Terapia Pulpar en Odontopediatría
August 12, 2022 | Author: Anonymous | Category: N/A
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TERAPIA PULPAR EN ODONTOPEDIATRÍA DRA ANDREA MUÑOZ LEYVA ODONTOPEDIATRÍA 8VO CUATRISEMESTRE
INTRODUCCIÓN •
Los seres a" #$ua" %ue "a ma&or'a (e "os mam')eros! se *ara*+er#,a -or -oseer (oshumaos! +#-os (e (#e+es
•
. La -r#mar#a (e+#*#/ es+a *os+#+u#(a -or 01 e"eme+os (e+ar#os %ue re*#2e "a (eom#a*#/ (e (#e+es -r#mar#os o (e*#(uos
•
Los -r#meros e"eme+os (e*#(uos eru-*#oa e "a *a3#(a( 2u*a" e+re e" -r#mero & se$u(o a4os (e 3#(a *om-"eme+5(os *om-"eme+5(osee (#*ha (e+e*#/ ha*#a "os +res a4os (e e(a(.
INTRODUCCIÓN •
Los #*#s#3os *e+ra"es #)er#ores ha*e su a-ar#*#/ e "a *a3#(a( 2u*a" a"re(e(or (e "os se#s meses (e e(a(.
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Los (#e+es -r#mar#os so reem-"a,a(os *o -os+er#or#(a( (e )orma -ro$res#3a -or "a (e+#*#/ -ermae+e a -ar+#r (e "os se#s a4os a-ro6#ma(ame+e
•
Es+e -ro*eso (e *am2#o (e ua (e+e*#/ a )a3or (e ua ue3a! se rea"#,a me(#a+e -ermae+e es (e 70! (a(o %ue e es+a se$u(a (e+#*#/ a-are*e 0 ue3as -#e,as(e+#*#/. (e+ar#as 9 & 0 -remo"ares! 7 mo"ares: %ue o +#ee -re(e*esores e "a -r#mera
INTRODUCCIÓN •
La -rese*#a "as (os (e+#*#oes e e" hom2re res-o(e a "a e*es#(a( (e a*omo(arse a" *re*#m#e+o ( "a *ara & (e "os ma6#"ares
•
Las ar*a(as (e+ar#as (e" #4o so"o -ue(e a"2er$ar u (e+erm#a(o umero (e -#e,as (e+ar#as! *u&o +ama4o es meor a "as -#e,as (e "a (e+#*#/ -ermae+e o
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(e;#+#3a. Co e" *re*#m#e+o! se -ro(u*e $ra(ua"me+e u aume+o e e" +ama4o (e "os ma6#"ares! e*es#+5(ose e*es#+5(ose o so"o mas e"eme+os (e+ar#os! s#o -#e,as mas $ra(es
INTRODUCCIÓN •
La (e+#*#/ (e*#(ua es mu& #m-or+a+e o so"o -ara "a *oser3a*#/ (e" es-a*#o
(e "os (#e+es -ermae+es s#o a(em5s a&u(a e e" (esarro""o (e < . La )oa*#/ 0.
A"#me+a*#/
7. =.
Res-#ra*#/ Armo'a es+>+#*a (e" #4o
INTRODUCCIÓN
Tam2#>! u -a-e" so2resa"#e+e %ue (esem-e4a es+os (#e+es es e" (e" ma+e#m#e+o (e" es-a*#o e "a ar*a(as (e+ar#a -ara "os (#e+es -ermae+es.
Los (#e+es +em-orar#os (esem-e4a +am2#> ua )u*#/ (e es+#mu"a*#/ (e" *re*#m#e+o *re*#m#e +o (e "os ma6#"ares me(#a+e "a mas+#*a*#/! e -ar+#*u"ar e *ua+o a" (esarro""o (e "a a"+ura (e "as ar*a(as.
•
Es -or es+o %ue +eemos "a o2"#$a*#/ (e #s+ru#r & or#e+ar a "os -a(re! a %ue se (e2e *oser3ar es+os (#e+es has+a %ue su -er#o(o (e r#,/"#s#s *o*"u&a.
INTRODUCCIÓN •
Se sa2e %ue u $ra ?mero (e (#e+es (e*#(uos es a)e*+a(o -or "es#oes *ar#osas *omo -or "es#oes +raum5+#*as a & %ue -ara re*u-erar "a aa+om'a & )u*#/ (e es+os (#e+es (e*#(uos es #e$a2"e %ue -re3#ame+e se rea"#*e u +ra+am#e+o -u"-ar es-e*';*o.
