Radiopaque, non resorbable paste for the treatment of pulpitis by pulpotomy in vital molars, both permanent and deciduous
Powder : Polyoxymethylene, Iodoform, excipient Liquid : Dexamethasone Acetate, Formaldehyde, Phenol, Guaiacol , excipient
Pulpotec is a ﬁlling paste for simple, rapid and long term treatment by pulpotomy of vital molars, both perma nent and deciduous. The addition of pharmacological cons tituents ensures an aseptic treatment, induces cicatrization of the pulpal stump at the chamber-canal interface, whilst maintaining the structure of the underlying pulp. The efﬁciency and the properties of «PD» Pulpotec are substantiated by a radiographic ﬁle compiled on the basis of results of over 300 pulpotomies performed with Pulpotec and monitored for periods of 3 to 13 years.
Adults : treatment of pulpitis on permanent vital molars. This actually includes the pre-treatment of molars prior to making abutments for a ﬁxed prosthesis (either individual or bridge).
Gerodontics : treatment by pulpotomy of molars suffe ring calciﬁed root-canal. Clinical recovery of the tooth can be brought about by using the same methods as those used in treating young adults.
Pedodontics : treatment of pulpitis on immature perma nent vital molars, enabling a complete radicular restoration of the tooth. Treatment of pulpitis in temporary vital molars. Treatment of infected deciduous molars by pulpotomy even in the presence of an abscess. This indication is the only exception to the rule of pulpotomy on vital teeth, and must be treated by regular pulpotomy, without going beyond the ﬂoor of the pulp chamber in order Pulpotec never to be introduced in the radicular canal of deciduous teeth. The numerous indications for using Pulpotec in pedodontics, clearly indicate its usefulness in this ﬁeld.
DIRECTIONS FOR USE
Perform pulpotomy in the usual way. Pulpotec being antisep tic, the use of a rubber dam is optional. Utilise high-speed rotary instruments in order to avoid tearing of the radicular endings and take care to eliminate all the cameral pulp. The use of Pulpotec after a pulpotomy performed with laser is also recommended.
Two methods can be recommended for inserting Pulpotec into the pulp-chamber :
- The traditional method : Mix Pulpotec liquid with Pulpotec powder and blend to obtain required thick, creamy consisten cy of the paste. Insert the paste into the pulp-chamber with a large sized paste ﬁller. The presence of small quantities of blood does not affect the efﬁciency of Pulpotec. Air-dry the cavity just prior to applying the paste. Seal with a temporary cement. Place a cotton roll between the 2 dental arches and request the patient to bite progressively but ﬁrmly, so that the Pulpotec paste clings to the walls of the pulp-cavity as well as to the root-canal oriﬁces.
- Another efﬁcient but simple method for inserting Pulpo tec into the pulp-chamber : mix the powder and the liquid on a glass slab and blend until the mix reaches the consistency of a small, supple ball of putty. Shape the ball into a cylinder and insert directly into the pulp-chamber. Press into place with a spatula and continue as indicated above with the tem porary cement and the cotton roll.
Setting time of Pulpotec is approximately 7 hours.
The second session should take place once the initial Pulpo tec insert has set. The treatment can then be completed by setting the ﬁnal tight obturation with amalgam or any other suitable material. This can be directly placed on the Pulpo tec, possibly leaving a thin intermediary layer of temporary cement to insulate Pulpotec from the ﬁnal obturation mate-rial. Pulpotec being Eugenol free, any bonding application on the treated tooth is advisable. Though not totally neces sary, a ﬁxed prosthesis is recommended in order to ensure tight sealing, resistance and long-term results.
In most cases, Pulpotec treatment is practically painless. Rare exceptions where pain has continued until the second session have, however, been recorded. 3 typical cases have been determined:
- Pain of medium intensity which has lasted until the second session. To remedy this, all traces of Pulpotec should be removed after de-obturation and a fresh dose of the product should then be inserted and covered with a tem porary 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.