected by caries using a drill.
2. Application of devitalizing pastes: arsenic or arsenic-free. Preparations with arsenic are applied from 24 (for single-canal teeth) to 48 (for multi-canal teeth) hours. Arsenic-free products – up to 14 days.
3. Closing the cavity with a temporary filling.
4. Removal of temporary filling material and extraction of dead nerve bundle.
5. Mechanical cleaning of root canals and treatment with antiseptics.
6. Restoration of the crown part of the tooth using photopolymer materials.

Some dentists still practice this method vital extirpation using resorcinol-formalin paste. However, this drug is toxic, stains the enamel in a pinkish-gray tint and there is a high risk of complications with subsequent retreatment or removal of the tooth.

Vital amputation

Vital extirpation consists of complete removal pulp using an operative (surgical) method.

Vital amputation is somewhat similar to non-vital amputation. The upper, coronal part of the pulp is removed in the same way. However, this is done surgically, and the nerve bundle in the apical part of the canal remains intact. Due to this, nutrition and protection of the tooth from pathogenic microorganisms continues.

Important! Vital amputation is performed only when treating multi-channel teeth. In single-root units there are no clear boundaries between the outer and inner parts of the pulp.

The method involves a number of procedures:

1. Opening the cavity and cleaning caries-affected tissues.
2. Removal of the coronal part of the pulp.
3. Application of a rubber dam and antiseptic treatment of the tooth.
4. Installation of the medicinal material, and on top of it - an insulating gasket.
5. Closing the cavity with temporary filling materials.

Further treatment is similar to non-vital amputation. The patient is prescribed physical therapy and non-steroidal anti-inflammatory drugs.

Vital extirpation

Vital extirpation is the most common method of treating pulpitis. With its help, any stage of pathology is treated. The method involves complete removal of the pulp using an operative (surgical) method.

Important! Treatment of pulpitis with vital extirpation is carried out over at least 3 visits. You cannot immediately fill the canals and restore the crown of the tooth after removing the pulp. It takes time for the root canals to heal and for the material to shrink.

Vital extirpation is carried out in several stages:

First visit:

Second visit:

• the temporary filling is removed;
• drugs are removed from the canals, they are re-cleaned and treated with antiseptics - sodium hypochlorite or chlorhexidine;
• root canals are filled with gutta-percha or cement pastes;
• the cavity is closed with temporary filling materials.

Third visit:

• the filling is removed;
• the crown part of the tooth is restored using photo-curing materials;
• the filling is adjusted to the bite - excess layers are removed;
• grinding;
• polishing

At the first two stages of vital extirpation, it is mandatory X-ray control treatment. It is necessary to determine the length of the channels, their anatomical structure and whether the pulp was completely removed.

Modern treatment methods are aimed at preserving the vitality of the tooth.

The most important part of the therapy is the passage and cleaning of the root canals. Before the procedure, the tooth cavity is necessarily isolated with a rubber dam. The dentist must accurately determine the length of the canals: incomplete filling or removal of materials beyond the apex - the maximum physiological narrowing - will lead to complications, and the tooth will have to be re-treated.

Important! The length of each channel is measured separately: the size of each of them can vary greatly.

Combined method

In some cases, it is impossible to cure pulpitis using one method - you have to resort to a combined method. It is used when:

1. One or more canals are severely curved.
2. It is impossible to completely go through and disinfect the canals mechanically.
3. The instrument broke and remained in the root canal.

With the combined method, two types of pulpitis treatment are used simultaneously, most often vital and non-vital. Accessible sections of the canals are traversed, the pulp is extracted, and the rest are treated with necrotizing pastes.

Complications in the treatment of pulpitis, in most cases, arise due to medical errors.

Possible complications

Complications in the treatment of pulpitis, in most cases, arise due to medical errors. Most often, periodontitis develops - inflammation of the root apex. The following negative consequences are possible:

1. 1. Unfilled canals or incompletely removed pulp. The complication is associated with insufficient qualifications of the doctor, lack of necessary equipment in the clinic, or hasty treatment in one visit.
   2. Extraction of filling material beyond the root apex. Occurs when the instrument is pushed beyond the apex. Occasionally there are cases of material being released into maxillary sinus or mandibular canal.
   3. Broken tool. This is the only case where the complication is not directly related to medical error. Most often, reamers and files break in the channels. However, the doctor must immediately report the problem and correct it.
   4. Violation of the integrity of the root canal. It is characterized by perforation or the creation of a false hole when the instrument ends up outside the root.

