Guideline on Pulp Therapy for Primary and Immature Permanent Teeth
REFERENCE MANUAL V 36 / NO 6 14 / 15 Guideline on Pulp Therapy for Primary and Immature Permanent Teeth Originating Committee Clinical Affairs Committee – Pulp Therapy Subcommittee Review Council Council on Clinical Affairs Adopted 1991 Revised 1998, 2001, 2004, 2009, 2014 Purpose The indications, objectives, and type of pulpal therapy The American Academy of Pediatric Dentistry AAPD( ) intends depend on whether the pulp is vital or nonvital, based on this guideline to aid in the diagnosis of pulp health versus the clinical diagnosis of normal pulp (symptom free and nor- pathosis and to set forth the indications, objectives, and mally responsive to vitality testing), reversible pulpitis (pulp is therapeutic interventions for pulp therapy in primary and im- capable of healing), symptomatic or asymptomatic irrever- mature permanent teeth. sible pulpitis (vital inflamed pulp is incapable of healing), or necrotic pulp.2 The clinical diagnosis3 is derived from: Methods 1. A comprehensive medical history. This revision included a new systematic literature search of 2. A review of past and present dental history and the PubMed electronic data base using the following param- treatment, including current symptoms and chief eters: Terms:® “pulpotomy”, “pulpectomy”, “indirect pulp treat- complaint. ment”, “stepwise excavation”, “pulp therapy”, “pulp capping”, 3. A subjective evaluation of the area associated with “pulp exposure”, “bases”, “liners”, “calcium hydroxide”, “formo- the current symptoms/chief complaint by question- cresol”, “ferric sulfate”, “glass ionomer”, “mineral trioxide ing the child and parent on the location, intensity, aggregate” (MTA), “bacterial microleakage under restorations”, duration, stimulus, relief, and spontaneity. “dentin bonding agents”, “resin modified glass ionomers”, 4. A objective extraoral examination as well as examina- and “endodontic irrigants”; Fields: all.
[Show full text]