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. Postponing a visit to a medical institution is strictly prohibited, since 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, 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 consequence, the formation of periodontitis.
Indications
The devital extirpation can be prescribed for various types of pulpitis, deep caries and periodontitis. Also, this method of surgical intervention can be indicated for tooth trauma or for other orthopedic reasons.
Indications for devital extirpation can be different, even such as the lack of time for qualified treatment at the initial intake, the absence 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 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;
- mixing jaws;
- microscopy
- inferior psyche of the patient.
All listed contraindications should be taken into account. Before the procedure, they must be excluded. Only in this case can unforeseen situations be avoided.
Stages
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 devital extirpation technique 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 comprehensive sanitation of the diseased tooth and anesthesia is performed. Then the tissues affected by the infection are removed, and the tooth is carefully treated with 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 anesthetic is necessarily injected into the carious cavity.
Arsenic paste is laid in the hole formed, which helps to kill tissue. 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 much time. In the process of applying arsenic paste, close attention is paid to sealing the carious cavity. Be sure to check whether arsenic acid has leaked between the wall of the carious cavity and the dressing, as this threatens the occurrence of toxic papillitis.
Depending on the number of roots and the required time, a second visit is planned. If, for some reason, repeated administration is not possible after such a short period of time, then a similar substance is laid, which has a delayed effect. After laying the paste, the hole in the tooth is closed with a temporary dressing.
Second visit
With devital extirpation, when the patient visits again, the patient removes the dental dressing and the remaining fragments of the stuffed substance. After this, the vault of the cavity is eliminated and the pulp is removed. The next stage of work is measuring and expanding to the necessary shape of the cone of the channel in accordance with all dental rules. In parallel with these manipulations, all remaining harmful bacteria are destroyed. The second visit is completed by filling the canals and applying a temporary seal to 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 signs. After confirming this, the dentist removes the temporary filling, and then lays the medicine and takes to reconstruct the tooth.
Thanks to current technologies, high-quality filling agents and the latest restoration methods, the previous tooth shape is fully restored with all the functions. The final stage of restoration is grinding the tooth, fluorinating the surface with the use of special preparations. All these actions of the dentist help protect tissues from the negative effects of bacteria and strengthen them.
Possible complications
In most cases, devital extirpation takes place without subsequent complications. But sometimes patients still complain of post-filling pains, which can have different durations. If the pain lasts for several days, then this does not indicate deviations and is considered normal. This is explained by the fact that devital amputation and extirpation are rather 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 pains arise as a result of the following medical errors:
- In case of incomplete pulp removal. In some cases, the dentist does not completely remove the pulp, which leads to the leaving of inflamed tissue at the apex of the root. It is as a result of this that the infection spreads and pains appear.
- As a result of removing beyond the apex of the root of the filling material. Such a mistake can lead not only to the occurrence of pain, but also to inflammation of the mandibular nerve.
- When leaving part of the tool in the channel. This leads to the fact that the channel is not completely sealed, which, in turn, contributes to infection and the appearance of pain.
- As a result of damage to the wall of the root of the tooth with dental instruments.
If such an unpleasant situation occurs, it is necessary to close the hole formed 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 switch to neighboring teeth. Sometimes such mistakes by doctors can lead to the appearance of cysts, the development of periodontitis, osteomyelitis, and other no less serious complications.
Pain can appear as a result of mechanical separation of the pulp near the apical hole. As a result of this, periodontal irritation occurs, which is eliminated with the help of painkillers. In particularly difficult cases, fluororization or darsonvalization may be necessary.
Complications include a burn of the mucosa, which can appear as a result of improper diathermocoagulation. To eliminate this complication, it is necessary to treat the lesion with antiseptic drugs and anti-inflammatory therapy.
Complications may also occur as a result of non-compliance with postoperative recommendations. The long-term presence of arsenic in the tooth cavity can provoke the development of periodontitis. This occurs as a result of postponing a follow-up visit after the first stage of devital pulpotomy. In order to prevent the development of complications, all the recommendations of the dentist must be implemented unconditionally.