Treatment methods for pulpitis are similar. All of them, with the exception of the biological one, are aimed at removing pulp, treating canals and restoring the supragingival part of the tooth. The most commonly used method is vital extirpation. However, in some cases, devital or conservative therapy is possible.

Every person in the world is faced with, it can be provoked various factors. If you don't apply for it in time qualified help, then the consequences of inaction can lead to serious problems which most often end in tooth extraction. Very often, dentists, examining another patient, discover he has pulpitis. But what are the main methods and stages for a child and an adult?

Pulpitis - what kind of pathology is this?

Pulpitis is an inflammation that affects the neurovascular bundle (pulp). One of the most common causes of inflammation is caries, which contributes to the destruction of hard tooth tissue. Pathogenic bacteria filling the carious cavity provoke inflammatory process pulp (popularly called the nerve).

Pulpitis can also develop due to a poorly performed filling procedure or tooth injury. There are several types of pulpitis, each of them requires emergency assistance from a specialist. Methods and stages of treatment of pulpitis are selected individually for each type.

Types of pulpitis

At initial form pulpitis, the pulp's reaction to irritation is hyperemia, during which the blood flow in the arteries of the pulp increases significantly. The amount of blood inside the cavity increases and thereby creates pressure on the small fibers of the nerve, which leads to aching pain. After the irritation is removed, the pain immediately goes away.

The acute form of pulpitis is accompanied by severe pain. If the pulp is not yet very inflamed, then the process can be stopped, in which case the pain goes away immediately. The pulp heals on its own, you just have to remove the causes of irritation.

If the pulp does not recover on its own, the pain continues to bother you and becomes even more acute, especially intensifying at night, then you cannot do without the help of a dentist. Upon examination, a tooth with a deep carious cavity and a painful bottom during probing is revealed. The stages in this case are selected depending on how much the tooth is affected and whether the inflammation has progressed further.

The purulent form is one of the most severe and is characterized by sharp pain, which intensifies at night, and cannot be relieved with painkillers.

The chronic form of pulpitis is characterized by attacks if an irritant appears, and if it is eliminated, the pain goes away. Blunt pain can last quite a long time. During the examination, a deep cavity with caries and bleeding is revealed.

Chronic hyperplastic pulpitis is an irreversible form that requires serious stages of pulpitis treatment to be carried out. This form is much more common in children and young people. It consists of hyperplastic pulp tissue called a pulp polyp.

Necrosis is an irreversible form of pathology; it is characterized by the death of the pulp, appears after prolonged bacterial invasion, or is a consequence of acute purulent pulpitis.

Symptoms of pulpitis

Pulpitis is very serious illness, requiring quick response and seeking qualified help. If the initial stage of the disease is accompanied by aching pain, which can be relieved by taking an anesthetic, then acute and chronic cause the strongest pain syndrome, which intensifies at night and does not subside even after taking medications.

When the tooth is exposed to irritants - thermal, mechanical or chemical - the pain intensifies. If you don’t start therapy in the acute phase of the pathology, then eventually everything will end chronic form, which is characterized by pain when touching a tooth, it intensifies when exposed to hot foods, and weakens when exposed to cold foods. If you do not take any measures and do not begin to carry out the stages of treatment of pulpitis, then inflammation can affect the bone structures of the jaw.

Why do you need to treat pulpitis?

If you imagine a person who is constantly busy with problems at work or in the family, he does not always immediately pay attention to a slight pain in a tooth. The first thing he does is take a painkiller: “Ketanov”, “Nurofen”, “Ketorolac”, “Baralgin”, “Nise” - and forgets about the problem. But over time, bacteria that remain in the pulp chamber of the tooth continue to destroy it and ultimately lead to pus appearing in the root canal.

After the pus leaves the root canal, flux appears, and it can manifest itself not only in the form of a slight swelling of the gums, but also in the form of severe swelling with a severe violation of symmetry. Severe forms pathologies require serious steps to be taken in the treatment of pulpitis, otherwise this may result not only in tooth loss, but also in pathologies such as phlegmon, blood poisoning and bone tissue damage.

