Periapical pathology

Classified in Biology

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Indirect Pulp Capping --> indicated in deep caries near the pulp without signs or symptoms of pulpal involvtment. Goals r avoid pulpal exposure and block passage of bacteria. Success if, absence of signs n symp of pulpal pathology, correct isolation, careful cleaning of axial walls, good seal of resto margins. Procedure, elimination of infected dentin, place biocompatible material on layer of demineralized uninfected dentin in order to inactivate remaining bacteria, remineralize lesion by formation of reparative dentin, materials, zinc oxide, eugeono dycal. 

Direct pulp capping --> indicated in temp teeth only when pulp has been inadvertently exposed during operative procedure. Tooth must be asymptomatic, pulp expo is minimal <1mm, good isolation never is exposure is due to decay. Based on application of agent directly on pulp, if failure, manifests as abscess or internal resorption. Caused by CaOH, materials, root canal repair material, calcium hydroxide powder.
pulpotomy --> amputation of coroonal portion of  affected pulp, pulp tissue at root canals levels is capable, in absence of inflammatin, of healing once the affected portion of pulp is removed. Indications, temp dentitionm in those cases where ony cameral pulp affected, with irreversible pulpitis, while root canal pulp is vital with no clinical or radiological signs of inflammation. Teeth susceptible to be restored. 2/3 radicular canals must be healthy. Contraindications, sponteneous pain or percussion provoked pain, abnormal mobility, presence of fistula, internal or external reabsorption, pulpar calcifications, presennce of periapical areas at interaradicular level, excessive bleeding during pulpar treatment. Materials used in this techniqeu have to accomplish certain requirements, bactericidla, innnocuous to pulp tissue, promote healting of radicular pulpl, do not interefere in radicular reabsorption process of temporary teeth. Materials, formocresol, glutaraldehyde, ferric sulphate, MTA, 3% NaOCL formacrestol, used during 3 mins, 70-79% radiological n clinical success and glutaraldehyde, better fixating properties with less diffusion, but less clinical and radiological response

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