Cvek pulpotomy – revisited

Abstract

Background/Aim While some studies support the notion that the time elapsed from coronal fracture and treatment with Cvek pulpotomy in permanent teeth plays an important role in minimizing the possibility of pain and discomfort, microbial pulp invasion, and ensuring pulp and periodontal healing, others consider that neither time between the accident and treatment nor size of exposure is critical if the inflamed superficial pulp tissue is amputated to the level of a healthy pulp. This study compares published data in an attempt to assess whether the outcome of Cvek pulpotomies is affected by these factors. Results and conclusions Evidence in the literature suggests to treat a permanent tooth with a complicated crown fracture as soon as possible to diminish the possibility of pain and prevent necrosis and infection of the pulp. Delay of treatment by 9 days or less may have minimal effect on the outcome of Cvek pulpotomies. While the literature indicates that pulp exposures of 4 mm or less may have a good prognosis after a Cvek pulpotomy, the prognosis in teeth with pulp exposures of more than 4 mm has not yet been clarified. Although the literature is not conclusive regarding a difference in the outcomes of Cvek pulpotomies in teeth with open or closed apices, it appears that teeth with open apices have a better prognosis. The outcome of a Cvek pulpotomy may be compromised by a luxation injury that diminishes the tooth's blood supply and innervation. A good restoration that prevents bacterial penetration into the tooth is essential for the success of a Cvek pulpotomy.

Success of endodontic management of compromised first permanent molars in children: A systematic review

“…Despite these guidelines, their use for cFPM in amongst dental care professionals appears to remain limited . Partial and coronal pulpotomies are endodontic techniques that have shown to be successful in immature anterior teeth in children and adults . Coronal pulpotomies have good success rates in permanent posterior teeth with closed apices in adults .…”

The assistance of Er,Cr:YSGG laser in pulp injury related to anterior teeth trauma

“…If the pulp examined is considered vital, a pulpotomy procedure involving partial removal (2 mm) of the pulp tissue using a sterile diamond bur housed in a high speed hand piece A B followed by the application of a pulp dressing prior to restoration is usually performed. 10 Furthermore, a partial pulpotomy might be advisable in cases of young patients with complicated trauma involving exposure larger than 1 mm or/and occurring within 48 hours of therapy. [6][7][8][9][10] Because the treatment includes surgical removal of soft tissue and preparation of the hard dental structure, the research investigated laser-assisted partial pulpotomy as an atraumatic and aseptic technique which represents an alternative to conventional procedures.…”

“…10 Furthermore, a partial pulpotomy might be advisable in cases of young patients with complicated trauma involving exposure larger than 1 mm or/and occurring within 48 hours of therapy. [6][7][8][9][10] Because the treatment includes surgical removal of soft tissue and preparation of the hard dental structure, the research investigated laser-assisted partial pulpotomy as an atraumatic and aseptic technique which represents an alternative to conventional procedures. The majority of the clinical studies reported in the literature highlight the laser coagulation procedure relating to mechanically-exposed pulp during the removal of caries.…”

Partial Pulpotomy of Immature Anterior Permanent Teeth with Complicated Crown Fractures: Report of Two Cases

“…The use of other alternatives, such as bioceramic-based cements, has been reported (10). A good restoration that prevents bacterial penetration into the tooth is essential for the success of partial pulpotomy (16). Regaining the normal shape and function of a crown severed with a complicated fracture is challenging.…”