J. Formocresol has been a popular pulpotomy medica-ment in the primary dentition and is still the most universally taught pulp treatment for primary teeth. American Academy on Pediatric Dentistry Clinical Affairs Committee-Pulp Therapy subcommittee, et al. (2013) studied 117 primary molars with deep carious lesions that were planned to have vital pulp therapy treatment. A patient may present with signs and symptoms that indicate reversible pulpitis, while if the pulp was histologically examined would demonstrate changes equivalent to chronic total pulpitis and need a pulpectomy or extraction (Seltzer et al., 1963). Maxillary primary incisors in children younger than 4 years that are mobile with large caries are likely infected. It was found that by using a glass ionomer interim therapeutic restoration (ITR) before treatment for 1–3 months accurately diagnosed the primary molar’s pulp vitality in 94% of the cases compared to 78% of the teeth when no ITR was used. Conclusions and practical implications: The guideline intends to inform the clinical practices with evidence-based recommendations on vital pulp  |  The diagnosis of the primary tooth’s vitality is not always straightforward. American Academy of Pediatric Dentistry Clinical Affairs Committee--Pulp Therapy Subcommittee; American Academy of Pediatric Dentistry Council on Clinical Affairs. A cavitated lesion in a primary molar may cause pain at bedtime but not have irreversible pulpitis. A normal pulp is a symptom-free tooth with normal response to appropriate pulp tests. The treatment objective of an ideal pulpotomy agent is to leave the radicular pulp vital and healthy, completely enclosed within an odontoblast-lined dentin chamber. Look for teeth with caries that show a missing filling, soft tissue redness, fluctuance, or a draining fistula. Histological evaluation of enamel matrix derivative as a pulpotomy agent in primary teeth. I recommend using a finger to press on a nonsuspicious tooth first. Kids and adults. Holan (2004) studied 97 primary incisors that exhibited dark discoloration after trauma. It is unwise to maintain untreated infected primary teeth in … The child can have a snack at bedtime and go to bed without brushing the teeth. This tooth sensitivity is usually the first sign that your child may have caries.1 Your doctor will recommend that your child undergo a pulpotomy if, upon dental examination, it is discovered that your child has caries (tooth … Although MTA is considered the gold standard material for pulpotomy procedures, it has some drawbacks (poor handling, staining potential, long setting time); thus, it is important to evaluate the clinical performance of other calcium silicate … A reversibly inflamed pulp can then cause the child to complain of “pain at night,” which is not spontaneous pain. Then, press on the suspicious tooth and look for any sign of discomfort in the child’s expression. 2006 Sep;7(3):124. A pulpectomy may be performed on primary teeth when the coronal pulp tissue and the tissue entering the pulp canals are vital but show clinical evidence of hyperemia (Fig. Pulpectomy, on the other hand, is similar to a root canal. The parents brought most of the children 7–14 days after trauma because most presented with a gray color within 1 month after trauma. The teeth that lightened in color showed pulp canal narrowing or obliteration, but in most cases no infection. An avulsed primary teeth should not be reimplanted and have a pulpectomy performed (Flores et al., 2007). Pediatric Dentistry – 21:2, 1999 Pulpotomy is the treatment of choice for cariously exposed pulps in vital primary teeth. In this technique, the coronal pulp is removed, and the remaining radicular pulp is opined to be vital and free of any pathological alterations [3]. According to Camp (2008), spontaneous pain is a persistent or throbbing pain that occurs without provocation or persists long after the causative factor has been removed.  |  Carla Cohn, DMD. In these18 patients, the dentist was not sure if the pain was reversible or irreversible pulpitis. Dr Chanel McCreedy reviews Pulp Therapy and Primary Tooth Pulpotomy for students preparing for their clinical rotations at TCDC. An interim therapeutic restoration using glass ionomer cement was placed. The National Institute of Dental and Craniofacial Research reports that 42 percent of children ages 2 to 11 develop cavities in their baby teeth. Pulpotomy for Primary Teeth with Tricalcium Silicate Material. Although pulpotomy is the treatment of choice for vital primary tooth pulp exposure throughout the pediatric dental literature 8, the current trend amongst many dentists is to perform pulpectomies for the pulp treatment of carious vital primary anterior teeth 9.