Pulpbehandling

Pulpbehandling, or pulp therapy, is a branch of dentistry dealing with treatment of dental pulp tissue in both primary and permanent teeth. The aim is to preserve tooth vitality when possible, or to remove infected or non-viable pulp tissue to relieve pain and prevent spread of infection, thereby maintaining tooth structure until natural eruption or restoration.

Therapy is divided into vital pulp therapy (VPT) and non-vital pulp therapy. Vital pulp therapy includes indirect pulp capping, direct pulp capping, and pulpotomy. Indirect pulp capping treats a deep carious lesion without exposing the pulp, placing a biocompatible material over residual dentin to encourage healing. Direct pulp capping covers an exposed pulp with a protective material to promote dentin formation. Pulpotomy involves removal of the coronal portion of the pulp while preserving the radicular pulp.

Non-vital pulp therapy, or pulpectomy, removes all pulp tissue from the root canal system and is followed by cleaning, shaping, and obturation. In primary teeth pulpectomy is common when infection or irreversible pulpitis is present; in permanent teeth it is used for necrotic pulps.

Materials used include calcium hydroxide and mineral trioxide aggregate (MTA) or other calcium silicate-based cements; historically formocresol was used for pulpotomy in deciduous teeth but concerns about safety have reduced its use. Sealing and restoration with durable materials is important for success. Follow-up is necessary to assess healing and tooth survival.

Prognosis depends on diagnosis, technique, materials, and tooth vitality. Pulp therapy aims to preserve function and prevent extraction, particularly in children to maintain arch length and development.