EVALUATION OF A VITAL PULPOTOMY PROCEDURE IN TEETH

人们普遍认为，当患者的牙病发生时，可以使用覆盖义齿

It is generally accepted that an overdenture may be indicated when the remaining teeth and periodontium cannot support a conventional partial denture. The patients' best interests are often fulfilled by not rendering them edentulous. The purpose of this clinical and histological study of 20 patients is to evaluate the feasibility of utilizing vital pulpotomy procedures as a substitute for complete endodontic treatment in single-canal teeth to be retained for overdenture support. A method is proposed that eliminates the need for endodontic treatment on overdenture abutment teeth. This approach reduces treatment time and cost, yet provides increased efficiency in mastication and sensory perception as well as a state of well being and increased confidence to the patient. Three teeth that satisfy criteria for overdenture abutments are identified in one arch of each patient. These teeth will be treated, as necessary, to achieve a healthy periodontium. Immediate dentures are fabricated and at delivery, the abutment teeth each have a pulpotomy performed utilizing a selective sterile technique. Following removal of pulpal tissue to a selected depth, hemorrhage is controlled until stopped. Dentinal chips are obtained from the pulpal wall and placed over the pulp. Dycal is placed over the dentinal chips to approximately a 1 mm. depth and when set, silver amalgan is gently layered in using lateral condensation to avoid pressure on the pulp. The remaining pulp chamber is filled and root surface contoured to meet the dimensions of conventional overdenture abutments. Complete root canal therapy will be performed if any of the pulpotomized teeth exacerbate. Post-insertion evaluations will be performed at 1 day, 2 weeks, 3 months, 1 year and 2 years. Histologic evaluation will be made when the third tooth (control) is extracted at the third month after insertion of the overdenture. The remaining two roots will serve as long-term overdenture abutments.