Dental diseases require qualified treatment. When a patient is diagnosed with pulpitis and other pathologies of the internal tissues of the teeth, pulp extirpation is usually performed. It is strictly forbidden to postpone a visit to a medical institution, as pathology can lead to serious consequences.
Description
Devital extirpation is a method of surgical treatment of acute or chronic pulpitis. As a result of surgery, the absolute removal of the pulp is carried out. The technique is considered one of the most reliable, as it prevents the further spread of infection and, as a result, the formation of periodontitis.
Indications
Devital extirpation may be prescribed for various types of pulpitis, deep caries and periodontitis. Also, this method of surgical intervention can be indicated in case of trauma to the tooth or other orthopedic circumstances.
Indications for devital extirpation may bedifferent, even such as the lack of time for qualified treatment at the initial appointment, the lack of a positive result with conservative treatment and the presence of allergic reactions to local anesthetics when vital extirpation cannot be applied. Consider contraindications.
Contraindications
Devital extirpation is contraindicated in:
- intolerance to the components of the devitalizing paste;
- purulent inflammation of the pulp;
- myocardial infarction, which was transferred from 6 to 12 months ago;
- exacerbation of hypertension diagnosed in the third stage;
- jaw reduction;
- microscopy;
- defective psyche of the patient.
All listed contraindications must be taken into account. Before the procedure, they must be excluded. Only in this case, unforeseen situations can be avoided.
Stages of implementation
The method of devital extirpation is based on the killing of the pulp and its complete removal. It is considered traditional and is carried out in all dental clinics. The technique of devital extirpation is implemented in several visits. It is because of this that the patient has to visit the dentist at least three times.
First visit
At the initial visit to the dentist, the patient undergoes a comprehensive sanitation of the diseased tooth and anesthesia is performed. Then the tissues affected by the infection are removed and the tooth is carefully processed.special medicines. A hole is formed in it through which access to the pulp is provided. If, after opening the tooth, the patient feels severe pain, then an anesthetic must be injected into the carious cavity.
Arsenic paste is placed in the formed hole, which helps to kill the tissues. If the manipulations are performed in a tooth with one root, then the process lasts a day, and for 2-root teeth it will take twice as long. In the process of applying arsenic paste, close attention is paid to sealing the carious cavity. Be sure to check if arsenic acid has leaked between the wall of the carious cavity and the bandage, as this threatens to cause toxic papillitis.
Depending on the number of roots and the required time, a second visit is planned. If, for some reason, re-admission is impossible after such a short period of time, then a similar substance is laid, which has a delayed effect. After the paste is placed, the hole in the tooth is closed with a temporary dressing.
Second visit
During a devital extirpation, the patient's dental dressing and the remaining fragments of the pledged substance are removed at the return visit. After that, the vault of the cavity is liquidated and the pulp is removed. The next stage of work is measuring and expanding to the required shape of the canal cone in accordance with all dental rules. In parallel with these manipulations, all remaining harmful bacteria are destroyed. The second visit ends with a fillingcanals and the imposition of a temporary filling on the cavity.
Third visit
If all the previous stages of devital extirpation were performed qualitatively and correctly, then by the final visit to the doctor, the patient does not experience any pain or unpleasant symptoms. Convinced of this, the dentist removes the temporary filling, and then lays the medicine and starts to recreate the tooth.
Thanks to current technology, high-quality filling products and the latest restoration methods, the original shape of the tooth is fully renewed with all functions. The final stage of restoration is tooth grinding, surface fluoridation using special preparations. All of the above actions of the dentist help protect tissues from the negative effects of bacteria and strengthen them.
Possible Complications
In most cases, devital extirpation resolves without further complications. But sometimes patients still complain about post-filling pains, which can have different durations. If the pain lasts for several days, then this does not indicate abnormalities and is considered normal. This is explained by the fact that devital amputation and extirpation are quite traumatic procedures.
If the pain does not subside for five or more days, then in this case you need to seek qualified medical help.
As practice shows,post-filling pain occurs as a result of the following medical errors:
- When the pulp is not completely removed. In some cases, the dentist does not completely remove the pulp, leaving inflamed tissue at the root tip. It is as a result of this that the infection spreads and pain appears.
- As a result of the filling material being pulled out of the root apex. Such a mistake can lead not only to pain, but also to inflammation of the mandibular nerve.
- When leaving part of the instrument in the channel. This leads to the fact that the channel is not completely sealed, which, in turn, contributes to infection and pain.
- As a result of damage to the root wall of the tooth by dental instruments.
When such an unpleasant situation occurs, it is necessary to close the resulting hole as soon as possible. Otherwise, this can lead to the development of a serious and severe inflammatory process, which is also dangerous because it can go to neighboring teeth. Sometimes such mistakes by doctors can lead to the appearance of cysts, the development of periodontitis, osteomyelitis and other equally serious complications.
Pain syndrome may appear as a result of mechanical separation of the pulp near the apical foramen. As a result, periodontal irritation occurs, which is eliminated with the help of painkillers. In particularly difficult cases, fluctoorization or darsonvalization may be necessary.
Complications include mucosal burns, which canappear as a result of improper diathermocoagulation. To eliminate such a complication, it is necessary to treat the focus with antiseptic drugs and conduct anti-inflammatory therapy.
The formation of complications can also occur as a result of non-fulfillment of postoperative recommendations. Long-term presence of arsenic in the tooth cavity can provoke the development of periodontitis. This occurs as a result of postponing a return visit after the first stage of a devital pulpotomy. To prevent the development of complications, all recommendations of the dentist must be followed unconditionally.