•
E" re*oo*#m#e+o (e es+os *o*e-+os -romue3e ua reso"u*#/ *"'#*a %ue -erm#+#r'a e" *um-"#m#e+o #here+esua a "a*o(u*+a (e+#*#/2#o"/$#*a (e*#(ua &&-ermae+e @o3e(e +o(as "as )u*#oes
TERAPI TERAPIA A PULP PULPAR AR •
E" o2@e+#3o -r#*#-a" (e "os +ra+am#e+os -u"-ares e (e+#*#/ +em-ora" es ma+eer "a #+e$r#(a( & "a sa"u( (e "os +e@#(os ora"es. • Es (esea2"e -o(er ma+eer "a 3#+a"#(a( (e "a -u"-a (e "os (#e+es a)e*+a(os -or *ar#es o +rauma+#smos. •
S# em2ar$o! u (#e+e -ue(e se$u#r s#e(o )u*#oa" e"#m#a(o "a -u"-a -ar*#a" o +o+a"me+e.
TERAPIA A PULP PULPAR AR TERAPI •
Las #(#*a*#oes! o2@e+#3os & e" +ra+am#e+o -u"-ar se"e**#oa(o! se 2asa e u (#a$/s+#*o *"'#*o %ue (e+erm#e e" es+a(o (e "a -u"-a.
•
U e6ame -reo-era+or#o *om-"e+o es ese*#a" -ara o2+eer u (#a$/s+#*o *orre*+o & -o(er es+a2"e*er e" +ra+am#e+o a(e*ua(o as' *omo or#e+ar e e" -ro/s+#*o (e >s+e.
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Es+e e6ame (e2e #*"u#r ua *om-"e+a h#s+or#a m>(#*a & (e+a"! *o es-e*#a"
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#+er>s e "as *ara*+er's+ *ara*+er's+#*as #*as (e" (o"or Ua e6-"ora*#/ *"'#*a & ra(#o"/$#*a! *o "as -rue2as *om-"eme+ar#as e*esar#as *omo "a -a"-a*#/! -er*us#/ & e3a"ua*#/ (e "a mo3#"#(a( s# o"3#(ar "a e6-"ora*#/ (#re*+a -u"-ar %ue -erm#+#r5 *o;rmar ues+ro (#a$/s+#*o.
TERAPIA A PULP PULPAR AR TERAPI DEBINICIÓN •
Se (e;e *omo Tera-#a r#a"es Pu"-ar2ase a "a *omo remo*#/ me*5#*a "a *ar#es &(e"a(e+#a a-"#*a*#/ (e me(#*ame+osma+er#a"es me(#*ame+osma+e +era-#a -ara "a(e )orma*#/ (e re-ara*#/ *o e" ; (e -reser3ar e" (#e+e e su "u$ar
TERAPIA TERAPI A PULP PULPAR AR •
5s#*ame+e! (e2emos *o*re+ar s# "a -u"-a se e*ue+ra orma"! o e u es+a(o 5s#*ame+e! (e #ama*#/ re3ers#2"e. E" es+a(o (e #ama*#/ -u"-ar re3ers#2"e re%u#ere u +ra+am#e+o -u"-ar 3#+a" & se *ara*+er#,a -or< . ause*#a (e (o"or es-o+5eo o -ers#s+e+e! -ers#s+e+e! 0. ause*#a (e ses#2#"#(a( ses#2#"#(a( a "a -er*us#/ -er*us#/ & a "a -a"-a*#/! 7. ause*#a (e mo3#"#(a( mo3#"#(a( -a+o"/$#*a! -a+o"/$#*a! =. ause*#a (e s#$os ra(#o$r5;*os ra(#o$r5;*os -a+o"/$#*os! F. as-e*+o (e "a -u"-a (e *o"or ro@o ro@o & hemorra$#a *o+ro"a2"e. *o+ro"a2"e.
TERAPI TERAPIA A PULP PULPAR AR • Por e" *o+rar#o! s# e" es+a(o -u"-ar es #rre3ers#2"e o se a*om-a4a (e e*ros#s se *os#(erar'a u +ra+am#e+o -u"-ar o 3#+a". E" es+a(o -u"-ar #rre3ers#2"e se *os#(erar'a ma#;es+a < . 0. 7. =. F.
La -rese*#a (e (o"or es-o+5eo & -ers#s+e+e G#-erses#2#"#(a( G#-erses#2 #"#(a( a "a -er*us#/ o -a"-a*#/ Mo3#"#(a( (e+ar#a B's+u"a (e (rea@e Les#oes ra(#o$r5;*as e3#(e+es e3#(e+es & as-e*+o -u"-ar )ra$me+a(o! *o *o"or $raa+e & hemorra$#a a2u(a+e.
TERAPIA A PULP PULPAR AR TERAPI •
E a%ue""os *asos (o(e "a #)e** #)e**#/ #/ o -ue(a ser *o+ro"a(a! e6#s+a u ->r(#(a #m-or+a+e (e hueso (e so-or+e *o mo3#"#(a( #m-or+a+e! rea2sor*#/ ra(#*u"ar ra(#*u"ar -a+o"/$#*a e6+esa! o e" (#e+e o -ue(a ser res+aura(o se *os#(erar'a "a e6+ra**#/
TERAPI TERAPIA A PULP PULPAR AR •
No o2s+a+e! a(em5s (e "o a+er#or ha2r5 %ue +eer e *ue+a ua ser#e (e )a*+ores & *os#(era*#oes %ue #u#r5 e "a (e*#s#/ ;a" (e" +ra+am#e+o a(e*ua(o a *a(a
-a*#e+e *omo so "os s#$u#e+es< . Es+a(o )'s#*o (e" -a*#e+e 0.