Main stages of endodontic treatment

The initial form of pulpitis can be cured very quickly, one visit to the dentist is enough, but for serious forms it requires a long period of time. The stages of therapy will require the patient to have several appointments with the doctor, and each of them is designed to relieve pain, disinfect the tooth cavity and other, But first things first. When performing root canal therapy, it is important to follow the steps:

Filling is the last action of the dentist, completing all stages. But the treatment does not end there; the doctor also recommends certain procedures that will effectively cope with inflammation and help protect against relapse.

Prescriptions after the first stage of treatment

After the doctor has treated pulpitis, its stages are completed, you will need to take medications and procedures at home for a few more days:

• Physiotherapy is the use of a laser; in this case, it is best to carry out the procedure using a helium-neon apparatus. Just a few procedures will be enough to consolidate healing effect and prevent relapse.
• Taking medications. Since pulpitis is an inflammation, it is simply necessary to take a course of non-steroidal anti-inflammatory drugs, such as Ibuprofen, in order to completely eliminate the inflammatory process.

It is very important to monitor a patient, for example a child, after he has undergone all stages of treatment for pulpitis of baby teeth, it is very important to monitor his condition, and if complaints arise, then immediately consult a doctor. A child cannot always independently determine what is happening to him, so the doctor advises parents to monitor him or simply come for a follow-up appointment a few days later.

Vital amputation method for pulpitis

There are several methods for treating pulpitis, one of them is vital amputation, which involves preserving the pulp only in the canals of the tooth, but it is removed in the crown area. This technique is undertaken if a multi-rooted tooth is affected. This method is not used to treat a single-rooted tooth, and all because there is no boundary between the coronal and root zones of the pulp. This technique consists of the following steps:

• local anesthesia is administered;
• areas affected by caries are removed;
• the pulp is removed;
• the tooth cavity is treated with medications;
• a medicinal pad is placed in the canal;
• then apply an insulating pad;
• temporary filling.

Method of surgical treatment of pulpitis

There are several methods of treating pulpitis, including the surgical approach. This method involves removing the nerve, and this occurs in both the coronal and root zones. This method is called depulpation. It is used for advanced forms, in which all measures must be taken to begin treatment of pulpitis; the stages consist of the following manipulations:

• all tissues affected by caries are drilled out;
• the nerve in the coronal and root parts is removed;
• the canals where the nerve was located are carefully processed;
• then the canals are filled, and then the coronal part.

It is worth remembering that it will not be possible to carry out all the procedures at once in one visit to the doctor, so you need to be prepared for the fact that there will be two, or maybe three, visits.

Now let’s take a closer look at all the stages of treatment.

Stages of pulpitis treatment: first visit to the doctor

So, in order to accurately understand all stages of pulpitis treatment, you need to know how everything happens and how the dentist carries out the treatment:

1. Most often, the patient seeks help at the moment when he is worried strong pain, which does not stop even after taking painkillers, so the doctor immediately gives anesthesia.
2. After the injection takes effect, they begin to eliminate tissues affected by caries; for this they use a drill, which allows them to be drilled out.
3. After this, you need to install a rubber dam to prevent saliva and bacteria from getting into the cleaned canal.
4. Then the pulp is removed using a pulp extractor; this tool is very thin and has small serrations that help pull the pulp out of the thin canal.
5. Next, you need to accurately measure the root canal in order to completely fill it and thereby protect it from complications. To do this, an x-ray is taken; a tooth may have several canals, which means that each one needs to be measured.
6. Afterwards all channels are processed antiseptic solutions and install a temporary filling.

This will complete the first visit, although very often it is not always possible to carry out all this for the first time; the first visit may end with anesthesia, drilling out the canals and placing medicine in them to kill the sensitivity of the nerve.

Follow-up and final visits

But the second visit to the doctor involves the following stages of treatment of pulpitis:

• The doctor removes the temporary filling, and then the medicine from the canals.
• Next, the channels are washed with antiseptics.
• A filling is installed, and a sealer is also used for this.
• Afterwards, an x-ray is taken to check how well the canals are sealed.
• If the x-ray shows that everything is fine, then a filling can be placed.

But not only adults suffer from pulpitis, it also often bothers children who do not yet have molars, but only milk ones. Treatment of pulpitis in children with primary teeth has simple stages, only partially similar to the treatment of primary teeth. But parents must remember that inaction and untimely treatment can lead to complications.

