Pulpectomy for Primary Teeth

This chapter provides a background on primary tooth pulpectomy and aid the clinician on the step-by-step techniques to successfully perform the procedure. Pulpal vitality assessment is based on reaching one of three clinical diagnostic assessments: normal pulp; reversible pulpitis; or irreversible pulpitis/necrosis. A primary molar with deep distal caries near the pulp without gingival swelling, but that has pain of a short duration when the child chews a candy, can be easily misdiagnosed as vital. The clinical evaluation involves assessing the child for signs and symptoms of irreversible pulpitis or necrosis clinically or by history. A temporary tooth color change occurring in primary incisors after trauma in many cases does not indicate necrosis. Radiographic evaluation with good-quality films is essential to help obtain the proper diagnosis of a primary tooth suspected to have irreversible pulpitis or necrosis. The chapter describes only primary molar pulpectomy because of space limitations.