Hra(o (e a*e-+a*#/ a" +ra+am#e+o (e" -a*#e+e #4o
7. =.
E" es+a(o (e (esarro""o (e+a" E" +#em-o (e -ermae*#a (e "a -#e,a (e+a" e "a 2o*a
F.
E" +#-o (e res+aura*#/ -os+er#or a" +ra+am#e+o -u"-ar
.
E" *os+o J 2ee;*#o (e" +ra+am#e+o
TERAPI TERAPIA A PULP PULPAR AR •
La ;a"#(a( es ma+eer "a 3#+a"#(a( -u"-ar
•
E "os *o+ro"es -os+er#ores o (e2e a-re*#arse a-re*#arse "es#oes e e" $erme (e" (#e+e -ermae+e # e3#(e*#as *"'#*as o ra(#o$r5;*as %ue #(#%ue -a+o"o$'a +a"es *omo (o"or! ses#2#"#(a( e #ama*#/! @u+o a "a -rese*#a (e rea2sor*#oes ra(#*u"ares.
TERAPI TERAPIA A PULP PULPAR AR •
E "as s#+ua*#oes #(#*a(as! >s+a es u +>*#*a a(e*ua(a a(e*ua(a
•
Se #s#s+e e "a #m-or+a*#a < KDe" (#a$/s+#*o -re3#o (e ause*#a (e -a+o"o$'a -u"-ar
0KL"e3ar a *a2o ua *u#(a(osa "#m-#e,a (e "a *a3#(a(! so2re+o(o (e "as -are(es e "a u#/ ame"oK(e+#ar#a 7KAs' *omo (e *ose$u#r *ose$u#r u 2ue se""a(o (e "a *a3#(a( es+e se""a(o resu"+a resu"+a m5s #m-or+a+e %ue e" +#-o (e ma+er#a" a-"#*a(o so2re "a "es#/.
TERAPIA A PULP PULPAR AR TERAPI •
E6#s+e 0 +#-os (e Tera-#a Pu"-ar Re*u2r#m#e+o Pu"-ar D#re*+o Re*u2r#m#e+o Pu"-ar I(#re*+o
RECURIMIENTO PULPAR INDIRECTO •
E" re*u2r#m#e+o -u"-ar #(#re*+o es+5 re*ome(a(o -ara (#e+es *o *ar#es -ro)u(as -r/6#mas a "a -u"-a -ero s# s#$os # s'+omas (e a)e*+a*#/ -u"-ar. -u"-ar.
•
Es+e -ro*e(#m#e+o *os#s+e e "a e"#m#a*#/ (e "a (e+#a #)e*+a(a & "a *o"o*a*#/ (e u ma+er#a" 2#o*om-a+#2"e so2re "a *a-a (e (e+#a a? (esm#era"#,a(a (esm#era"# ,a(a -ero o #)e*+a(a.
RECURIMIENTO PULPAR INDIRECTO •
Co "a ;a"#(a( (e< . E3#+ar ua e6-os#*#/ e6-os#*#/ -u"-ar! 0. Rem#e Rem#era"#,ar ra"#,ar "a "es#/ me(#a+e me(#a+e "a )orma*#/ (e (e+#a (e+#a re-ara+#3a! 7. "o%uear e" -aso (e 2a*+er#as 2a*+er#as e #a*+#3ar "as -o*as -o*as %ue -ue(a %ue(ar
RECURIMIENTO PULPAR INDIRECTO •
La (#;*u"+a( (e" -ro*e(#m#e+o -ro*e(#m#e+o es+r#2a e (e+erm#ar *ua" es e" 5rea #)e*+a(a & *ua" "a (esm#era" (esm#era"#,a(a. #,a(a.
•
C"'#*ame+e! (e-e(er5 (e" +#-o (e (e+#a "a 2"a(a (e2e ser e"#m#a(a & "a C"'#*ame+e! mas (ura ma+e#(a.
RECURIMIENTO PULPAR INDIRECTO •
Los ma+er#a"es m5s u+#"#,a(os ha s#(o < K G#(r/6#(o (e *a"*#o K Io/mero (e 3#(r#o K Ó6#(o (e ,#* eu$eo"
E" Ó6#(o (e Z#* ha s#(o *ues+#oa(o -or -ro(u*#r u e)e*+o se(a+e so2re e" +e@#(o -u"-ar %ue -ue(e! ;a"me+e! emas*arar u -ro*eso (e (e$eera*#/ -u"-ar
RECURIMIENTO PULPAR INDIRECTO •
La ;a"#(a( es ma+eer "a 3#+a"#(a( -u"-ar
•
E "os *o+ro"es -os+er#ores o (e2e a-re*#arse a-re*#arse "es#oes e e" $erme (e" (#e+e -ermae+e # e3#(e*#as *"'#*as o ra(#o$r5;*as %ue #(#%ue -a+o"o$'a +a"es *omo (o"or! ses#2#"#(a( e #ama*#/! @u+o a "a -rese*#a (e rea2sor*#oes ra(#*u"ares.