Stages of treatment of pulpitis of primary teeth in children

Often pulpitis in a child is severe, so in this case the doctor may recommend removal baby tooth, but still, if there is even the slightest opportunity to preserve it, and the bite will not be affected, then treatment begins. Stages of treatment for pulpitis of primary teeth:

1. On the first visit, the doctor opens the nerve and applies a paste that has a devitalizing effect; it helps kill the pulp. If it contains arsenic, then it can be kept for no more than 2 days, and a product without arsenic can be kept for up to 7 days.
2. IN next visit A special substance is pumped into the tooth to mummify the infected pulp, most often it is a resorcinol-formalin mixture.
3. On the last visit, a permanent filling is installed.

Treatment of pulpitis is a simple procedure if you seek help from a doctor in time. Moreover, today thanks to modern technologies And effective means You can cure a bad tooth very quickly.

You shouldn’t sit until the last moment and wait until the pain becomes completely unbearable; it’s better to visit the dentist regularly, then you won’t have to endure the pain and have the tooth removed.

Hello, dear readers. We have prepared new interesting material for you, in which we will tell you about the biological method of treating pulpitis. You will learn what it is, in what cases it is used and how effective this technique is.

Dental problems are familiar to most people in the world. Only the lucky few have never felt toothache, and heard about caries only from advertising. This is a fact, as is the fact that great amount Our compatriots and residents of other countries are terrified of dentists. And not at all because they were “healed by evil doctors.” This is a subconscious fear. Dentistry is associated with pain. And although modern medicine has long been offering effective and safe means for anesthesia during procedures, the stereotype has not been eliminated to this day. For this reason, caries often turns into a much more dangerous and painful inflammation, and then decomposition of the dental nerve, the pulp, occurs.

What is a biological method of treating pulpitis?

In most cases, the development of pulpitis occurs in such a way that it is impossible to save the nerve. However, any specialist understands that without pulp the tooth is dead. It breaks down faster due to natural processes. Therefore, there are a number of cases when doctors try to save not only the tooth itself, but also part of the nerve. Let's explain the situation in more detail.

The pulp consists of two parts. One is located inside the crown of the tooth under the layers of dentin and enamel, the other is in the root canals. First of all, the carious process affects top part. While the inflammation has just begun, you can try to stop it. If it doesn’t work out, you have to remove the coronal part.

The biological method is without even removing the crown part. But this technique has certain limitations. They are associated with the regenerative capabilities of the dental nerve.

When is this type of treatment used:

• in children;
• in teenagers;
• in young people no older than 25–27 years.

Unfortunately, most dentists do not even offer conservative treatment for pulpitis. Why is this happening?

1. Firstly, they simply don’t have time. The flow of patients is too high.
2. Secondly, dentists are conservative people. They rarely experiment, preferring proven methods that provide an almost 100% guarantee.

If you come at the first signs of tooth pain and intend to save the nerve, immediately ask if this is possible. If the doctor answers in the negative, clarify why. Sometimes it is easier to go to a private clinic.

Why is it better to preserve the pulp?

We have already mentioned the fact that this is a kind of source of life for the tooth. It provides two main factors - nutrition and protection. When the nerve is destroyed or removed, the tooth becomes more fragile. In addition, by removing the pulp completely, the dentist is forced to clean and fill the root canals. This endodontic procedure is often performed poorly. As a result, bacteria multiply inside the canals, and an inflammatory process begins in the area of ​​the root apex. That’s why it’s so important to try to preserve the pulp, or at least part of it.

Unfortunately, in practice it is not often possible to achieve success. Usually people come for an appointment after the nerve has begun to deteriorate and a purulent inflammatory process has begun. In this case, there is simply nothing to treat. If the inflammation is initial stage, there is a chance to save the nerve and the specialist chooses the means for treatment. It takes place in two stages.

The main indications for the use of a biological method of treating pulpitis:

• primary inflammation of the pulp. In this case, a small fragment of the nerve is affected, located directly under the resulting carious cavity;
• not aggravated pulpitis, occurring in a fibrous form;
• accidental opening of the pulp chamber by a doctor when treating deep caries;
• The patient's age is up to 27 (maximum 30) years.

At the first stage of treatment, the doctor performs the following actions:

• administers an anesthetic drug to relieve the patient of pain;
• deletes hard tissues affected by bacteria;
• isolates the tooth from saliva using a rubber dam;
• treats the cavity with antiseptics;
• applies a special gasket based on calcium compounds to the bottom of the cavity. These may be materials such as Septodont, Life or their analogues;
• installs a protective liner to isolate the pulp. This is usually a glass ionomer based cement;
• installs a temporary filling.

