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Pulpotomy in a Primary Molar Using a Calcium Silicate Material - Dr. Juan Carlos Hernández-Cabanillas

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Date: 08-30-2021 18:47:11 pm


Calcium silicate cements are commonly used as a filling material in pulpotomies, as clinical studies on the material have demonstrated a high rate of success due to their ion release and compatibility with different adhesive systems. In the following case, a pulpotomy was performed using BISCO’s TheraCal PT on a second temporary molar after 180 days of evolution.

Diagnosis
An 8-year-old patient presented to the clinic and his mother reported that the child had occasional pain on stimulation in the upper right molar area. On clinical examination, a cavitated carious lesion was observed on the occlusal-interproximal on the second upper primary molar. Radiographically, a radiolucent shade was observed that covered the enamel, dentin, and was possibly in contact with the pulp (Figures 1 and 2). Based on the clinical and radiographic findings, the diagnosis of reversible pulpitis was established and pulpotomy was indicated as treatment.

Treatment
The operative field was isolated with a clamp and all infected tissue was removed with manual and rotary instruments. The pulp chamber ceiling was removed with a sterile drill to access the inflamed tissue and remove it with an excavator until the entrance to the root canals was visualized. Hemostasis was achieved with a moist sterile cotton pellet (Figure 3).

A dual-cured, resin-modified calcium silicate material (BISCO, TheraCal PT) was placed directly into the pulp chamber until it completely covered the area (Figure 4). It was then light-cured for 10 seconds and showed good adaptation to cavity walls and margins (Figures 5 and 6). Finally, the tooth was restored with a stainless-steel crown (Figure 7).

Conclusion
Clinical and radiographic follow-up at 180 days showed adequate treatment progress. The tooth remained asymptomatic without signs of degeneration or pulp necrosis, and cold and vertical percussion vitality tests were favorable.

The use of calcium silicate materials is increasingly common in modern pediatric dentistry as they offer significant advantages over materials historically used for pulpotomy fillings. In addition, the technology offered in TheraCal PT’s dual-cured resin matrix allows for strong adaptation to the walls and margins of the pulp chamber, adequate working time, and a sequence of quick and easy steps—making it an ideal choice for successful pulpotomies.



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