•
Se (e2e ""e3ar a *a2o ua *u#(a(osa "#m-#e,a (e "a *a3#(a(! so2re+o(o (e "as -are(es e "a u#/ ame"oK(e+#ar#a! as' *omo (e *ose$u#r u 2ue se""a(o (e "a *a3#(a( es+e se""a(o resu"+a m5s #m-or+a+e %ue e" +#-o (e ma+er#a" a-"#*a(o so2re "a "es#/.
RECURIMIENTO PULPAR DIRECTO •
E" re*u2r#m#e+o -u"-ar (#re*+o #m-"#*a "a *o"o*a*#o (e u a$e+e 2#o*om-a+#2"e e "os +e@#(os saoso-u"-ares se +raum5+#*a ha e6-ues+o9G#(r/6#(o #a(3er+#(ame+e remo*#/ (e *ar#es -or ua %ue "es#/ (e Ca"*#o:(ura+e "a
•
E e" *aso (e "os (#e+e +em-ora"es! s/"o se ""e3ar5 a *a2o *ua(o "a -u"-a ha&a s#(o a**#(e+a"me+e a**#(e+a"me+e e6-ues+a (ura+e e" -ro*e(#m#e+o o-era+or#o o e *asos (e m'#mas e6-os#*#oes +raum5+#*as.
•
La ;a"#(a( (e" +ra+am#e+o es ma+eer "a 3#+a"#(a( (e" (#e+e s# e3#(e*#a e3#(e*#ass *"'#*as # ra(#o$r5;*as (e -a+o"o$'a -u"-ar! -u(#>(ose a-re*#ar )orma*#/ (e (e+#a re-ara+#3a.
RECURIMIENTO PULPAR DIRECTO •
E" (#e+e (e2e es+ar as#+om5+#*o & "a e6-os#*#/ -u"-ar m'#ma & "#2re (e *o+am#a*#/ (e u#(os ora"es. No se *os#(era "as e6-os#*#oes -or "es#oes -or *ar#es &a %ue )5*#"me+e se -ro(u*e *o+am#a*#/ e #ama*#/ -u"-ar.
•
E" o2@e+#3o (e" +ra+am#e+o es se""ar e" -u"-a *o+ra "a ;"+ra*#/ 2a*+er#aa! es+a2"e*er "a )orma*#/ (e u -ue+e (e+#ar#o e e" s#+#o (e "a e6-os#*#/! & ma+eer "a 3#+a"#(a( (e "a -u"-a su2&a*e+e
RECURIMIENTO PULPAR DIRECTO •
E" >6#+o (e" re*u2r#m#e+o -u"-ar (#re*+o (e-e(e (e "a sa"u( (e "a -u"-a *oroa" & ra(#*u"ar & es+ar "#2re (e "a #3as#/ 2a*+er#aa
•
E" o(o+/"o$o (e2e 2asarse e "a a-ar#e*#a )'s#*a (e "a -u"-a & (e "os +e@#(os e6-ues+os! e3a"ua*#/ ra(#o$r5;*a & e" (#a$/s+#*o *o -rue2as -ara (e+erm#ar "a 3#+a"#(a( -u"-ar.
RECURIMIENTO PULPAR DIRECTO •
E" +e@#(o (e "a -u"-a e6-ues+a (e2e ser 2r#""a+e e *o"or ro@o & +eer ua "#$era hemorra$#a %ue es )5*#"me+e *o+ro"a(a *o 2o"#+as (e a"$o(/ & a-"#*a(o ua m'#ma -res#/.
•
Br#$o"e++o se4a"/ %ue "as -e%ue4as e6-os#*#oes *o u 2ue sum##s+ro (e sa$re +#ee "as me@ores -os#2#"#(a(e -os#2#"#(a(ess (e *ura*#/.
•
Au%ue es #m-re*#so e" +>rm#o -e%ue4as e6-os#*#oes (e2e +eer "a meor +ama4o -ara re(u*#r -os#2#"#(a( (e a**eso (e 2a*+er#as. Se se4a"a ua "#m#+a*#/ -ara "a +>*#*a a e6-os#*#oes *o (#5me+ros (e meos (e mm
RECURIMIENTO PULPAR DIRECTO •
Las ra'*es (e "os (#e+es -r#mar#os so m5s *or+as %ue "a (e "os (#e+es
•
-ermae+es. Las *5maras -u"-ares (e "os (#e+es -r#mar#os so $ra(es & e6#s+e am-"#os *o(u*+os ra(#*u"ares ra(#*u"ares..