After this, the patient receives a series of appointments. In particular, this laser therapy. One to three sessions are required. Using a helium-neon laser, the specialist acts on the neck of the tooth.

In parallel, NSAIDs (Ibuprofen and its analogues) are used to relieve inflammation. There is no point in prescribing a course of antibiotics, since “”, “Ampicillin” and similar drugs are unable to destroy bacteria that cause the development of caries. If treatment is unsuccessful, the pulp will be removed and the tooth will be filled.

The second stage of treatment (applied if the first is successful) includes:

• removal of temporary filling;
• insulation of the cavity with a rubber dam from moisture;
• installation of a seal. These are usually light-curing materials.

It is important to see your doctor regularly. If pain or discomfort appears, most likely the inflammation has returned. Here we have to resort to less gentle treatment methods. In such situations, do not delay contacting a doctor.

Back in 1999, the author V. Suntsov described the method conservative treatment pulpitis using a gel based on chlorhexidine and calcium phosphate compounds. The duration of such treatment is from two weeks to a month. The technique is relevant in the treatment of injured teeth

Video - Treatment of pulpitis of baby teeth

Conditional conservative treatment

Conditionally conservative is a method of treating pulpitis in which the doctor removes the coronal part of the pulp, while maintaining the viability of the root. Amputation of part of the pulp is performed under local anesthesia. The procedure is painless and quite quick.

This treatment is often called vital amputation. That is, a part is amputated while preserving its elements that go through the root canals into the periodontium. The technique is used for multi-rooted teeth. First of all – molars. In a single-rooted tooth, such an operation is impossible, because it does not have a clear distinction between the root and coronal pulp.

Like the biological method, vital amputation is carried out in two stages. At first, the following sequence of actions is performed:

• first, the enamel and dentin affected by the carious process are removed;
• then the doctor removes the damaged coronal pulp;
• the cavity is treated with medications;
• a therapeutic bandage based on calcium hydroxide is installed;
• A glass ionomer gasket is installed at the bottom of the cavity;

After the procedure is completed, the dentist may place a temporary filling on the tooth to monitor the condition. In parallel, physiotherapy and NSAID treatment are used, as in the previous case.

At the second stage:

• the tooth is isolated from saliva by a rubber dam;
• the temporary filling is removed;
• the surfaces of the cavity are cleaned and treated with adhesive;
• A permanent composite filling is installed.

The effectiveness of the use of red and infrared radiation in the treatment of pulp inflammation in the initial stage has also been proven. The procedures are simple, quick, and no medical examination is required. There is only one minus - there are no guarantees that the preserved nerve will not begin to become inflamed again under a permanent filling.

If after a week or more the patient begins to feel pain, the scenario is classic:

• referral for radiography or radiovisiography;
• the image is examined by the attending dentist;
• if inflammation develops again under the filling, apply classical methods treatment.

Unfortunately, relapses of pulpitis with conservative and conditionally conservative treatment methods occur frequently. In addition, these methods are not suitable for middle-aged and older people. In particular, the biological method of treating pulpitis is based solely on the ability of the pulp to recover at a young age.

Video - Treatment of pulpitis using a conservative method

What about contraindications to biological treatment?

This method, like any other, has its contraindications. In particular, we are talking about:

• purulent-necrotic pulpitis located in;
• aggravated chronic pulpitis;
• gangrenous pulpitis (they are also called ulcerative-necrotic);
• concrete;
• pathologies with focal periodontitis;
• cases when the carious cavity is located on the approximal surface or in the cervical area of ​​the tooth;
• all types of pulpitis, provided that the tooth will subsequently be covered with a crown or used as a support for installing a bridge;
• pulpitis in weakened patients, the elderly or with somatic pathologies.

It is also worth noting that the patient’s age should be a maximum of 35 years, moreover, he should not suffer from concomitant diseases!

Are you interested in this opportunity? Ask your doctor questions.

Consequences after improper treatment of pulpitis

Consequences	Photo
As a result of unfilled canals, the following develop: radicular cyst,
The occurrence of prolonged pain and neuralgia is possible as a result of refilling
If the doctor makes a mistake - perforation is allowed, a root fracture occurs, and also appears after treatment, then this will lead to tooth extraction

We wish you successful treatment. Don't forget that you can comment on the article, distribute it through blogs (with the source indicated) and social networks!

Video - Treatment methods for pulpitis