Application Of Pulpotomy And Dental Pulp Revascularization In The Treatment Of Permanent Teeth Diagnosed With Endodontic Diseases

Pulpotomy refers to the treatment of cutting off the inflamed pulp,covering the pulp tissue with pulp capping agent and preserving the remaining healthy pulp tissue.It is a type of vital pulp therapy.This article shows the application of pulpotomy in the treatment of deep caries(3 cases)and chronic pulpitis(3 cases),in which 2 patients combined with caries risk assessment measures.In these cases,high-speed emery ball drill and Er: YAG laser were used to remove the crown infected pulp of the carious pulp exposure.The healthy pulp tissue was tightly covered with the bioceramic material i Root BP Plus,and the resin material was replaced for permanent filling at the follow-up visit.During 3months follow-up,the patients had no subjective pain symptoms,the clinical examination showed that the pulp temperature test reaction of the teeth were normal,and the electrical activity test of them were similar to that of the control teeth.There was no internal resorption,abnormal calcification or periapical tissue abnormality in the radiographic observation.After oral health education and correction of bad living habits,the caries risk of two patients was significantly reduced.Dental pulp revascularization is a treatment method to protect dental pulp stem cells,dental papilla mesenchymal stem cells and periodontal ligament stem cells as much as possible by thoroughly and effectively disinfecting the root canal.Stimulating periapical tissue bleeding and introducing blood into the root canal,it provides a suitable microenvironment for stem cell proliferation and differentiation by using the growth factor rich blood clot.So as to promote the tooth root to continue to elongate,dentin wall thickening and apical foramen closure.This paper presents two cases of periapical periodontitis of young permanent teeth caused by fracture of abnormal central cusp.After irrigation with 1.5% sodium hypochlorite and 17% EDTA and root canal sealing with triple antibiotic pastes(metronidazole,ciprofloxacin and cefaclor)to control inflammation,the aseptic K-file stimulated the root apical area to introduce blood into the root canal to form a blood clot.Then the crowns were sealed tightly with i Root BP Plus and composite resin.During the follow-up of 3 and 6 months,the patients had no subjective pain symptoms,no sinus in gingiva and showed positive reaction of electrical activity test.In addition,the radiographic examination displayed significant reduction of low-density shadow in apical area.However,no imaging manifestations of root redevelopment such as thickening of the dentin wall,root elongation and apical foramen closure were observed.Pulpotomy aims to preserve healthy pulp tissue in order to maintain normal pulp state and function,while pulp revascularization aims to regenerate pulp like tissue to promote the continuous development of the root.Both of them are the preferred treatment options after different degrees of pulp injury.