•
Los (#e+es -r#mar#os -rese+a (e +res a *#*o *ueros -u"-ares mu& -rom#e+es.
RECURIMIENTO PULPAR DIRECTO CONTRAINDICACIONES < CONTRAINDICACIONES • La *o+ra(#**#oes *o+ra(#**#oes -ara e" re*u2r#m#e+o -u"-ar (#re*+o so< . Do"or es-o+5eo & o*+uro 0. E6*es#3a mo3#"#(a( (e+ar#a. 7. L#$ame+o -er#o(o+a" esa*ha(o.
RECURIMIENTO PULPAR DIRECTO CONTRAINDICACIONES< =. E3#(e*#a ra(#o$r5;*a (e (e$eera*#/ (e$eera*#/ e ,oas -er#ra(#* -er#ra(#*u"ares u"ares & e )ur*a. F. I*o+ro"a2"e hemorra$#a a" mome+o (e "a e6-os#*#/. . E6u(a(o -uru"e+o o seroso a" mome+o (e "a e6-os#*#/
RECURIMIENTO PULPAR DIRECTO •
Las -r#*#-a"es *ara*+er's+#*as *ara*+er's+#*as -ara u *ua(ro *"'#*o e6#+oso e u re*u2r#m#e re*u2r#m#e+o +o -u"-ar (#re*+o so< KMa+e#m#e+o (e "a 3#+a"#(a( (e -u"-a 0KBa"+a (e ses#2#"#(a( o (o"or 7KM'#ma res-ues+a #ama+or#a (e -u"-a =K Ause*#a (e s#$os ra(#o"/$#*os (e *am2#os (#s+r/;*os.
RECURIMIENTO PULPAR DIRECTO •
E" >6#+o (e "os -ro*e(#m#e+os (e re*u2r#m# re*u2r#m#e+os e+os -u"-ares (e-e(e (e -re3e*#/ (e m#*ro;"+ra*#/ -or u se""a(o a(e*ua(o (e "a res+aura*#/.
GIDRÓIDO DE CALCIO CALCIO PORUQ • E" G#(r/6#(o (e *a"*#o -ro(u*e e*ros#s (e *oa$u"a*#/ a" *o+a*+o *o "a su-er;*#e (e (e "a -u"-a. •
E" +e@#(o e+o*es se (#)ere*#a e o(o+o2"as+os! %ue e"a2ora ua ma+r#, e
•
a"re(e(or (e = semaas. Es+o (a "u$ar a "a )orma*#/ (e u -ue+e (e (e+#a re-ara+#3a! *ausa(a -or "a *a"#(a( a"+ame+e a"*a"#a (e h#(r/6#(o (e *a"*#o! %ue +#ee u -G (e a 0
CALCIO GIDRÓIDO DE CALCIO •
S+a"e& ha se4a"a(o %ue "os e)e*+oses+5 (e h#(r/6#(o (e *a"*#o e" -ue+e (e (e+#a se -ro(u*e s/"o *ua(o e" a$e+e e *o+a*+o (#re*+oe*o +e@#(o -u"-ar sao. •
E" G#(r/6#(o (e *a"*#o +#ee ua a**#/ a+#2a*+er#aa s#$#;*a+#3a! %ue ha s#(o #(e+#;*a(o #(e+#;*a( o *omo u 2ee;*#o a(#*#oa" a "os -ro*e(#m#e+os (e re*u2r#m#e+o.
•
Tam2ur#* e+ a". resum#/ "os e)e*+os m#era"#,a+es (e" *a"*#o h#(r/6#(o! %ue #*"u&e "a a*+#3a*#/ *e"u"ar (e a(eos# +r#)os)a+o resu"+a+es (e" #o h#(ro6#"o (e *a"*#o & e" aume+o (e a"*a"##(a( e e" -ro*eso (e m#era"#,a*#/
PULPOTOMÍA •
E (#e+es +em-ora"es "a -u"-o+om'a #(#*a(a e a%ue""os *asos *o e6-os#*#/ -u"-ar -or *ar#es -ro)u(aes+ar5 -r/6#ma a "a -u"-a o +rauma+#smo! s#e(o e" es+a(o (e "a -u"-a orma" o *o -u"-#+#s re3ers#2"e
PULPOTOMÍA •
La -u"-o+om'a *os#s+e e "a remo*#/ %u#r?r$#*a (e "a -u"-a *oroar#a 3#+a" #ama(a has+a "a -or*#/ (e #$reso (e "os *o(u*+os ra(#*u"ares! & "ue$o! e "a *o"o*a*#/ (e ua (ro$a o me(#*ame+o e e" -#so (e "a *5mara -u"-ar! so2re "os +e@#(os remae+es ra(#*u"ares! ra(#*u"ares! a ; (e ;@ar"os o ma+eer"os
PULPOTOMÍA •
Se 2asa e e" he*ho (e %ue "a -u"-a ra(#*u"ar -ermae*e saa o es *a-a, (e saar (es-u>s (e "a am-u+a*#/ (e "a -u"-a *oroa" a)e*+a(a o #)e*+a(a.
