Non-absorbable and radiopaque paste for the treatment of pulpitis by pulpotomy of permanent or temporary vital molars
Powder: polyoxymethylene, iodoform, excipient Liquid: dexamethasone acetate, formaldehyde, phenol, guaiacol, excipient
Pulpotec “PD” is a filling paste for the simple, rapid and long-lasting treatment of pulpitis by pulpotomy of permanent or temporary vital molars. The addition of pharmacological components ensures the asepsis of the treatment, causes healing of the pulp stump at the camero-canal interface and allows the maintenance of the underlying pulp structure. The effectiveness and properties of Pulpotec are conﬁrmed by an X-ray record of over 300 molar pulpotomies performed with Pulpotec and followed over a period of 3 to 13 years.
adults : treatment of pulpitis on
living teeth of permanent molars, including, in fact, the preparation of the
molars for the realization of joint prosthesis abutments (bridge or unitary).
In gerontology : treatment of molars with calcified canals, making it possible to obtain clinical silence of the tooth by pulpotomy with the same indications as in young adults.
In pedodontics: treatment of pulpitis on living teeth of immature deﬁnitive molars, allowing complete root ediﬁcation of the tooth. Treatment of pulpitis on living teeth of temporary molars. Treatment, by pulpotomy, of infected temporary molars, even in the presence of abscesses. This indication is the only exception to the principle of treatment on living teeth and must be treated by simple pulpotomy, without going beyond the floor of the pulp chamber, Pulpotec must never be introduced into the root canal of lacteal teeth. The large number of indications for Pulpotec in pedodontics makes it particularly useful in this specialty.
Perform a pulpotomy using the usual technique. Pulpotec being antiseptic, the installation of the dam is optional. Use high speed rotating instruments to avoid root thread tearing and take care to remove all cameral pulp. The use of Pulpotec after performing a laser pulpotomy is also recommended.
2 methods of fitting the Pulpotec can be recommended:
- Traditional method: extemporaneously mix Pulpotec liquid and Pulpotec powder until a paste of creamy consistency is obtained. Use a large diameter dough packing to introduce it into the pulp chamber. The presence of some residual blood does not affect the effectiveness of Pulpotec in any way, it will suffice to give an air syringe pressure in the pulp chamber just before placing the Pulpotec there. Place a temporary filling cement on the tooth, interpose a cotton roll between the two arches and bite the patient gradually, but frankly, so that Pulpotec closely follows the walls of the pulp chamber and the openings of the root canals.
- There is also another simple and equally effective method to introduce Pulpotec into the pulp chamber: extemporaneously mix the powder and the liquid of the Pulpotec on a glass plate until you obtain a pellet with a supple mastic consistency, give it an elongated shape in order to place it directly in the pulp chamber, push it further with a spatula, then proceed as previously with the temporary filling cement and the cotton roll.
The setting time for Pulpotec is approximately 7 hours.
During a second session carried out after the installation of the Pulpotec, the treatment will be completed by the installation of a final waterproof filling, in the form of an amalgam or any other suitable material, placed directly on the Pulpotec, leaving, optionally, a thin intermediate layer of temporary cement which will act as an insulation material between Pulpotec and the definitive filling material. Pulpotec does not contain eugenol, it is possible to perform a bonding on the treated tooth. Although this is not essential, it is recommended to perform a joint prosthesis on the treated tooth to perfect its seal and to consolidate it in order to ensure greater durability.
Potential side effects
In the majority of cases, the placement of Pulpotec causes little or no pain. There is, however, the exceptional possibility of persistent pain. 3 cases have been described:
- Pain of moderate intensity persisting until the 2nd session. After unblocking, Pulpotec will be removed and a new dose of product will be reinserted and covered with a temporary dressing.
- Persistent arthritis-like pain: this disappears after systemic anti-inflammatory treatment.
- In about 1 in 1,000 cases, severe pain, the causes of which may be:
undiagnosed coronary fracture or perforation of the floor
After disobturation and new diagnosis, treat as appropriate: by pulpectomy, if necessary by avulsion.
A tooth treated with Pulpotec and bearing a fixed prosthesis (crown, bridge) and radiologically sound, can present after a variable time (3 months to a few years) arthritis-type pain. These normally stop after grinding the overbite which is the cause.
Avoid contact of Pulpotec with soft tissue. If necessary, rinse thoroughly with water. Contains polyoxymethylene and formaldehyde. Toxic by inhalation and ingestion. Contact with skin may cause irritation, burns or hypersensitivity. In the event of contact with the eyes, rinse thoroughly with running water and consult a doctor.
Store at room temperature between 5 ° and 30 ° C, away from direct light.
Portion: 15 g powder + 15 ml liquid
*Pulpotec is indicated for the treatment of pulpitis, by pulpotomy, of vital molars (also infected in the case of milk teeth).
However, vital premolars and monoradiculate can also be treated successfully by practitioners experienced in the use of Pulpotec on molars.
In these cases too, pulpotomy, which is a simple technique, must not be performed scrupulously to obtain good results.
Treatment in one sitting?
Treatment with Pulpotec is normally carried out in two sessions, the second being scheduled between 4 and 8 days after the first. However, if it is necessary or impossible to schedule a second session, it is quite possible to carry out the treatment of the tooth in one session.
This method shows great results too. Then place Pulpotec, after pulpotomy, according to one of the two recommended methods (usual or rapid). Be sure to perform the pulpotomy in a very conscientious manner with sharp instruments.
After having treated according to the “directions for use”, wait about 5 minutes after placing the temporary cement and then use a rotary instrument to remove it. Replace it with a permanent waterproof seal (composite, glass ionomer, amalgam).
If there is any doubt about the initial diagnosis of pulp vitality or when a definitive prosthetic reconstitution is planned, it is recommended to proceed with the treatment in two sessions.