Dentaltown May 2018 - 41

Looks like a dentin bridge formed below the RRM. Do you remove the RRM in its entirety
before restoring? ■

mxlplx
Member Since: 01/19/06
Post: 11 of 162

12/5/2017

RRM provides the critical permanent seal of the dentinal tubules or communications. It's
important that it remains. ■

the mathetes
Member Since: 10/05/07
Post: 12 of 162

12/5/2017

Awesome case! Do you use a hypochlorite-soaked cotton pellet to get bleeding controlled
and for sterilization? What's the consistency of this RRM like? I have used MTA and Biodentene
in residency. What's the price? I'm a pediatric dentist, this seems to show good promise. ■

DecayRemedy
Member Since: 01/26/12
Post: 13 of 162

12/5/2017

RRM handles like ZOE. I place two increments. First increment over the orifice, pack,
quickly spray with water and dry, pack it down again. Then, place second increment, then Cavit
or ZOE, temp.
Using the 2.5% NaOCl with cotton pellet for 5 mins, sometimes the bleeding only slows.
That's why I place two increments of RRM. ■

the mathetes
Member Since: 10/05/07
Post: 14 of 162

12/5/2017

Please excuse my ignorance on the subject but I have a few questions. I didn't realize pulpotomies in adult teeth could be a long-term solution like this. It's a great conservative treatment
option and probably less expensive to the patient.
So, I'm guessing the same procedure as for a pulp on a primary tooth (access, remove coronal
pulp, control bleeding)? The main difference is using RRM instead of ZOE?
Is this for a situation where caries extends to the tooth but the tooth is asymptomatic and
vital? If the tooth becomes symptomatic or necrotic over time, you would just complete the
pulpectomy, correct? How long do you wait until restoring these? Immediately? Weeks? Always
an onlay?
You mentioned you prefer this over a pulp cap. Do you do this only if there is a pulp exposure? What about if there is a thin wall of dentin remaining-would you do this or indirect cap?
I guess my thinking on permanent teeth was little exposure, pulp cap; big exposure, root
canal. Good to know this is a viable "in-between" option for adult teeth. How is your success
with these long term? Do you see a large number eventually needing a pulpectomy? Is doing a
pulpotomy on an adult tooth as a definitive treatment within the standard of care in the U.S.? ■

jhobgoDDS
Member Since: 06/15/15
Post: 20 of 162

12/6/2017

I've tried to place final restorations right away. The problem is the RRM takes a while to set.
I'm not sure I can seal over the unset RRM with the flowable without a void. The resin is done
within one week, if that's what you mean by permanent restoration.
Onlay or crown, I would give it a couple of months to assess health of the tooth with followup X-ray.
If success rates are 70 or 80 percent long term, then that certainly would justify the procedure
as a final endodontic treatment in place of a root canal. I'd figure a root canal to be a 95 percent
success rate. I have no idea yet what the long-term success rates are, for the lack of data. If success
rates are 70 or 80 percent long term, then that certainly would justify the procedure as a final
endodontic treatment in place of a root canal.
I'm waiting for my first failure case. I'm having all show up six months or later for follow-up

the mathetes
Member Since: 10/05/07
Posts: 22, 24, 27 and 29 of 162

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