•
La )orma*#/ (e u -ue+e (e+#ar#o -ue(e *u2r#r "a -u"-a ra(#*u"ar.
PULPOTOMÍA •
Es+e +ra+am#e+o! e (#e+es -r#mar#os! es+5 #(#*a(o *ua(o e" +e@#(o *oroa" #)e*+a(o -ue(e ser e"#m#a(o & e" +e@#(o ra(#*u"ar remae+e es @u,$a(o *omo 3#+a" -or *r#+er#os *"'#*os & ra(#o"/$#*os
PULPOTOMÍA •
I(ea"me+e!! e" )5rma*o %ue se ha (e u+#"#,ar -ara "a mom#;*a*#/ (e "a -u"-a! (e2e I(ea"me+e ser< K a*+er#*#(a K Io*uo a" +e@#(o -u"-ar & a "as es+ru*+uras a(&a*e+es K De2e -romo3er "a *ura*#/ (e "a -u"-a ra(#*u"ar o su ma+e#m#e+o K No #+er)er#r *o e" -ro*eso (e rea2sor*#/ ra(#*u"ar
PULPOTOMÍA • INDICACIONES
J E6-os#*#/ -u"-ar *ar#osa a +rauma+#smo e u (#e+e as#+om5+#*o. J Car#es %ue *"'#*a & ra(#o"/$#*ame ra(#o"/$#*ame+e +e se a*er*a a "a -u"-a! s# s'+omas! re+ra**#/ (e u *uero -u"-ar .
*o
PULPOTOMÍA INDICACIONES:
J Ro+ura (e u 2or(e mar$#a" -or *ar#es e u -r#mer mo"ar +em-ora" es #(#*a*#/ (e -u"-o+om#a. J E a%ue""os *asos %ue se %u#era % u#era *oser3ar e" (#e+e -or ra,oes (e ma+e#m#e+o (e es-a*#o e "as %ue o sea )a*+#2"e )a*+#2"e -oer u ma+ee(or ma+ee(or (e es-a*#o & +e$amos "a -u"-a ra(#*u"ar a)e*+a(a a)e*+a(a
PULPOTOMÍA LA PULPOTOMÍA ESTARÁ CONTRAINDICADA :
E -rese*#a (e s#$os o s'+omas %ue #(#%ue a)e*+a*#/ (e" +e@#(o -u"-ar remae+e! +a"es *omo < •
Do"or es-o+5eo
•
Do"or a "a -er*us#/
•
Mo3#"#(a( aorma"
•
B's+u"as
PULPOTOMÍA LA PULPOTOMÍA ESTARÁ CONTRAINDICADA :
• •
Rea2sor*#/ ra(#*u"ar #+era Ca"*#;*a*#oes -u"-ares
•
Rea2sor*#oes Rea2 sor*#oes e6+eras -a+o"/$#*as
•
Ra(#o"u*#(e, -er#a-#*a" e #+erra(#*u"ar
•
E6*es#3o sa$ra(o
PULPOTOMÍA TÉCNICA:
•
Aes+es#a "o*a"
•
A#s"am#e+o *o (#%ue (e $oma
•
A-er+ura *amera". Se e"#m#a e" +e@#(o su-er;*#a" a+es (e "a -u"-ar -ara m##m#,ar "a *o+am#a*#/ 2a*+er#a(e 2a*+er#aa. a. *ar#es A *o+#ua*#/ see6-os#*#/ e"#m#a e" +e*ho (e "a *5mara -u"-ar! (e@a(o u a**eso su;*#e+eme+e am-"#o %ue -erm#+a "a e"#m#a*#/ (e +o(o e" +e@#(o + e@#(o -u"-ar *oroa" me(#a+e "a u+#"#,a*#/ (e u e6*a3a(or a;"a(o o 2#e *o ua )resa re(o(a (e *o+ra5$u"o a 2a@a 3e"o*#(a(
PULPOTOMÍA TÉCNICA
•
Co+ro" (e "a hemorra$#a.
K E es+e -u+o ""e3aremos a *a2o "a e3a"ua*#/ (e" +e@#(o -u"-ar remae+e! -ara *o;rmar ues+ro (#a$/s+#*o. E" as-e*+o (e "a -u"-a o (e2e ser e6*es#3ame+e os*uro & "a hemorra$#a (e2e ser )5*#" (e *o+ro"ar *o "a a-"#*a*#/ (e 2o"#+as (e a"$o(/. Para *ose$u#r "a hemos+as#a o (e2emos u+#"#,ar #$? hemos+5+#*o! -ues (e o *ose$u#r"a es+ar'amos a+e ua a)e*+a*#/ (e" +e@#(o ra(#*u"ar *o #ama*#/ #rre3ers#2"e #rre3ers#2"e %ue os #(#*ar'a "a e*es#(a( (e ua -u"-e*+om'a o ua e6+ra**#/ (e-e(#e(o (e-e(#e(o (e" *aso.
