1. National Medical University
A.A.Bogomolets
Lecturer:
Dr. A.V.Barysenko
Student:
Parisa Pour Khosrow

2. Plan:
1. The methods of pulpitits treatment
2. Conservative (biological) pulpitis treatment
3. Biological (conservative) pulpitis treatment
method technique

3. PULPITIS TREATMENT METHODS
PULPITIS TREATMENT METHODS
Conservative (biological) Operative (endodontic)
Save all
Vital Devitalization
pulp
Vital Vital extirpation
amputation
Devitalize Devitalize
amputation extirpation
Mixed methods

4. Conservative (biological) pulpitis treatment
The biological method of pulpitis treatment is
directed to make pulp healthy with renewal of its
function. The important value has its complete
renewal or saving its basic functions:
• formative
• nutritive
• reparative
• It save the valuable hard tooth tissue structure
• made protective
• barrier actions
• prevented the apical periodontitis development

5. The pulp has a very good defensive
properties. It has ability to detain microbial
invasion, especially at first 24-48 hours of
inflammation development. During
inflammation increasing pulp lymph
formation and outflow; increasing nerves
regulative influence on pulp trophic. In pulp
increasing formation biological active
substance, which stimulated its regeneration.

6. During selection of conservative method of pulpitis
treatment the dentist must pay attention to the row of
different factors:
 Clinical form of pulpitis.
 Disease duration.
 Patient age.
 Patient general condition.
 Available general systemic diseases.
 Caries cavity localization.
 Teeth groups (one-root, multy-root).
 Absence changes in periodontium
 Infection ingress into tooth pulp.
 Caries coarse.
 Absence previous antibiotic or
 corticosteroid therapy of systemic
 diseases.

7. At first appointment
1. Oral cavity toilet.
2. Preparation of the operation field, isolation by cotton
rolls or rubber dam.
3. Obtain regional anesthesia:nerve block or infiltration.
4. Remove all caries dentin of caries cavity and, with a
sharp explorer, test the pulp for depth of anesthesia.
When necessary made perforation of pulp chamber
for better penetration of medicaments into pulp.
5. Irrigation caries cavity with warm antiseptic solution.
6. Placing the medicament paste on the caries cavity
floor (indirect of direct pulp capping).
7. Temporary filling (dressing) of the caries cavity.

8. Different materials for the biological
(conservative) treatment of pulpitis:
1. Antibiotics
2. Sulfonamide
3. Corticosteroids
4. Calcium hydroxide (The most important)
5. Zinc oxide-eugenol

9. Calcium hydroxide
have a very base reaction – pH=12,5.
It has antibacterial, anti-inflammatory
action,stimulate dentin remineralization
And secondary dentin formation.

10.  After 7-14 days at the second patient appointment when
pain is absent removed temporary dressing, when need
place the fresh portion medicament paste on the caries
cavity floor, paced the isolation base and finally close the
caries cavity with composite or amalgam restoration. After
successfully treatment on the surface of the opened pulp
the formation of dental bridge is observed. When indirect
pulp-capping method was used in the pulp the formation
secondary dentin was observed.
 When the pain continued (but with lesser insensitivity) the
caries cavity repeated filled with temporary dressing.
When the pain continued with more insensitivity it means
that pulpitis become irreversible and the most effective
treatments method is pulpectomy.
 After vital pulp therapy the dentist must made control
examination the tooth through 3, 6 and 12 months after
treatment. Clinical estimations based on radiographic
examination and pulp vitality test.