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Endodontics - 3 Questions
In a young patient with immature root development and vital pulp exposure, pulpotomy preserves radicular pulp vitality allowing continued root development (apexogenesis). Pulpectomy would halt root formation.
Perforations that occur in the furcation area of multi-rooted teeth have the poorest prognosis due to the complexity of the anatomy and the difficulty in achieving adequate sealing and healing. Furcation involvement often leads to periodontal issues and complicates treatment options, making it more challenging to maintain the tooth.
Discoloration due to pulp degeneration has the best prognosis for bleaching. This is because: 1) The staining is primarily from hemoglobin breakdown products which respond well to oxidizing agents, 2) The discoloration is usually uniform and not deeply embedded, 3) No metallic particles are involved, 4) Responds well to both vital and non-vital bleaching techniques. Tetracycline stains are difficult due to deep incorporation in dentin structure, restorative materials may contain metals, and erythroblastosis fetalis causes deep intrinsic staining that resists bleaching.
MCQ