PULPOTOMÍA TÉCNICA
•
A-"#*a*#/ (e" a$e+e.
KUa 3e, *ose$u#(o e" *o+ro" (e "a hemorra$#a! se a-"#*ar5 ua 2o"#+a (e a"$o(/ #m-re$a(a *o e" ma+er#a" %ue ha&amos e"e$#(o e"e$#(o 9)ormo*reso"! su")a+o )>rr#*o! )>rr#*o! MTA: e "as *a+#(a(es (e+erm#a(as se$? e" a$e+e! & se (e@ar5 e" +#em-o #(#*a(o. A" re+#rar e" a"$o(/ e" as-e*+o (e2e ser $raa+eKos*uro $raa+eKos*uro & s# hemorra$#a. Pos+er#orme+e se *o"o*ar5 ua 2ase (e /6#(o (e ,#*Keu$eo". Se *o(esar5 mu& "#$erame+e -ara e3#+ar (a4ar "a *a-a (e ;@a*#/ su-er;*#a" & se #+e+ar5 ua 2uea a(a-+a*#/ so2re "as -are(es -ara e3#+ar "a ;"+ra*#/ mar$#a"
PULPOTOMÍA •
Res+aura*#/. Es mu*ha "a #m-or+a*#a %ue +#ee ua a(e*ua(a res+aura*#/ ;a" Res+aura*#/. e "os (#e+es e "os %ue se ha rea"#,a(o u +ra+am#e+o -u"-ar! -u"-ar! -ues es )u(ame+a" e3#+ar "a ;"+ra*#/ mar$#a" %ue -ue(e *om-rome+er e" +ra+am#e+o! a(em5s (e "a -os#2#"#(a( (e )ra*+ura (e" res+o (e es+ru*+ura (e+a".
•
S# se +ra+a (e u mo"ar "a res+aura*#/ m5s a(e*ua(a es ua *oroa (e a*ero #o6#(a2"e. Au%ue e a"$uos *asos se ha su$er#(o "a -os#2#"#(a( (e ua res+aura*#/ (e ama"$ama! resu"+a(os (e"a(#s+#+os es+u(#os es+ar'a #(#*a(a s/"o *ua(o"os "a "es#/ a)e*+a su-er;*#e o*"usa"!mues+ra ma+e#e%ue ma+e#e(o (o e" res+o (e "as -are(es #+a*+as! & *ua(o e" +#em-o a su orma" e6)o"#a*#/ o sea su-er#or a "os (os a4o
PULPECTOMÍA •
E" -u"-e*+om'a e"#m#a*#/ *om-"e+a "a -u"-ae" (e+a". Cua(o se +>rm#o em-"ea -ara (es*r#2#rr(eo+a (es*r#2# u -ro*e(#m#e -ro*e(#m#e+o +o e (#e+es (e -r#mar#os! 3o*a2"o +am2#e s#$#;*a o2+ura*#/ (e" *o(u*+o ra(#*u"ar *o ma+er#a" rea2sor2#2"e & ;s#o"/$#*ame+e +o"era2"e
PULPECTOMÍA •
No es re*ome(a2 re*ome(a2"e (e@ar s# +ra+am#e+o "as #)e**#oes (e "os (#e+es +em-ora"es! -ues+o"e%ue -ue(e (rear & -ermae*er as#+om5+#*os (ura+e u -er'o(o (e +#em-o #(e;#(o. •
Es+os (#e+es so )ue+e (e #)e**#/ &! -or "o +a+o! ha (e +ra+arse a(e*ua(ame+e a(e*ua(am e+e o 2#e e6+raer"os
PULPECTOMÍA INDICACIONES: • E (#e+es *o *ar#es -ro)u(as! & *o e6-os#*#/ -u"-ar e h#s+or#a (o"orosa
es-o+5ea. •
-#e,as (e+a"es *o -ro*esos #ama+or#os -u"-aresKra(#*u"ares -u"-aresKra(#*u"ares *u&os *o(u*+os
•
seas a**es#2"es. E (#e+es e "os %ue "a e6*eres#s (e "a -u"-a *oroa" -rese+a u sa$ra(o e6*es#3o (e" *o(u*+o ra(#*u"ar -u"-ar.
PULPECTOMÍA INDICACIONES:
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E (#e+es *o ua 2uea es+ru*+ura ra(#*u"ar & *u&a *oroa +e$a "a -os#2#"#(a( (e ser res+aura(a a(e*ua(ame+e.
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Cua(o o ha& ->r(#(a (e hueso (e sos+> (e2#(a a -a+o"o$'a ra(#*u"ar -rese+e.
