Paediatric Endodontics

Pediatric dentistry is one of the fastest-growing disciplines in daily clinical practice,whereas contemporary pedodontics involves the introduction of many new instruments,materials and techniques.Pulp therapy (pulpotomy and pulpectomy) procedure is widely used in pediatric dentistry to treat the pediatric patient since many years, while attempting to prevent the vitality of the tooth or to prevent premature exfoliation of the primary teeth.First decision regarding the primary tooth should be either to preserve it or extract it.Main reason for pulp therapy in primary teeth is to maintain teeth in the oral cavity for their functions such as esthetic,phonetics and mastication.

Root canal treatment is indicated when the pulp has become non-vital or irreversibly infected.Total elimination of microorganisms from the canal is the main goal of pulpectomy.Successful pulpectomy depends not only on specific factors such as root canal infection,complexity of root canal morphology, etc.,but is also very much depend on dentist's skill and attitudes toward the pulpectomy procedure.To achieve proper canal preparation cleansing by mechanical instrumentation and irrigation of the canals are required.Hence,in order to increase the chance of success of the endodontic treatment in primary teeth,substances with antimicrobial properties are often used as root canal filling materials in primary teeth.

Dental Pulp

The Pulp is a soft mesenchymal connective tissue that occupies pulp cavity in the central part of the teeth.

Pulp Cavity

The entire space occupied by pulp, composed of the pulp chamber and root canal

Coronal Pulp

• It is the pulp occupying the pulp chamber of the crown of the tooth
• In young teeth, it resembles the shape of the outer dentin
• It has six surfaces: occlusal, mesial,distal, buccal, lingual and floor.
• Pulp horns are projections into the This pulp constricts at the cervical region where it continues as the radicular pulpcusp.

Radicular Pulp

• It is the pulp occupying the pulp canals of the root of the tooth
• In the anterior tooth it is single and in the posterior teeth it is multiple
• The radicular portions of the pulp is continuous with the periapical tissues through apical foramen
• As age advances the width of the radicular pulp is reduced.

Apical Foramen

• Pulp cavity terminates at root apex as small opening called apical foramen
• Radicular pulp continuous with connective tissue of the periodontium through this foramen.
• Wide open during development of root

Accessory Canals

• Leading laterally from the radicular pulp into the periodontal tissue.
• Present in the apical third of the root sheath cells
• May also be present at the furcation region

Vital pulp therapy

• Defined as a treatment initiated to preserve and maintain pulp tissue in a healthy state.
• Stimulate the formation of reparative dentin to retain the tooth as a function unit.
• Dentin bridge formation and continuation of root development are primary goals of vital pulp therapy.