BIOLOGICAL (CONSERVATIVE) METHOD OF TREATMENT OF PULPITIS

The biological method of treating pulpitis is directed toward the improvement of pulp with the restoration of its function. Important significance has its complete restoration or keeping of its basic functions: protective, plastic, trophic. The treatment of the inflamed pulp is necessary for keeping the valuable structure of the hard tooth tissues, its protective, barrier properties, prevention of the development of apical periodontitis.

Contemporary developments on physiology and morphologies of pulp, which proved its high viability, reactive ability and plastic function are the theoretical substantiation of the biological method of treatment of pulpitis. High viability of pulp is provided: 1) the additional sources of nutrition of tooth - anastomosises, fistulas, the circular system of blood circulation in the coronal pulp; 2) the friable connective tissue, which surrounds vessels near the apex, which excludes the possibility of their pressing with the inflammation; 3) the abundant capillary network of coronal pulp; 4) the cell of reticuloendothelial system and hyaluronic acid, the being important factor of protection of the structural formations of pulp from the harmful effects; 5) the stability of fermentation- inhibiting system.

1. Basic
tasks

2. Displays

3. Contraindi-
cations

4. Conditions
of carrying out

5. Stages of
treatment

6. Mistakes and
complications

7. Efficiency of
treatment in
distant
terms (1-1,5 ye.)

Task	Performance sequence	Warnings to self-control
1. To carry out single-session method of treatment of pulpitis with indirect covering of pulp.	Antiseptic processing of oral cavity (irrigation). Givalex; Stomatidin. Local anesthesia (regional and infiltration anesthesia). Isolation of tooth with cofferdam or sterile cotton rolls. Necrectomy. Formation of carious cavity. Antiseptic processing of carious cavity with warming neutral solutions of antiseptics or antibiotics: 0,5% solution of aethonium, 0,01% aqueous solution of chlorhexidine; Decoctions of medicinal plants. Do not use alcohol, alcoholic solutions, hydrogen peroxide. Drying of carious cavity with sterile cotton balls. Covering calcium-contained curative medicine, which is polymerized. Filling of carious cavity.	During the collection of anamnesis it is necessary to learn about the presence of allergic diseases in patient. During the fulfillment of the stages of treatment it is necessary to adhere to the rules of asepsis and antiseptics.
2. To carry out single-session method of treatment of pulpitis with direct covering of pulp.	Antiseptic processing of oral cavity (irrigation). Givalex; Stomatidin. Local anesthesia (regional and infiltration anesthesia). Isolation of tooth with cofferdam or sterile cotton rolls. Necrectomy. Formation of carious cavity. Antiseptic processing of carious cavity with warming neutral solutions of antiseptics or antibiotics: 0,5% solution of aethonium, 0,01% aqueous solution of chlorhexidine; Decoctions of medicinal plants. Do not use alcohol, alcoholic solutions, hydrogen peroxide. Opening of pulp cavity in one point with sterile rounded bur (for decrease intrapulpal pressure). Do not injury pulp. Stopping bleeding from pulp with aminocapronic acid, hemostatic sponge. Do not use hydrogen peroxide. Drying of carious cavity with sterile cotton balls. Covering soft calcium-contained curative medicine, which is not polymerized. Covering solid calcium-contained curative medicine, which is polymerized. Filling of carious cavity.	During the collection of anamnesis it is necessary to learn about the presence of allergic diseases in patient. During the fulfillment of the stages of treatment it is necessary to adhere to the rules of asepsis and antiseptics.
3. To carry out two-session method of treatment of pulpits.	First visit: Antiseptic processing of oral cavity (irrigation). Givalex; Stomatidin. Local anesthesia (regional and infiltration anesthesia). Isolation of tooth with cofferdam or sterile cotton rolls. Necrectomy. Formation of carious cavity. Antiseptic processing of carious cavity with warming neutral solutions of antiseptics or antibiotics: 0,5% solution of aethonium, 0,01% aqueous solution of chlorhexidine; Decoctions of medicinal plants. Do not use alcohol, alcoholic solutions, hydrogen peroxide. Drying of carious cavity with sterile cotton balls. Covering paste, which consist of antibiotics, corticosteroids, enzymes, nitrofurans, glycosaminoglycans. Filling of carious cavity with temporary material in 7-14 days. Second visit: Isolation of tooth with cofferdam or sterile cotton rolls. Removing temporary filling and curative paste. Antiseptic processing of carious cavity with warming neutral solutions of antiseptics or antibiotics: 0,5% solution of aethonium, 0,01% aqueous solution of chlorhexidine; Decoctions of medicinal plants. Do not use alcohol, alcoholic solutions, hydrogen peroxide. Drying of carious cavity with sterile cotton balls. Covering calcium-contained curative medicine, which is polymerized. Filling of carious cavity.	Some curative pastes are prepared ех tempore. These manipulations you will do, if the patient does not have pain.