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E (#e+es e "os %ue "a rea2sor*#/ ra(#*u"ar o a2ar%ue m5s (e u +er*#o (e su "o$#+u(
PULPECTOMÍA CONTRAINDICACIONES
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E (#e+es e "os %ue e" e6ame ra(#o$r5;*o mues+re -er)ora*#/ -er)ora*#/ (e" -#so -u"-ar! o %ue e e" mome+o (e re+#rar "a -u"-a *oroa" se "es#oe e" )o(o (e "a *a3#(a(.
•
Cua(o ha& rea2sor*#/ ra(#*u"ar ma&or (e u +er*#o (e su "o$#+u( o e *asos (e e6+rema (es+ru**#/ (es+ru**#/ *oroar#a %ue o -erm#+a su res+aura*#/.
•
E -#e,as (e+a"es %ue +e$a ->r(#(a (e so-or+e /seo.
•
E -a*#e+es *o e)erme(a(es s#s+>m#*as
PULPECTOMÍA •
Para "a o2+ura*#/ (e "os *o(u*+os e "a -u"-e*+om#a! se ha u+#"#,ar -ara "os ma+er#a"es rea2sor3#2 rea2sor3#2"es "es %ue a*om-a4e a "a r#,/"#s#s & o sea(e#rr#+a+es +e@#(os -er#o(o+a"es # -ara e" $erme (e" (#e+e -ermae+e. •
Los ma+er#a"es (e o2+ura*#/ %ue se u+#"#,a )u(ame+a"me+e so < KLa -as+a (e o6#(o o 6#(o (e ,#*Keu$eo" ,#*Keu$eo" KLa -as+a &o(o)orm#*a me,*"a(a *o h#(ro6#(o (e *a"*#o
PULPECTOMÍA TÉCNICA
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Ua 3e, e"#m#a(a "a -u"-a *amera" & "o*a"#,a(os "os *o(u*+os se -ro*e(e a #s+rume+ar es+os *o "#mas! *o "a ;a"#(a( (e e6+#r-ar e" +e@#(o -u"-ar ra(#*u"ar & e" ma+er#a" or$5#*o e6#s+e+e e "os *o(u*+os.
•
Los *o(u*+os (e2e #rr#$arse a2u(a+eme+e s/(#*o a"De2e 0 (ura+e "a #s+rume+a*#/! #s+rume+a* #/! -ara )a*#"#+ar "a sa"#(a*o (e"h#-o*"or#+o ma+er#a" or$5#*o. #rr#$arse *o sua3#(a(! s# -res#/ e6*es#3a! -ara e3#+ar #m-u"sar e" "'%u#(o ha*#a "os +e@#(os -er#a-#*a"es -er#a-#*a"es..
PULPECTOMÍA TÉCNICA
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Ua 3e, "#m-#os! "os *o(u*+os se se*a *o -u+as (e -a-e". S# se ha e"#m#a(o -or *om-"e+o +o(o e" ma+er#a" or$5#*o se -ro*e(e a "a o2+ura*#/ (e" *o(u*+o.
•
La -as+a u+#"#,a(a se #+ro(u*e *o "a a&u(a (e "as "#mas! *o(esa(ores o @er#$as.
•
Ua 3e, o2+ura(os "osa*o(u*+os! -u"-ar /6#(o (e ,#*K se eu$eo" & se -ro*e(e re*os+ru#rse e" re""ea (#e+e. "a S#*5mara se +ra+ara (e u*o mo"ar +em-ora"! *o"o*ar5 ua *oroa (e a*ero #o6#(a2"e %ue (ar5 #+e$r#(a( a "a *oroa (e" (#e+e -erm#+#e(o ua *orre*+a mas+#*a*#/! -or u "a(o! & u *orre*+o ma+e#m#e+o (e" es-a*#o! -or o+ro.
PULPECTOMÍA SEGUIMIENTO • Se (e2e ha*er ua re3#s#/ *a(a meses. E a%ue""os *asos e "os %ue sea -os#2"e
o 3o"3er a 3er a" -a*#e+e e3#+aremos ha*er ua -u"-e*+om'a -or %ue -o(r'a ser -er@u(#*#a"" -ara e" (#e+e -ermae+e %ue ha& (e2a@o! e es+e *aso es+ar'a -er@u(#*#a #(#*a(a "a e6+ra**#/.
Y DESPUQS FRACASO:
Es+ar5 #(#*a(a "a e6+ra**#/ s# se a-re*#a *ua"%u#era (e "os s#$u#e+es s#$os< J Tume)a**#/ (e "a e*'a J A2s*eso -a"?r#*o J Rea2sor*#/ -rema+ura J Ra(#o"u*#(e, a-#*a" J Mo3#"#(a( (e "a -#e,a J Do"or
J Ses#2#"#(a( a "a -er*us#/
HRACIAS
ILIOHRABÍA •
() h++-
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