First use
Advice for new Pulpotec® users:
- Strictly adhere to the instructions in the packaging and respect the limitations of use.
- Treat only pulpitis in vital molars (the only exception to this essential rule is the treatment of infected temporary molars, even if an abscess is present. However never apply Pulpotec® beyond the floor of the pulp chamber).
- Treat only molars, permanent or temporary (see FAQ).
- Pulpotomy is a simple procedure that must be performed carefully to achieve good results. Perform a straightforward pulpotomy with high-speed mechanised rotary instruments to avoid tearing the root threads and by evicting all cameral pulp.
- A little residual blood in the cameral chamber does not affect the success of the pulpotomy.
- Pulpotec® being Eugenol free, any bonding application on the treated tooth is advisable.
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FAQ
Go to Safety & FORMALDEHYDEHow Pulpotec® maintains vitality of underlaying pulp?
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How Pulpotec® maintains vitality of underlaying pulp?
FAQ
Yes, when used as intended, Pulpotec maintains the vitality of the residual radicular pulp after a pulpotomy treatment.
The components of Pulpotec®, formaldehyde in particular, are not diffused beyond the pulp chamber, but only react at the level of the interface paste / pulp, maintaining the vitality of the underlying radicular pulp.
Toxicological and scientific data show that repeated exposure to formaldehyde is safe under appropriate protective equipment (wear gloves, mask and protectives glasses).
Yes. Numerous documented clinical cases highlight long-term efficiency with clinical and radiographical follow-up covering period up to 18 years after the placement of Pulpotec® during pulpotomy on permanent vital molars.
As practitioner’s diagnoses and work count for major importance in the treatment’s success, it is needed to ensure:
- an uncompromising initial diagnosis;
- a pulpotomy carried out scrupulously, using sharp-cutting instruments to assure a clear section, without tearing radicular fibres, and taking care of efficiently removing all the cameral pulp;
- a permanent obturation, covering the Pulpotec®, being perfectly tight.
The management of pain is detailed in clinical follow-up. It highlights the fact that 80% to 100% of patient have immediate pain relief after pulpotomy treatment with Pulpotec®. In the minority of case where pain remains, it is assessed by the patient as mild pain and it disappears in most cases within 2-3 days.
In some rare and exceptional cases, pain has continued. These situations are described hereafter.
a) Occasionally pain may persist during 1 – 2 days, and its causes are in general:
- A pulpitis which has not been treated for a long time. A rapidly treated pulpitis does rarely cause any pain.
- Too much compression of the Pulpotec® in the pulp chamber, causing pressure on the underlying radicular pulp.
- A pulpotomy treatment that was not done meticulously enough, using unsharp cutting instruments, leaving some radicular pulp fibres residues in the pulp chamber.
b) Other cases leading to more persistent pain were:
- Pain of medium intensity which has lasted until the second session. To remedy this, all traces of Pulpotec® should be removed after desobturation and a fresh dose of the product should then be inserted and covered with a temporary dressing.
- Persistent pain of arthritic type. This will disappear after anti-inflammatory treatment.
In approximately 1 case per 1000, acute pain could be caused by:
- treating a tooth which is not vital
- an undiagnosed coronal fracture or perforation of the cavity floor.
In this case, after de-obturation, a new diagnosis should be made and treated accordingly either by pulpectomy or, where necessary, by extraction.
c) Finally, in some very rare cases pain occurs during mastication, appearing only several months after the tooth was treated.
Unless a different diagnosis is set (lack of tightness, cameral perforation, fracture of the tooth), one can conclude that the pain of arthritic type is usually due to an over-occlusion of the treated tooth. In this case, a controlled milling of the occlusal surface of the treated tooth is usually sufficient to suppress the symptoms.
Yes, when used as intended, Pulpotec maintains the vitality of the residual radicular pulp after a pulpotomy treatment.
Scientific literature confirms the fact that the components of Pulpotec®, formaldehyde in particular, are not diffused beyond the pulp chamber, but only react at the level of the interface Pulpotec®/pulp, maintaining thus the vitality of the underlying radicular pulp.
Vital bicuspids and single-rooted teeth can also be successfully treated by experienced dentists having good knowledge and experience of Pulpotec®. As a matter of fact, this type of pulpotomy is more delicate to realize and should be achieved by practitioners having a good prior knowledge of the technique on molars. As in these teeth pulp chamber is absent or limited, special care is required to avoid weakening of the tooth during instrumentation and over instrumentation leading to exposition of radicular pulp to Pulpotec®.
Treatment with Pulpotec® can be realized in one or two visits.
Independently of the number of visits, one of the key points is to ensure highly tight restoration above the pulpotomy treatment. Pulpotec® being Eugenol free, any bonding application on the treated tooth is advisable.
If the clinical situation requires 2 visits, the second one is generally foreseen 4 to 8 days after the first one.